Douche

A douche is a device used to introduce a stream of water into the body for medical or hygienic reasons, or the stream of water itself. The word comes from the French language, in which its principal meaning is a shower (it is thus a notorious false friend encountered by non-native speakers of English; the phrase for vaginal douching is douche vaginale, meaning vaginal shower).

The word can refer to the rinsing of any body cavity but usually applies to vaginal irrigation, rinsing of the vagina. A douche bag is a piece of equipment for douching: a bag for holding the water or fluid used in douching (the term douche bag can also be used as an insult; see below for slang uses). To avoid transferring intestinal bacteria into the vagina, the same bag must not be used for a vaginal douche and an enema.

Overview
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 very 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. For example, the U.S. Department of Health and Human Services strongly discourages douching, warning that it can lead to irritation, bacterial vaginosis, and pelvic inflammatory disease aka 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.

In May 2003, a randomized, controlled, multicenter 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.

Antiseptics may also result in an imbalance of the natural bacteria in the vagina, also resulting in an increased likelihood of infection. 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. Douching may also wash bacteria into the uterus and Fallopian tubes, causing fertility problems.

In May 2007, 40 women were enrolled in a open-label trial. The women all had bacterial vaginosis as defined by Amsel's criteria and were treated for 6 days with a douche containing Lactobacillus acidophilus. Vaginal smears were collected from the patients and analyzed according to Nugent's criteria at the time of diagnosis, after 6 days of treatment, and again at 20 days after the last treatment. At the same times, determination of vaginal pH and a Whiff test were performed. RESULTS: The Nugent score decreased significantly from bacterial vaginosis or an intermediate flora toward a normal flora during treatment, and remained low during the follow-up period for almost all of the patients, indicating bacterial vaginosis in 52.5% and in 7.5% of the patients before treatment and at follow-up, respectively. After treatment, significant decreases in vaginal pH were observed, to less than pH 4.5 in 34/40 women, and the odor test became negative in all of the patients. CONCLUSIONS: In this preliminary study, treatment of bacterial vaginosis with a vaginal douche containing a strain of L. acidophilus contributed to the restoration of a normal vaginal environment.

Douching after intercourse is estimated to reduce the chances of conception by only 15-25%. 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 (N.Y.) School of Medicine 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.

The practice of douching is now largely restricted to the United States, where douching equipment is often available in pharmacies. A 1995 survey quoted in the University of Rochester study found that 27 percent 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%).

The irrigation of the anus is also known as an enema.

Slang uses
Douche bag, or simply douche, are considered pejorative terms in Australia, the United States, Canada and New Zealand. The slang usage of the term dates back to the 1960s. The term may be used in a phrase such as "that guy is such a douche bag!" One may also be called a "douche nozzle," Referring to the part of the douche that actually enters the vagina to induce irrigation.