Ladies, should you wash Miss 'V' when there's vaginal odor?

Dear Doctor,

What’s douching and should I consider doing it once in a while?

Rachael

Dear Rachael,

Douching is cleaning of the inside of the vagina with water or other cleansing fluids. It is a fairly common practice, with some studies estimating that about one in every four women regularly douche.

Douches are sold as prepackaged mixtures of water and vinegar, baking soda or iodine. The mixture is squirted upwards into the vagina, then washes itself outwards.

Douching is not necessary, and is unhealthy. Just washing the outside of the vagina is good enough, and is all that you require.

Why do some women douche? Some just feel ‘unclean’ on the inside. Others erroneously think they need to wash their insides after sexual intercourse, or to prevent infections or pregnancy. Yet others have reported the need to wash off vaginal odors.

Well, all these and whatever other reasons are mistaken. The vagina is self-regulatory, with an acidic environment maintained by a natural balance of bacteria and mucous production. This fends off infections and reduces irritation.

For starters, douching will not reduce the risk of sexual infections. In fact, the risk becomes higher. It’s useless to try to prevent pregnancy by douching, what you need is effective contraception.

The vagina has a natural odour which changes as the day advances, and with your cycle. Any odor that appears unnatural requires a gynaecological review, not misguided douching.

When you douche, you inevitably interfere with the healthy bacterial balance in the vagina. This worsens anything that you were trying to remedy.

Douching is linked with both bacterial and fungal vaginal infections. If you already have an infection, douching can push up the infective organisms into your uterus, Fallopian tubes and ovaries. You may end up with pelvic inflammatory disease, which is a serious condition. You also get predisposed to sexually transmitted infections and even HIV.

Longer term effects include vaginal dryness and irritation, ectopic pregnancy and infertility. Newer studies have even linked douching with an increased risk of gynaecological cancer.

So what should you do if you feel compelled to douche for whatever reason? Just resist the temptation, and don’t do it. Wash the outside of your vagina with warm water, or a mild soap.

Avoid heavily scented products as they may increase irritation and predispose to vaginal infections. Let the inside of the vaginal self-clean. The mucous that gets produced washes away blood, semen and vaginal discharge.

If you are worried about an odor, discharge or unusual irritation, then you should see your gynaecologist. These may be signs of a vaginal infection or some other condition. You will need a thorough assessment to make a diagnosis, and recommendations for a specific remedy. Don’t take matters into your own hands, all you may end up doing is worsening your symptoms and predisposing yourself to other risks. Vaginal douching is never recommended.

— Dr Alfred Murage is a consultant obstetrician and gynaecologist