Ellen Campbell -Grizzle - PHARMACY TODAY MANY JAMAICAN women appear to be uncomfortable about talking with their pharmacists about vaginal problems. They avoid the "V" word choosing to use euphemisms ranging from "down there " to "gladys." Their reticence might be increased by the fact that prescription areas (in pharmacies) are not secluded enough. In order to encourage clients to talk about private matters, the Pharmacy Council now requires that all pharmacies designate and use a "confidential area."
Women do seek advice about douching for various reasons. Some want to remove sperm after sexual intercourse and to avoid sexually transmitted infections (STIs), others want to wash away blood at the end of the menstrual cycle while some just want to feel fresher "down there" and reduce odours.
However, douching does not prevent pregnancy or STIs including HIV/AIDS and can have serious health consequences. Under normal circumstances, the vagina cleans itself and regular washing with a mild soap is sufficient.
Douching involves the use of water or other solutions to flush the vagina (birth canal). The liquid is held in a bottle and squirted into the vagina through a tubing and a nozzle. This changes the delicate chemical balance in the vagina and disrupts the normal vaginal flora.
In this environment, other disease causing germs flourish and spread upwards into cervix, uterus and fallopian tube. Routine douching (once per week or more) increases the risk of Pelvic Inflammatory Disease (PID) by 73 per cent and can lead to infertility. The risk of ectopic pregnancy (fertilised egg attaches inside of the fallopian tube instead of the uterus) is also greater.
When the physician recommends douching, women must use the correct technique to avoid problems. Instructions may vary slightly based on whether the fountain syringe or bulb syringe is to be used. The pharmacist will give the following general instructions:-
lie on your back with knees bent
insert the tip at the end of the nozzle into your vagina and gently slip in as far as it can go gently squeeze the bottle and a feeling of fullness will indicate that sufficient fluid has been introduced remove the gadget and use one hand to hold the labia (lips of the vagina) for one minute. After releasing the labia, the fluid will be expelled.
When your doctor recommends "home made" douches for you, make sure that these are prepared by your pharmacist. Vinegar and water mixture is made up of 15-30 mL of white vinegar to 1L of warm water. Sodium bicarbonate mixture contains 15-30mL of Sodium Bicarbonate in 1L of water. The exact proportions are important.
Pharmacists no longer recommend routine douching to keep the vagina healthy and safe. If you are suffering from vaginal pain, itching, burning, foul odour, painful urination or a discharge that differs from the thick, white cottage cheese appearance, consult a physician.
There is no need to be bashful about discussing vaginal matters with your pharmacist. Douching only offers temporary relief for symptoms but does not adequately treat infections.
When using a vaginal spermicide for contraception, do not douche for at least six hours after intercourse. Douching within 24 hours before a medical examination can mask a suspected infection or lead to incorrect diagnosis and treatment. If you need to talk more about keeping your vagina healthy and safe, ask your pharmacist, you have the right to know!
Ellen Campbell Grizzle is the President of the Caribbean Association of Pharmacists (CAP) and Director, Information & Research, National Council on Drug Abuse (NCDA).
