A scary new report adds one more item to the “why women shouldn’t douche” list.
Gynecologists have been telling their patients not to clean their vaginas with douches for years—and now they have yet another strong point against it: The practice is associated with nearly a doubled risk of getting ovarian cancer, according to a large study from the National Institute of Environmental Health Sciences.
“Douching is just wrong,” Sherry Ross, M.D., an ob/gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. “There is no reason to douche at all. It’s marketing at its finest to get that vagina smelling like Hawaiian tropics.”
Douches are available prepackaged in drugstores (although some women DIY them). They’re usually bags or bottles filled with a mixture of water and vinegar, baking soda, or iodine, according to the U.S. Department of Health and Human Service’s Office on Women’s Health. Most douches come complete with a tube or nozzle that goes into the vagina and makes it easier to spray the liquid up there in an ostensible effort to maintain good vaginal hygiene.
Your vagina actually cleans itself, so there’s no need to buy products that are specially made to do the job. And not only is it totally unnecessary, douching can actually be dangerous.
Using a douche can upset the usual bacterial harmony in your vagina, Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells SELF. “When you douche, you’re clearing out the normal bacteria that should be there, which kind of throws off the balance that helps to keep the vagina healthy,” he says.
That may be why douching has been linked to an increased risk of bacterial vaginosis, or the most common vaginal infection in women 15 to 44, according to the Centers for Disease Control and Prevention. BV is easily cleared up with antibiotics, but other potential douche-induced problems aren’t as easy to fix.
Like cancer. The National Institute of Environmental Health Sciences report, which was published this June in the journal Epidemiology, used data from The Sister Study, a research effort that followed 50,884 women in the United States and Puerto Rico who had a sister with breast cancer. The researchers asked the women about their use of talcum powder—which people have previously worried causes ovarian cancer—and douches in the past year. When they followed up with them years later, 154 of the participants had been diagnosed with ovarian cancer. While talc wasn’t associated with an increased risk of ovarian cancer, douching was linked with a woman being almost twice as likely to develop the illness.
“I’m sure there probably need to be more studies to really show the association [between douching and ovarian cancer], but it’s just one potential reason it’s not safe,” says Ross.
It’s important to understand that this news doesn’t automatically mean a woman who douches will get ovarian cancer. “Our research provides evidence that women who douche have higher risk of ovarian cancer, but that observation does not establish causality, nor shed much light on a possible mechanism,” corresponding study author Clarice Weinberg, Ph.D., deputy chief of the biostatistics and computational biology branch at the National Institute of Environmental Health Sciences and adjunct professor at the University of North Carolina department of epidemiology and department of biostatistics, tells SELF in an email.
One potential reason for the link is that many douches contain chemicals called phthalates. They’re “considered to be endocrine disruptors, which means that they can interfere with the body’s natural hormones. In this way, phthalates could adversely affect reproductive organs such as the fallopian tubes and ovaries,” says Weinberg, who also notes that women who douche have been found to have higher level of phthalates in their systems. “This observation suggests that those chemicals can be absorbed through the vagina into the bloodstream,” she says.
Another possible explanation is that perhaps “douching forces toxins into the reproductive tract,” says the National Institute of Environmental Health Sciences’ release on the study. “On the other hand, it is possible that the association we saw is not causally due to douching. It could have been a chance finding,” says Weinberg.
It’s also smart to remember that the women in the study all had at least one sister with breast cancer, which automatically raised their risk of getting ovarian cancer, according to the American Cancer Society. But when the research team redid the analysis excluding families who had genes related to breast and ovarian cancer, the link was still there, says Weinberg.
While the science is sketchy on the douching-ovarian cancer connection, there are plenty of other reasons not to douche that we have no doubts about.
One of those is pelvic inflammatory disease, which happens when STIs like gonorrhea and chlamydia infect reproductive organs. “The thinking is that normally the cervix prevents bacteria from getting into the uterus or fallopian tubes, but douching causes an increase in pressure that can facilitate moving bacteria up into the uterus or tubes,” says Abdur-Rahman. Although PID is often manageable when caught early, it can eventually lead to infertility—one in eight women who have had PID will have a tough time getting pregnant, says the CDC.
Douching can even cause issues with having a baby. The practice may contribute to preterm birth (because of infections) and ectopic pregnancy, or when a fertilized egg implants in a fallopian tube instead of in the uterus, according to the U.S. Department of Health and Human Service’s Office on Women’s Health. Here’s one major theory on why the latter might happen: “Normally, fertilization of the egg occurs in fallopian tubes, then it will move into the uterus. If you have a big increase in pressure, it can push the fertilized egg back into the fallopian tube,” says Abdur-Rahman.
All of the above isn’t to say you shouldn’t wash the area if you feel it’s necessary, says Ross. But you don’t need to wash inside the canal; she recommends using just water and a gentle, fragrance-free soap on the vulva (or the outer part of the genitals), because you don’t need anything else: “It goes back to knowing that you need to take care of your vaginal hygiene, but do it in a way that’s safe and doesn’t increase your risk for problems.”
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