Association between vaginal douching and acute pelvic inflammatory disease

Article Abstract:

Douching of the vagina (a self-administered rinsing of the area with medication or cleansing agent under low pressure) is practiced routinely by many women in the United States. In spite of its frequency, its effects on the genital tract are unknown, but an association with pelvic inflammatory disease (PID), an inflammation of the female reproductive organs, has been suggested. To investigate this possibility, 100 patients with verified PID (pelvic inflammation, often associated with tubal or uterine lining infection), 119 women with PID symptoms in whom tubal or uterine infection had not been verified, and 763 women without evidence of PID (controls), were studied. Subjects underwent physical and gynecological examination, including questioning about frequency and type of douching. Biopsy from the endometrium, the lining of the uterus, and laparoscopy (viewing the pelvic organs with a tube and light introduced under general anesthesia) were performed on some patients with symptoms of PID. Specimens from the cervix (neck of the uterus) were evaluated for infection. Results showed that women with PID were younger, less often white, more likely to have borne children, and different in several other ways. They were also more likely to have douched during the previous two months, and the strongest association was for those who douched three or more times per month. In a subgroup of 42 women with acute tubal infection verified by laparoscopy, douching was associated with disease for white, nonwhite, and nonblack women, but not for black women. The association between douching and PID was strongest for women with the fewest lifetime sexual partners (10 or fewer), and weakest for those with the most (more than 25). No relationship was found between presence of microorganisms associated with PID, and douching, or between PID and any particular type of douche used. Although the methods used by this study do not allow a causal relationship to be inferred, it is likely that douching may increase the risks for PID. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Vagina, Pelvis, Douching

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Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use

Article Abstract:

This study included a group of 141 women with pelvic inflammatory disease (PID; infection of the reproductive organs within the pelvis) which was proven by visual inspection of the uterus and fallopian tubes and/or tissue biopsy. They were compared to a control group of 739 sexually active female patients with no symptoms of PID who were seen in a sexually transmitted disease clinic. All of the women were assigned to various groups on the basis of infection with Chlamydia trachomatis (chlamydia), Neisseria gonorrhea (gonorrhea) or both. The results shows that, in women who were infected with chlamydia, the risk of acquiring chlamydial PID was significantly reduced by the use of oral contraceptives. However, the rate of gonorrheal PID was unaffected by the use of oral contraceptives.

Women, Risk factors, Diseases, Oral contraceptives, Neisseria gonorrhoeae, Chlamydia infections

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Clinical manifestations of vaginal trichomoniasis

Article Abstract:

Trichomonas vaginalis microorganisms were found in 15 percent of 779 randomly selected women attending the Seattle-King County Sexually Transmitted Disease Clinic. Vaginal trichomoniasis is characterized by vaginal discharges, abnormal vaginal odor, itching of the vulva, vaginal and vulvar redness and spotty inflammation of the vagina. The symptoms of the infection are not very sensitive indicators of its presence, but are still useful for diagnosing patients for whom vaginal fluid sample would be ineffective. Detection and control of this infection could be improved by wider and more sensitive testing of vaginal fluid for symptom-free infection.

Trichomonas vaginalis, Trichomonas

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