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Douche

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Douche
A vaginal bulb syringe with lateral holes near the tip of the nozzle (about 1 cm, or ½ inch, thick)
ICD-9-CM96.44
MeSHD044364

A douche /ˈduːʃ/ is a device used to introduce a stream of water into the body for medical or hygienic reasons, or 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.

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

Etymology

First Known Use: 1766 The word douche came to English via French, from Italian: doccia "conduit pipe" and [docciare] Error: {{Lang}}: text has italic markup (help) "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 – where today it means shower.[3]

Overview

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 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). Douching may be related to a lower probability that a woman becomes pregnant.[7]

This "fountain syringe" should only be 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 may also result in an imbalance of the natural bacteria in the vagina, also resulting in an increased likelihood of infection.[8] Furthermore, unclean douching equipment may also introduce undesirable foreign bodies into the vagina. For these reasons, the practice of douching is now strongly discouraged except when ordered by a physician for specific medical reasons.[8] Douching may also wash bacteria into the uterus and Fallopian tubes, causing fertility problems.[9]

Douching after intercourse is estimated to reduce the chances of conception by only 15–25%.[citation needed] In comparison, proper condom use reduces the chance of conception by as much as 97%. 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 higher douching is cited as a reason for the higher prevalence of bacterial vaginosis among African-American women, compared to the population at large.[4]

Slang uses

Douche bag, or simply douche, is considered to be a pejorative term. The slang usage of the term originated in the 1960s, particularly in reference to Thomas Edison's treatment of Nikola Tesla.[10]

See also

References

  1. ^ Rengel, Marian (2000). Encyclopedia of birth control. Phoenix, Ariz: Oryx Press. p. 65. ISBN 9781573562553.
  2. ^ Cottrell, BH (2010 Mar-Apr). "An updated review of of evidence to discourage douching". MCN. The American journal of maternal child nursing. 35 (2): 102–7, quiz 108–9. PMID 20215951. {{cite journal}}: Check date values in: |date= (help)
  3. ^ http://www.merriam-webster.com/dictionary/douche
  4. ^ a b Velasquez-Manoff, Moises (Jan. 11, 2013). "What's in Your Vagina? A healthy microbiome, hopefully". Slate. {{cite web}}: Check date values in: |date= (help)
  5. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 20215951, please use {{cite journal}} with |pmid=20215951 instead.
  6. ^ WebMD article on the causes of yeast infections, including douching.
  7. ^ Rothman KJ, Funch DP, Alfredson T, Brady J, Dreyer NA (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ a b c d Seppa, N. (2 January 1999). "Douching associated with pregnancy risk" (PDF). Science News. 155 (1): 7. Retrieved 1 March 2013.
  9. ^ Warning from Kelly Shanahan, MD on douching.
  10. ^ Terms of Derogation
Look up douche bag in Wiktionary, the free dictionary.
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