VAGINAL DOUCHE
Place in Therapy
Place in therapy
There is no place in therapy for vaginal douching in the self-care treatment of vulvovaginal candidiasis.1-6 Vaginal douching for the eradication of vulvovaginal candidiasis should not be recommended for any women, especially pregnant women and women diagnosed with pelvic inflammatory disease (PID).1-6 If vaginal douching is to be performed by a woman, it should only be done under the supervision and care of the primary care provider.1-3 Women perform vaginal douching using various different products (homemade and commercial products) and do so for numerous reasons: vaginal hygiene after sexual intercourse or menstruation, prevention of infection or as a contraceptive method.1-6 Vaginal douching, especially when performed frequently (once a week or more) has consistently been shown to be associated with an increased risk of PID, endometritis, ectopic pregnancy and ascending genital tract infections.1-6 The evidence to describe the increased risk of cervical cancer associated with vaginal douching is currently inconclusive and further research is required to investigate this relationship.4 Additionally, many studies have found a racial difference where Black women may be at a higher risk of adverse health effects associated with vaginal douching compared to other women; this may be due to higher performance rates of vaginal douching in Black women compared to White women.4-6 All women should be educated that it is not necessary to douche frequently for routine vaginal hygiene maintenance4 and that vaginal douching should not be used to eradicate vulvovaginal candidiasis.1-6
References:
1. Pollock LL. “Vaginal Symptoms, Hygiene and Infections.” PSC, Patient Self-Care: Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, Ontario, Canada: Canadian Pharmacists Association, 2010. 760-774.
2. Medicine Net: Vaginal Douche (Douching). Last reviewed May 18, 2010 [Accessed May 19, 2012]. Available from: http://www.medicinenet.com/vaginal_douche_douching/article.htm.
3. Spence D. Candidiasis (vulvovaginal). Clinical Evidence. 2010;01:815-53.
4. Zhang J, Thomas G, Leybovich E. Vaginal douching and adverse health effects: a meta-analysis. Am J Public Health. 1997;87:1207-1211.
5. Kendrick JS, Atrash HK, Strauss LT, et. al. Vaginal douching and the risk of ectopic pregnancy among black women. Am J Obstet Gynecol. 1997; 176(5):991-97.
6. Ness RB, Soper DE, Holley RL, et al. Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases. 2001 Apr; 28(4):240-5.
There is no place in therapy for vaginal douching in the self-care treatment of vulvovaginal candidiasis.1-6 Vaginal douching for the eradication of vulvovaginal candidiasis should not be recommended for any women, especially pregnant women and women diagnosed with pelvic inflammatory disease (PID).1-6 If vaginal douching is to be performed by a woman, it should only be done under the supervision and care of the primary care provider.1-3 Women perform vaginal douching using various different products (homemade and commercial products) and do so for numerous reasons: vaginal hygiene after sexual intercourse or menstruation, prevention of infection or as a contraceptive method.1-6 Vaginal douching, especially when performed frequently (once a week or more) has consistently been shown to be associated with an increased risk of PID, endometritis, ectopic pregnancy and ascending genital tract infections.1-6 The evidence to describe the increased risk of cervical cancer associated with vaginal douching is currently inconclusive and further research is required to investigate this relationship.4 Additionally, many studies have found a racial difference where Black women may be at a higher risk of adverse health effects associated with vaginal douching compared to other women; this may be due to higher performance rates of vaginal douching in Black women compared to White women.4-6 All women should be educated that it is not necessary to douche frequently for routine vaginal hygiene maintenance4 and that vaginal douching should not be used to eradicate vulvovaginal candidiasis.1-6
References:
1. Pollock LL. “Vaginal Symptoms, Hygiene and Infections.” PSC, Patient Self-Care: Helping Your Patients Make Therapeutic Choices. 2nd ed. Ottawa, Ontario, Canada: Canadian Pharmacists Association, 2010. 760-774.
2. Medicine Net: Vaginal Douche (Douching). Last reviewed May 18, 2010 [Accessed May 19, 2012]. Available from: http://www.medicinenet.com/vaginal_douche_douching/article.htm.
3. Spence D. Candidiasis (vulvovaginal). Clinical Evidence. 2010;01:815-53.
4. Zhang J, Thomas G, Leybovich E. Vaginal douching and adverse health effects: a meta-analysis. Am J Public Health. 1997;87:1207-1211.
5. Kendrick JS, Atrash HK, Strauss LT, et. al. Vaginal douching and the risk of ectopic pregnancy among black women. Am J Obstet Gynecol. 1997; 176(5):991-97.
6. Ness RB, Soper DE, Holley RL, et al. Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases. 2001 Apr; 28(4):240-5.