Douching and endometritis - Results from the PID Evaluation and Clinical Health (PEACH) Study

Background: Douching has been related to risk of pelvic inflammatory diseas e (PID). Goal: To examine the association between douching and PID in a large, multi center, clinical trial of PID after adjustment for race/ethnicity. Study Design: Interviews were conducted with 654 women who had signs and sy mptoms of PID. Vaginal Gram stains and upper genital tract pathology/cultur es were obtained from all the women. Women with evidence of plasma cell end ometritis and/or gonococcal or chlamydial upper genital tract infections we re 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 enrollme nt than women who never douched. These associations remained after adjustme nt for confounding factors, after analysis of black women only; and among w omen with normal or intermediate vaginal flora but not bacterial vaginosis. Conclusion: Among a predominantly black group of women with clinical PID, f requent and recent douching was associated with endometritis and upper geni tal tract infection.