An estimated 20% to 40% of American women between ages 15 and 44 say they use a vaginal douche. Higher rates are seen in teens and African-American and Hispanic women. Besides making themselves feel fresher, women say they douche to get rid of unpleasant odors, wash away menstrual blood after their period, avoid getting sexually transmitted diseases, and prevent a pregnancy after intercourse. Yet, health experts say douching is not effective for any of these purposes. They also warn that it can actually increase the risk of infections, pregnancy complications, and other health problems.

What Is Douching? The word ''douche'' is French for ''wash'' or ''soak.'' It is a method to wash out the vagina, usually with a mixture of water and vinegar. Douches that are sold in drugstores and supermarkets contain antiseptics and fragrances. A douche comes in a bottle or bag and is sprayed through a tube upward into the vagina.

Advantages Some women say douching makes them feel cleaner. There is, though, very little scientific evidence of benefit from douching.

Disadvantages Overall, the risks of douching far outweigh the benefits. Vaginal infections (bacterial vaginosis). Douching upsets the natural balance of bacteria in the vagina (called vaginal flora). These changes make the environment more favorable for the growth of bacteria that cause infection. Studies have found that women who stopped douching were less likely to have bacterial vaginosis. Having bacterial vaginosis can increase the risk of preterm labor and sexually transmitted infections. Pelvic inflammatory disease (PID). PID is an infection of the uterus, fallopian tubes, and/or ovaries. Research has found that women who douche may have a 73% higher risk of getting PID. Pregnancy complications. Women who douche more than once a week have more difficulty getting pregnant than those who don't douche. Douching may also increase the risk of ectopic pregnancy by as much as 76%. With an ectopic pregnancy, the embryo implants outside the uterus. The more a woman douches, the greater the risk of having an ectopic pregnancy. Cervical cancer . Douching at least once a week has been linked to a possible increased chance of developing cervical cancer.

Should You Douche? According to health experts, including those at the American College of Obstetricians and Gynecologists (ACOG), you should avoid douching. Having some vaginal odor is normal. However, if you notice a very strong odor, it could be a sign of infection. The acidity of the vagina will naturally control bacteria, and simply washing the vagina with warm water and mild soap is enough to keep clean.