Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study

Douching has been related to risk of pelvic inflammatory disease (PID).

To examine the association between douching and PID in a large, multicenter, clinical trial of PID after adjustment for race/ethnicity.

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.

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.

Among a predominantly black group of women with clinical PID, frequent and recent douching was associated with endometritis and upper genital tract infection.