||Douching is remarkably common,
especially among African-American women in the U.S. Douching, in retrospective studies,
has been associated with PID in the past. You see that they’re all greater than one. The
problem is: 1) there have been very few studies, and 2) the temporal relationship her is
very unclear, in other words, do women douche because they have infection, and therefore
it looks like douching is related to PID, or do they douche and they get an infection from
douching, and so douching is related to PID in a way that’s completely different in
terms of causality.