Douche

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"Douche bag" redirects here. For other uses, see Douchebag.Not to be confused with French and other foreign language words for shower.This article is about vaginal irrigation. For anal irrigation, see Rectal douching.

Douche
Vaginal bulb syringe.jpg
A vaginal bulb syringe with lateral holes near the tip of the nozzle
Pronunciation /duːʃ/
ICD-9-CM 96.44
MeSH D044364

A douche is a term for a device used to introduce a stream of water into the body for medical or hygienic reasons, or for the stream of water itself. Douche usually refers to vaginal irrigation, the rinsing of the vagina, but it can also refer to the rinsing of any body cavity. A douche bag is a piece of equipment for douching—a bag for holding the fluid used in douching. To avoid transferring intestinal bacteria into the vagina, the same bag must not be used for an enema and a vaginal douche.

Contents

Douching after sexual intercourse is not an effective form of birth control. [1] Additionally, douching is associated with a number of health problems, including cervical cancer, pelvic inflammatory disease, endometritis, and increased risk of sexually transmitted infections. [2]

Etymology

The word's first known use is in 1766. Douche came into English via French, from Italian : doccia "conduit pipe" and docciare "pour by drops" to douche, from doccia water pipe, probably back-formation from doccione conduit, from Latin : duction-, ductio means of conveying water, from ducere to lead. [3] [ failed verification ] In French today it means shower , as it does in many European languages.

Overview

Vaginal douche apparatus with five quart tank from 1905 nursing text Vaginal douche apparatus.jpg
Vaginal douche apparatus with five quart tank from 1905 nursing text

Vaginal douches may consist of water, water mixed with vinegar, or even antiseptic chemicals. Douching has been touted as having a number of supposed but unproven benefits. In addition to promising to clean the vagina of unwanted odors, it can also be used by women who wish to avoid smearing a sexual partner's penis with menstrual blood while having sexual intercourse during menstruation. In the past, douching was also used after intercourse as a method of birth control, though it is not effective (see below).

Many health-care professionals state that douching is dangerous, as it interferes with both the vagina's normal self-cleaning and with the natural bacterial culture of the vagina, and it might spread or introduce infections. Douching is implicated in a wide variety of dangers, including: adverse pregnancy outcomes including ectopic pregnancy, low birth weight, preterm labor, preterm birth, and chorioamnionitis; serious gynecologic outcomes, including increased risk of cervical cancer, pelvic inflammatory disease, endometritis, and increased risk for sexually transmitted infections, including HIV; it also predisposes women to develop bacterial vaginosis (BV), [4] which is further associated with adverse pregnancy outcomes and increased risk of sexually transmitted infections. [5] Due to this, the U.S. Department of Health and Human Services strongly discourages douching, citing the risks of irritation, bacterial vaginosis, and pelvic inflammatory disease (PID). Frequent douching with water may result in an imbalance of the pH of the vagina, and thus may put women at risk for possible vaginal infections, especially yeast infections. [6]

In May 2003, a randomized, controlled, multi-center study was conducted with 1827 women ages 18–44 who were regular users of a douche product and who had been treated recently for a sexually transmitted bacterial infection or bacterial vaginosis. Women were randomly assigned to use either a newly designed and marketed douche product or a soft cloth towelette. There was little or no indication of a greater risk of PID among women assigned to use the douche product (versus soft cloth towelette). [7]

The "fountain syringe" is used for douching, by replacing the attached enema nozzle with the vaginal nozzle (shown bottom left). The vaginal nozzle is longer and thicker and has lateral holes Combination enema and douche syringe.jpg
The "fountain syringe" is used for douching, by replacing the attached enema nozzle with the vaginal nozzle (shown bottom left). The vaginal nozzle is longer and thicker and has lateral holes

Antiseptics used during douching disturb the natural balance of bacteria in the vagina and can cause infections. [8] Unclean douching equipment may introduce foreign bodies into the vagina. Douching may also wash bacteria into the uterus and fallopian tubes, causing fertility problems. [9] For these reasons, the practice of douching is now strongly discouraged except when ordered by a physician for medical reasons. [8]

Douching after intercourse is estimated to reduce the chances of conception by only about 30%. [10] In comparison, proper male condom use reduces the chance of conception by as much as 98%. [11] In some cases douching may force the ejaculate further into the vagina, increasing the chance of pregnancy. A review of studies by researchers at the University of Rochester Medical Center (N.Y.) showed that women who douched regularly and later became pregnant had higher rates of ectopic pregnancy, infections, and low birth weight infants than women who only douched occasionally or who never douched. [8]

A 1995 survey quoted in the University of Rochester study found that 27% of U.S. women age 15 to 44 douched regularly, but that douching was more common among African-American women (over 50%) than among white women (21%), [8] and frequent douching contributes to more frequent bacterial vaginosis among African-American women than the average. [4]

Medical doctor Harriet Hall writes that not only can douching change the pH of the vagina and lead to infections, "There is no need ... to cleanse the vagina. It cleanses itself". [12]

Slang uses

Douchebag and its variants, or simply douche, [13] [14] are pejorative terms [14] referring to an arrogant, obnoxious, or despicable person. [15] The slang usage of the term originated in the 1960s. [16]

See also

Related Research Articles

<span class="mw-page-title-main">Bacterial vaginosis</span> Excessive growth of bacteria in the vagina

Bacterial vaginosis (BV) is an infection of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination may occur. Itching is uncommon. Occasionally, there may be no symptoms. Having BV approximately doubles the risk of infection by a number of sexually transmitted infections, including HIV/AIDS. It also increases the risk of early delivery among pregnant women.

<span class="mw-page-title-main">Pelvic inflammatory disease</span> Infection of uterus, fallopian tubes, ovaries or the inner surface of pelvis

Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no symptoms. Signs and symptoms, when present, may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, bleeding after sex, or irregular menstruation. Untreated PID can result in long-term complications including infertility, ectopic pregnancy, chronic pelvic pain, and cancer.

<span class="mw-page-title-main">Vagina</span> Part of the female reproductive tract

In mammals and other animals, the vagina is the elastic, muscular reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix. The vaginal introitus is normally partly covered by a thin layer of mucosal tissue called the hymen. The vagina allows for copulation and birth. It also channels menstrual flow, which occurs in humans and closely related primates as part of the menstrual cycle.

Nongonococcal urethritis (NGU) is inflammation of the urethra that is not caused by gonorrheal infection.

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

Vaginitis, also known as vulvovaginitis, is inflammation of the vagina and vulva. Symptoms may include itching, burning, pain, discharge, and a bad smell. Certain types of vaginitis may result in complications during pregnancy.

<span class="mw-page-title-main">Diaphragm (birth control)</span> Cervical barrier type of birth control

The diaphragm is a barrier method of birth control. It is moderately effective, with a one-year failure rate of around 12% with typical use. It is placed over the cervix with spermicide before sex and left in place for at least six hours after sex. Fitting by a healthcare provider is generally required.

<span class="mw-page-title-main">Cervicitis</span> Inflammation of the uterine cervix

Cervicitis is inflammation of the uterine cervix. Cervicitis in women has many features in common with urethritis in men and many cases are caused by sexually transmitted infections. Non-infectious causes of cervicitis can include intrauterine devices, contraceptive diaphragms, and allergic reactions to spermicides or latex condoms. Cervicitis affects over half of all women during their adult life.

A pessary is a prosthetic device inserted into the vagina for structural and pharmaceutical purposes. It is most commonly used to treat stress urinary incontinence to stop urinary leakage and to treat pelvic organ prolapse to maintain the location of organs in the pelvic region. It can also be used to administer medications locally in the vagina or as a method of contraception.

<span class="mw-page-title-main">Female reproductive system</span> Reproductive system of female humans

The human female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. The reproductive system is immature at birth and develops at puberty to be able to release matured ova from the ovaries, facilitate their fertilization, and create a protective environment for the developing fetus during pregnancy. The female reproductive tract is made of several connected internal sex organs—the vagina, uterus, and fallopian tubes—and is prone to infections. The vagina allows for sexual intercourse, and is connected to the uterus at the cervix. The uterus accommodates the embryo by developing the uterine lining.

<span class="mw-page-title-main">Feminine hygiene</span> Personal care products for menstruation, vaginal discharge, etc.

Feminine hygiene products are personal care products used for women's hygiene during menstruation, vaginal discharge, or other bodily functions related to the vulva and vagina. Products that are used during menstruation may also be called menstrual hygiene products, including menstrual pads, tampons, pantyliners, menstrual cups, menstrual sponges and period panties. Feminine hygiene products also include products meant to cleanse the vulva or vagina, such as douches, feminine wipes, and soap.

<span class="mw-page-title-main">Vaginal discharge</span> Medical condition

Vaginal discharge is a mixture of liquid, cells, and bacteria that lubricate and protect the vagina. This mixture is constantly produced by the cells of the vagina and cervix, and it exits the body through the vaginal opening. The composition, amount, and quality of discharge varies between individuals and can vary throughout the menstrual cycle and throughout the stages of sexual and reproductive development. Normal vaginal discharge may have a thin, watery consistency or a thick, sticky consistency, and it may be clear or white in color. Normal vaginal discharge may be large in volume but typically does not have a strong odor, nor is it typically associated with itching or pain. While most discharge is considered physiologic or represents normal functioning of the body, some changes in discharge can reflect infection or other pathological processes. Infections that may cause changes in vaginal discharge include vaginal yeast infections, bacterial vaginosis, and sexually transmitted infections. The characteristics of abnormal vaginal discharge vary depending on the cause, but common features include a change in color, a foul odor, and associated symptoms such as itching, burning, pelvic pain, or pain during sexual intercourse.

<span class="mw-page-title-main">Chorioamnionitis</span> Medical condition

Chorioamnionitis, also known as amnionitis and intra-amniotic infection (IAI), is inflammation of the fetal membranes, usually due to bacterial infection. In 2015, a National Institute of Child Health and Human Development Workshop expert panel recommended use of the term "triple I" to address the heterogeneity of this disorder. The term triple I refers to intrauterine infection or inflammation or both and is defined by strict diagnostic criteria, but this terminology has not been commonly adopted although the criteria are used.

<span class="mw-page-title-main">Vaginal flora</span> Microorganisms present in the vagina

Vaginal flora, vaginal microbiota or vaginal microbiome are the microorganisms that colonize the vagina. They were discovered by the German gynecologist Albert Döderlein in 1892 and are part of the overall human flora. The amount and type of bacteria present have significant implications for an individual's overall health. The primary colonizing bacteria of a healthy individual are of the genus Lactobacillus, such as L. crispatus, and the lactic acid they produce is thought to protect against infection by pathogenic species.

A vaginal disease is a pathological condition that affects part or all of the vagina.

Female genital disease is a disorder of the structure or function of the female reproductive system that has a known cause and a distinctive group of symptoms, signs, or anatomical changes. The female reproductive system consists of the ovaries, fallopian tubes, uterus, vagina, and vulva. Female genital diseases can be classified by affected location or by type of disease, such as malformation, inflammation, or infection.

<span class="mw-page-title-main">Vaginal yeast infection</span> Medical condition

Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation. The most common symptom is vaginal itching, which may be severe. Other symptoms include burning with urination, a thick, white vaginal discharge that typically does not smell bad, pain during sex, and redness around the vagina. Symptoms often worsen just before a woman's period.

The vaginal flora in pregnancy, or vaginal microbiota in pregnancy, is different from the vaginal flora before sexual maturity, during reproductive years, and after menopause. A description of the vaginal flora of pregnant women who are immunocompromised is not covered in this article. The composition of the vaginal flora significantly differs in pregnancy. Bacteria or viruses that are infectious most often have no symptoms.

References

  1. ↑ Rengel, Marian (2000). Encyclopedia of birth control . Phoenix, Ariz: Oryx Press. p.  65. ISBN   9781573562553.
  2. ↑ Cottrell, BH (Mar–Apr 2010). "An updated review of evidence to discourage douching". MCN: The American Journal of Maternal/Child Nursing. 35 (2): 102–7, quiz 108–9. doi:10.1097/NMC.0b013e3181cae9da. PMID   20215951. S2CID   46715131.
  3. ↑ "Douche – Definition and More from the Free Merriam-Webster Dictionary". Merriam-webster.com. 2012-08-31. Retrieved 2013-08-03.
  4. 1 2 Velasquez-Manoff, Moises (Jan 11, 2013). "What's in Your Vagina? A healthy microbiome, hopefully". Slate .
  5. ↑ Cottrell, B. H. (2010). "An Updated Review of Evidence to Discourage Douching". MCN: The American Journal of Maternal/Child Nursing. 35 (2): 102–107, quiz 107–9. doi:10.1097/NMC.0b013e3181cae9da. PMID   20215951. S2CID   46715131.
  6. ↑ "WebMD article on the causes of yeast infections, including douching". Women.webmd.com. 2011-10-31. Retrieved 2013-08-03.
  7. ↑ Rothman KJ, Funch DP, Alfredson T, Brady J, Dreyer NA (May 2003). "Randomized field trial of vaginal douching, pelvic inflammatory disease and pregnancy". Epidemiology. 14 (3): 340–8. doi: 10.1097/00001648-200305000-00015 . PMID   12859036.
  8. 1 2 3 4 Seppa, N. (2 January 1999). "Douching associated with pregnancy risk" (PDF). Science News. 155 (1): 7. doi:10.2307/4011204. JSTOR   4011204. Archived from the original (PDF) on September 26, 2012. Retrieved 1 March 2013.
  9. ↑ "Warning from Kelly Shanahan, MD on douching". Health.ivillage.com. Archived from the original on 2007-11-11. Retrieved 2013-08-03.
  10. ↑ Baird, Donna; Weinberg, Clarice (June 1996). Grigg, Bill (ed.). "NIH Study: Among Women Who Want to Get Pregnant, Douching May Delay Conception". American Journal of Public Health. Retrieved 2019-07-12– via NIH.
  11. ↑ Trussell J (2011). "Contraceptive Efficacy." (PDF). In Hatcher RA, Trussell J, Nelson AL, Cates W, Kowal D, Policar M (eds.). Contraceptive Technology (Twentieth Revised ed.). New York NY: Ardent Media. Archived from the original (PDF) on 2017-02-15. Retrieved 2019-07-13.
  12. ↑ Hall, Harriet (2018). "The Care and Feeding of the Vagina". Skeptical Inquirer. 42 (5): 28–29.
  13. ↑ "Define Douche at Dictionary.com". Dictionary.com. Retrieved 24 December 2015.
  14. 1 2 "douche – Dictionary Definition". Vocabulary.com. Retrieved 24 December 2015.
  15. ↑ "Define Douchebag at Dictionary.com". Dictionary.com. Retrieved 24 December 2015.
  16. ↑ "Terms of Derogation". Drbilllong.com. Archived from the original on 14 April 2006. Retrieved 2013-08-03.
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