Blog: BV - Bacterial Vaginosis
by #42412

Interesting article...

To douche or not to douche, that is the question

Date:   4/28/2005 4:54:03 PM   ( 12 y ) ... viewed 4027 times

I ran across an interesting article called: Douching and Bacterial Vaginosis: the cart or the horse?
Here is the link, but the most important part of the medical mumbo-jumbo is the last paragraph, copied below.

http://www.medscape.com/viewarticle/452423

Sort of the same question I asked regarding sexually active women vs. younger girls. (Do sexually active women have BV more often or do they just go to the GYN more often?)

The question below is Do women who douche get BV more often or do women who have BV douche more often in an attempt to cover the odor?
Compelling question because if you think about it I don't think most women ever think about douching until there's a reason to, unless their mother taught them to or they are just really self conscious. What the article states is that, in this particular study, a medicated douche containing 0.30% povidone-iodine solution was effective in reducing total bacteria counts and the first bacteria to recover were the "good bacteria".

This is a good point - because in other entries I have mentioned a dilute hydrogen peroxide douche - but if douching is bad? well... then what?

I'm sure it really all depends on what you douche with, maybe something that's full of perfumes and who knows what else is not a good choice but something medicated might be alright? It's hard to decide because they've pounded into my head for so many years that douching is bad. I think I may go and see if I can find a douche with this particular ingredient and give it a try.






Investigators have proposed that douching predisposes to these disease entities by disrupting the normal vaginal flora; yet no microbiologic evidence is introduced to substantiate this hypothesis. What little data exist would argue against this theory. Onderdonk and associates (Obstet Gynecol. 1992;80:333-338) demonstrated that different results occurred when different types of douching products were evaluated. Vinegar douches caused a transient reduction in total bacterial count, mostly attributable to a washing-out effect, whereas a 0.30% povidone-iodine preparation caused a significant reduction in total bacterial counts, compared with a physiologic saline solution in the same subjects. Monif and colleagues (Am J Obstet Gynecol. 1980;137:432-438) had documented a similar phenomenon. In addition, these investigators demonstrated that the first bacteria to recover were constituents of the normal vaginal flora. They postulated that the efficacy of a 2-week course of povidone-iodine gel in achieving a microbiologic cure was caused by a greater effect on abnormal bacterial constituents, which, in time, led to the quantitative buildup of 1 or more governing normal constituents of the vaginal bacterial flora, to the point of effective inhibition of Gardnerella vaginalis and other anaerobic bacteria.

A powerful epidemiologic argument that douching does not cause BV is to be found in the cited publication by Ness and coworkers. They found that women who reportedly douched before or after sex did not have an increased risk of IVF or BV. This group of women reported a statistically higher frequency of sexua| intercourse, on average, than other women in the study.

Does douching cause BV or do women with BV douche more frequently? Better attempts at a definitive answer are merited.


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