There was a time when the “wash for better health” commercial was widely broadcast on TV, making many people take vaginal washing as a measure to maintain their health. In a survey conducted today, the results of more than 5,000 polls probably show the current situation. Nearly half of women use vaginal douching because their doctors recommend it, and about 10% of women have the habit of not douching regularly. Vaginal douching, which many doctors once used as a vaginal infection treatment, has now been found to be detrimental to health. In the past, many medical measures were taken for granted as being right, but they may not be right, so how do you determine right from wrong? As I mentioned in my previous article “Doctors are divided, who should we listen to” (reply 115 after adding WeChat drgongxiaoming), the best way to assess the appropriateness of a medical measure is to do research and design a randomized controlled study to see if the measure is ultimately beneficial. There are studies, and there was a meta-analysis published in 1997 (i.e., a pooling of published studies, which is a higher level of evidence than individual studies) that analyzed the relationship between vaginal douching and the development of many diseases. Vaginal douching increases the incidence of pelvic inflammatory disease. The results shown in Figure 1 indicate a negative effect when the marker falls on the unilateral side of 0. The OR (ratio) is above 1 on the right side, with an overall OR of 1.73 (1.07-2.79), suggesting that vaginal douching increases the chance of pelvic inflammatory disease by 73%. The higher the number of douches, the higher the chance of inflammation, and the chance of pelvic inflammatory disease increases up to 4 times if vaginal douching is performed weekly. Figure 1 . Meta-analysis showing that vaginal douching increases the incidence of pelvic inflammatory disease Vaginal douching increases the risk of ectopic pregnancy and infertility Figure 2 probably shows that vaginal douching increases the chance of ectopic pregnancy. The pooled data suggest that patients who douched were 1.8 times more likely to have an ectopic pregnancy than those who did not douche (RR 1.76, CI 1.10-2.82). The study also found that using commercial douches was more risky than using water. Another study found that women who douched vaginally were 30% less likely to become pregnant than women who did not douche, and this difference was particularly pronounced among younger women. The difference was particularly pronounced among younger women, where women aged 18-24 had a 50% decrease in pregnancy, women aged 25-29 had a 29% decrease in pregnancy, and women aged 30-39 had a 6% decrease in pregnancy. Figure 2. meta-analysis shows that vaginal douching increases the risk of cervical cancer Vaginal douching increases the incidence of cervical cancer Figure 3 study suggests that vaginal douching slightly increases the risk of cervical cancer (RR value 1.25, 95% confidence interval 0.99-1.55). The risk of cervical cancer was increased by 86% in those who had frequent vaginal douching (more than once a week) compared to those who did not douche. Similarly, the increased risk was higher with commercial douches than with water. In another study of 657 sex workers in Kenya, the risk of HIV infection was found to be 1-fold higher and the risk of gonococcal infection 1.7-fold higher due to the disappearance of lactobacilli by vaginal douching. A 10-year cohort study of 1270 Kenyan sex workers found that women who douched with water had a 2.64 times higher risk of HIV infection than women who did not douche, and the risk was even higher if they douched with an antiseptic lotion. A survey of 2897 South African women also found that the risk of HIV infection was 1.74 times higher in women who douched than in women who did not douche. Vaginal douching increases the risk of low birth weight babies Many studies have reported that douching before or during pregnancy may increase the risk of preterm birth and low birth weight babies. In a group of 4665 women of childbearing age and 11,553 single live births, 650 douched 2-3 times per week were 40% more likely to deliver a low birth weight baby than those who did not douche. After controlling for relevant confounding factors, the results showed that vaginal douching was associated with an increased risk of delivering a low birth weight baby OR=1.29 (95% CI:1.06-1.57). Frequency of douching was dose-dependently associated with delivery of low birth weight infants, with OR=2.49 (95% Cl:1.23-5.01) for daily douching and OR=1.13 (95% Cl:0.83-1.55) for monthly douching. The vagina itself is a slightly acidic environment with the presence of lactobacilli, with a pH around 4.5, which inhibits the growth of other pathogenic bacteria. Vaginal douching disrupts the internal environment of the vagina and instead promotes the growth of abnormal flora, leading to vaginal inflammation. In addition, it is speculated that vaginal douching may provide a liquid carrier for pathogenic bacteria, making them more likely to migrate, and the increased incidence of ectopic pregnancy may be related to problems secondary to pelvic inflammatory disease. Vaginal douching performed around the time of ovulation has a higher chance of retrograde entry of pathogenic bacteria into the body for infection. During pregnancy, the upstream infection may lead to amnionitis leading to preterm delivery. For the treatment of vaginal inflammation in general, vaginal douching should be abandoned as a treatment option at this time, and the American College of Obstetricians and Gynecologists (ACOG) suggests that vaginal douching is opposed at all times. From our survey data, it appears that physician recommendation to douche is still a major reason why many women currently practice vaginal douching. It seems that a change in physician perception is now the key, and since studies have confirmed many disadvantages, physicians should abandon the various lotions available on the market for vaginal douching. For general vaginal inflammation, symptomatic suppository therapy is sufficient, and there is no need to use vaginal douching treatment that adds to the problem.