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Bidets are bathroom fixtures that use a stream of water to clean you off after using the bathroom. Bidets have been popular in Asia, South America, and Europe for many years, and are standard plumbing appliances in many household bathrooms.

In recent years, claims about the environmental and sanitary benefits of bidets have given rise to their increased popularity in the United States.

It’s true that using a bidet means that you’ll likely use less toilet paper. But as far as being more sanitary than a flush toilet, that claim might not be as simple as it seems. Let’s take a look at what we actually know about bidets to determine if they really are more hygienic than using toilet paper.

The big concern about bidet use boils down to bacteria and viral organisms that can be present in a bidet’s nozzle. A 2017 study of a university hospital in Japan found that 254 out of 292 bidet toilets were contaminated with Staphylococcus aureus, Streptococcus spp., Enterococcus spp., or other organisms.

Of course, if you use a bidet that has any type of bacteria in the nozzle, it’s not a guarantee that you’ll develop an infection or a virus. However, it is possible.

Bidet use may pose a particular health concern for people with vaginas. Normally, your vagina has a healthy ecosystem of bacteria called Lactobacillus. These bacteria actually work as a protection for your vagina, warding off infections caused by harmful bacteria such as bacterial vaginosis.

A 2010 study of 268 women found that habitual use of bidet toilets may disrupt healthy vaginal microflora. Normal microflora (Lactobacillus spp.) was not found in 42.86 percent of bidet users, compared to 8.77 percent of people who did not use bidets. In addition, out of the 268 women, fecal bacteria were detected in 46 of the bidet users and in only 4 of the nonusers.

If you’re pregnant, you may want to carefully consider the decision to use a bidet. A 2019 study showed that pregnant women deemed to be “high-risk” who used a bidet regularly were more likely to give birth prior to their due dates.

A handful of studies isn’t enough to prove, one way or the other, whether bidets are unsanitary or pose particular health risks. It’s worth noting, too, that many of the existing studies were conducted in hospital settings where bidets were shared.

It’s possible that using a bidet in your own home and cleaning it regularly lowers any existing risks significantly. At the very least, these study results indicate that more research is needed to fully understand how bidets can have an impact on your health.

For the most sanitary result, always use your bidet properly.

When you’re using a bidet in a public setting, test the nozzle by turning it on before it’s time to actually use it. See where the stream of water is going to come from so that you’re not surprised by where it hits you and so that you don’t make a mess. Always clean a public bidet nozzle off with toilet paper (or whatever you have available) before you use it, if you can.

If you have a vulva, always direct the stream of water from front-to-back, the same way you would if you were using toilet paper to wipe.

Don’t use a towel that’s hanging nearby to wipe off any remaining water from your backside. That towel is for wiping off your hands, and it could be covered with other people’s bacteria.

If you have a bidet in your home, follow the manufacturer’s guidelines for regular cleaning of your bidet attachment or toilet device. Most nozzles have a cleaning setting, which you can use daily to run clean water over the head of the nozzle.

Wipe the inside of the nozzle while it’s on this setting, at least once a month. Keep up with any semiannual filter changes on your device to make it last, and also to keep you and anyone else who uses your bidet safe from contamination.

Some research has shown that regular bidet use could increase your exposure to certain pathogens. This may be more likely to happen in settings where bidets are shared by many people.

If you have a bidet at home, it’s important to use it correctly. And be sure to keep up with recommended cleaning and maintenance so that it’s safe to use (and sanitary).