Background: Douching has been related to risk of pelvic
inflammatory disease (PID).
Goal: To examine the association between douching and
PID in a large, multicenter, clinical trial of PID after adjustment
for race/ethnicity.
Study Design: Interviews were conducted with 654 women
who had signs and symptoms of PID. Vaginal Gram stains and
upper genital tract pathology/cultures were obtained from all
the women. Women with evidence of plasma cell endometritis
and/or gonococcal or chlamydial upper genital tract infections
were compared with women who had neither endometritis nor
upper genital tract infection.
Results: Women with endometritis or upper genital tract
infection were more likely to have douched more than once a
month or within 6 days of enrollment than women who never
douched. These associations remained after adjustment for
confounding factors, after analysis of black women only; and
among women with normal or intermediate vaginal flora but
not bacterial vaginosis.
Conclusion: Among a predominantly black group of women
with clinical PID, frequent and recent douching was associated
with endometritis and upper genital tract infection.