Q. I have always believed that douching was part of good hygiene, but my daughter’s doctor told her not to douche. Who’s right?
A. At one time, doctors routinely instructed their female patients to douche; however, that is no longer the case. Studies have shown that there is a higher rate of infection of the reproductive tract among women who douche than among women who do not. At least one study has detected a significant increase in cervical cancer in women who douche more than once a week. There are also a handful of studies that suggest that douching may increase the risk of ectopic or tubal pregnancy.
What remains unanswered by these studies is whether douching itself promotes infection and other problems by altering the normal vaginal environment, or whether women who have problems tend to douche more than those who don’t. I personally believe that the latter is true, and that douching per se may not be dangerous, as long as it is not done more than once a week. That is not to say, however, that douching is necessary. Normal hygiene (daily bathing and showering) is all that is required to maintain personal cleanliness. If you do douche, however, I suggest that you avoid using perfumed or prepackaged chemical mixtures, which could not only be irritating but could alter the normal acid concentration of the vagina. Make your own douching solution by mixing 2 tablespoons of cider vinegar with 1 quart of warm water. Do not depend on a douche for contraception. It is not effective or dependable. Do not attempt to ward off infection yourself by douching; in fact, if you do have an infection, douching can spread it. See your doctor for a precise diagnosis before “self-treating”.
Dr. Marianne Legato, Professor Emerita of Clinical Medicine at Columbia University is an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine. She is founding member of the International Society for Gender Medicine and also the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and its next iteration, The Foundation for Gender-Specific Medicine. These enterprises are the first collaborations between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender and sex. Her ground breaking textbook on Gender-and Sex Specific Medicine has been published in 2017 in the 3rd edition.
She has published extensively on Gender and Sex Specific Medicine, both scientifically and for the lay public. She is also the founding editor of the journal Gender Medicine, and the Journal Gender and Genome, published for the scientific community. In 1992, Dr. Legato won the American Heart Association’s Blakeslee Award for the best book written for the lay public on cardiovascular disease. She is a practicing internist in New York City and has been listed each year in New York Magazine’s “Best Doctors” since the feature’s inception in 1993.
