Does Douching Work?

illustration of a douching apparatus from an 1882 medical handbook

As a newly minted teenager, I was helping my mother go through some of my recently deceased great-grandmother’s things. I held a mysterious object in my hands and studied it curiously, puzzling over its unfamiliar form, pastel color scheme, and floral pattern. Finally, I gave up: “What is this?” I exclaimed. My mom, instantly uncomfortable, muttered her answer through clenched teeth: “It’s a douche bag,” she replied.

I remember being rather scandalized, but also a bit amused to be holding a piece of ancient misogynist history in my hands. Even as a junior high student, I knew that douching was marketed toward women with the message that their vaginas were “dirty” and in need of “cleansing” — scientifically invalidated ideas to which we surely no longer adhered. It seemed fitting that we were sorting through the belongings of a person born in the 19th century, dividing them into the useful and useless. Surely the douche bag belonged in the latter category.

Just because douching products are available in drugstores doesn’t mean they’re safe or effective.

Little did I know, more than 20 years ago, that douching hasn’t exactly been relegated to a historical footnote. Overall, nearly 25 percent of American women 15 to 44 years old douche regularly — which is down from nearly a third in 2002. Douching rates may vary by ethnic group: CDC data from 2005 found that 59 percent of non-Hispanic black women, 36 percent of Latinas, and 27 percent of white women douche. Socioeconomic status and education level can also be a factor.

For those of you who don’t know, vaginal douching is the practice of flushing the vagina with a liquid, which is administered through a nozzle that is inserted into the vagina. Some people believe that douching cleanses or deodorizes the vagina, or can prevent pregnancy or infections. Some might think their partners expect them to douche, or that douching will “tighten” or “rejuvenate” their vaginas. These ideas, however, are misguided: Vaginas have ways of staying clean without assistance from a dubious “hygiene” product, and douching can actually help spread infection farther into the body. Douching does not prevent pregnancy, and, according to Our Bodies, Ourselves, douching after vaginal sex can weaken the effectiveness of spermicide. Furthermore, douching can alter the pH balance in the vagina, which can leave one more vulnerable to developing infections.

Despite these risks, the majority of people who use vaginal douches do so because they believe the practice is necessary for good hygiene. For instance, they may believe that douching before or after sex or a menstrual period will keep them “clean” or “fresh.” However, vaginas can keep themselves clean. First, they produce mucus, which washes away blood, semen, discharge, and other things. Second, vaginas are home to “good” bacteria. While we mostly think of bacteria as disease-causing, there are actually many beneficial species that live in our bodies and are essential to our health. Lactobacilli are one type of beneficial vaginal bacteria, and they produce three types of chemicals that help keep vaginas clean:

  • hydrogen peroxide, which is a disinfectant
  • bacteriocins, which are natural antibiotics (meaning they kill other bacteria)
  • lactic acid, which maintains a proper pH of less than 4.5, which inhibits the survival of many disease-causing bacteria

It is possible that douching harms lactobacilli, which both kills off the source of the disinfecting and antibiotic chemicals, as well as disrupts the vagina’s normal pH. This might allow harmful bacteria and other pathogens to flourish.

While douching has been practiced for millennia, it’s been controversial for at least a century. For example, a 1915 book on “diseases of women” states that routine douching in healthy women is not advisable: “They are not required for mere cleanliness, in fact, they interfere in a measure with the normal germicidal vaginal contents, which nature has provided to keep the vagina in a healthy condition.” Of course, the rest of the section included ample information on douching as treatment for other types of gynecological problems, which is not supported by current evidence. Back then, the consensus on douching was more favorable, with most people believing it had legitimate medical uses. A 1921 women’s health guide likened douching to a “massage” and claimed that it improves digestion, cardiac and lung health, and flushes away “fatigue toxins.” None of these claims, of course, is true.

Vaginas have a natural, mild odor, and vaginal secretions are normal, but if you are troubled by your vagina’s odor or discharge it might be an indication that something is wrong — in which case, you shouldn’t douche but rather should make an appointment with a health care provider, such as Planned Parenthood, to make sure you don’t have an infection that needs to be treated. Just because douching products are available at supermarkets and drugstores doesn’t mean they’re safe or effective.