Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents


      The objective of the study was to examine the association between douching and 4 sexually transmitted infections (STIs).

      Study Design

      We followed up 411 high-risk human immunodeficiency virus-infected and uninfected female adolescents aged 12-19 years over a median 3-year period, both by time from study entry/first STI-free visit until an incident STI for participants who never, intermittently, and always douched and also by reported douching at a given STI-free visit and incidence of STI at the next visit, using adjusted Cox proportional hazards models to calculate hazard ratios (HR).


      The time to STI was shorter for adolescents who always (HR, 2.1; 95% confidence interval [CI], 1.2-3.4) and intermittently (HR, 1.5; 95% CI, 1.0-2.2) douched, compared with never-douchers. An adjusted hazard for STI was 1.8 times larger for always-douchers (95% CI, 1.1-3.1) and 1.4 times larger for intermittent douchers (95% CI, 0.9-2.0), compared with never-douchers. When classifying by follow-up after an STI-free visit, always-douchers had a shorter STI-free time than never-douchers (HRadj, 2.1; 95% CI, 1.5-3.1).


      Counseling to discourage douching may reduce STI risk in adolescents.

      Key words

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      Linked Article

      • Douching and the risk for sexually transmitted disease: Tsai et al
        American Journal of Obstetrics & GynecologyVol. 200Issue 1
        • Preview
          The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Tsai CS, Shepherd BE, Vermund SH. Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents. Am J Obstet Gynecol 2009;200:38.e1-38.e8. The full discussion appears at , pages e11-e14.
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      • Discussion: ‘Douching and the risk for sexually transmitted disease’ by Tsai et al
        American Journal of Obstetrics & GynecologyVol. 200Issue 1
        • Preview
          In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Tsai CS, Shepherd BE, Vermund SH. Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents. Am J Obstet Gynecol 2009;200:38.e1-38.e8.
        • Full-Text
        • PDF