Here's Another Reason Women Should Not Use Vaginal Douches

Doctors advise against douching -- the cleaning of the inside of the vagina -- because it can lead to bacterial infection, pelvic inflammatory disease and problems during pregnancy. While the practice is on the decline, nearly one in five women ages 15-44 still does it.

Now a study published this week identifies another harm: higher exposure to phthalates, a class of chemicals that are suspected to be hormone disruptors. And African-American women appear to be at increased risk because of their more frequent use of these products.

It appears to be the first time scientists have looked at personal care products and phthalate exposure, and study authors were surprised by the magnitude of the relationship between exposure and levels of chemicals.

"We were surprised it was as important as it was," said co-author Tracey Woodruff, an OB/GYN professor at UCSF.

In the study, Woodruff and her colleagues looked at 759 women, ages 20-49, who had participated in a national health survey from the Centers for Disease Control and Prevention, and had said they used a range of feminine hygiene products. The women also provided urine samples. Researchers tested those samples for metabolites of phthalates.

Women who reported douching in the last month had 52 percent higher concentrations of the metabolite diethyl phthalate (DEP) in their urine, compared with women who had never used the product. Women who used the products two or more times a month had 152 percent higher concentration of DEP than non-users.

In a statement, senior author Ami Zota, an assistant professor at the George Washington University School of Public Health, said, "These findings raise questions about the health and safety of vaginal douches and other fragranced products used in and around the vaginal area."

In the study, 37 percent of African-American women reported douching in the last month, compared with 14 percent of white women and 10 percent of Mexican-American women.

Woodruff framed the higher use of of the product by African-American women as a social justice issue, saying that advertising is targeted to them and that "certain groups of women feel they might need to conform to certain beauty standards and practices within the population."

"This is not uncommon for many types of beauty products," she added.

According to the National Institutes of Health, (NIH) phthalates are a group of chemicals "used to soften and increase the flexibility of plastic and vinyl." But they are also used as fragrance in beauty products.

Woodruff noted that "phthalate" generally does not appear on product labels. Instead, it merely says "fragrance."

"If women are using douche products, and they're scented, there's potentially a high likelihood" that they contain phthalates.

The researchers reviewed many feminine care products, including tampons, sanitary napkins, feminine spray, feminine powder and feminine wipes/towelettes, but did not find an association with phthalate exposure with these other products.

Woodruff said the study did not look at health effects. Indeed, the health effects are "not yet fully known," says the NIH, although they are under investigation.

Pregnant women are being recruited for new studies at UCSF, Woodruff said. One of the areas of investigation is to "measure phthalate exposure and look for adverse health effects."