The Importance of the Vaginal pH
The pH of the vagina refers to the degree of acidity of the vagina.
The vagina has a lower pH than other parts of the body and is thus more acidic.
Maintaining the pH balance of the vagina is essential to keeping it healthy.
An acidic vaginal environment is protective. It creates a barrier that prevents unhealthy bacteria and yeast from multiplying too quickly and causing infection.
Higher vaginal pH levels have been linked with several other conditions, including infertility, premature birth, and increased risks for sexually transmitted infections.
A normal vaginal pH is usually less than 4.5. The lower the number, the more acidic the vaginal environment will be.
The vaginal pH level is between 3.8 and 4.5, which is moderately acidic. However, what constitutes a “normal” pH level can vary slightly based on your stage of life.
For example, during your reproductive years (ages 15 to 49), your vaginal pH should be below or equal to 4.5. But before menstruation and after menopause, a healthy pH tends to be higher than 4.5.
A high vaginal pH level — above 4.5 — provides the perfect environment for unhealthy bacteria to grow. Having a high vaginal pH puts you at risk for infections, odor and discomfort. In the vagina, a high pH may cause infections as it can allow bacteria and yeast to thrive
Lactobacilli bacteria live in the vagina and secrete lactic acid and hydrogen peroxide, which give the vagina its acidic pH level.
Vaginal pH can change throughout a person’s lifetime. It is usually higher than 4.5 before a person has their first menstrual period and after menopause.
Vaginal pH is usually less than 4.5 during a woman’s reproductive years unless a condition or infection raises it.
Several conditions and infections can affect the vaginal pH balance, usually by increasing pH levels.
An acidic vagina usually doesn’t cause disease. But if the acidity rises too much, it might reduce your fertility. Sperm thrive in an alkaline environment. The optimal pH for sperm motility is between 7.0 and 8.5. During sex, the pH level inside the vagina temporarily rises, making the normally acidic environment more alkaline to protect the sperm so they can make their way to the egg.
Causes of changes in vaginal pH include the following:
Bacterial vaginosis
Bacterial vaginosis is a medical condition that occurs when too much bacteria is present in the vagina. This can cause an increase in vaginal pH levels.
A person with bacterial vaginosis may experience itching, burning, or pain in the vagina. They may also feel a burning sensation when urinating and notice a white or gray discharge.
The presence of infections other than bacterial vaginosis may also increase the vaginal pH. Examples include Trichomonas vaginalis and group B Streptococcus (GBS).
Douching
Douching refers to washing or cleaning the vagina using particular solutions, such as those containing vinegar or baking soda.
These solutions claim to reduce vaginal odor, but, in fact, they may worsen it. This is because they wash out good bacteria, which affects the vaginal pH balance and can make someone more prone to infections.
Menopause
Reduced estrogen levels during menopause may affect a person’s vaginal pH. Women tend to have higher pH levels during menopause. In the study, women in menopause had an average vaginal pH of 5.3.
Menses
Blood has a higher pH than the vaginal environment. When a person is menstruating, the presence of menstrual blood can increase vaginal pH levels.
Sex with Men
Semen is basic, which is the opposite of the vagina’s acidic environment. When semen enters the vagina, it may temporarily increase the pH. Condoms are protective.
Antibiotics
Antibiotics are used to kill harmful bacteria, but these medications can kill good bacteria as well; and his will include bacteria in the vagina. If a person is taking antibiotics, their vaginal pH may be out of balance. These drugs kill not only the bad bacteria that cause disease, but also the good bacteria you need to maintain a healthy, more acidic vaginal pH level.
Signs and symptoms of an unbalanced vaginal pH
A high pH level that leads to BV or another infection may cause symptoms like:
a foul or fishy smell
unusual white, gray, or green discharge
vaginal itching
burning when you urinate
Remedies to restore pH balance:
Avoiding harsh soaps and douching. Soaps typically have a high pH, and using them to clean the vaginal area may increase vaginal pH. It is best to use warm water and a gentle cleanser to clean the vulva but to refrain from using soap inside the vagina. This will help to maintain the vaginal pH balance.
Taking a probiotic supplement or suppository. Probiotics help to restore the body’s natural bacterial levels. Some foods also contain probiotics, including yogurt, miso, and kombucha.
Changing tampons regularly. Leaving a tampon in for too long can increase the vaginal pH because the pH of blood is slightly basic. Changing tampons frequently also reduces the risk of bacterial infections, including toxic shock syndrome (TSS).
Using barrier protection during sex. Using barrier protection, such as condoms or dental dams, not only helps to prevent pregnancy and STIs but can prevent semen and other fluids from affecting pH levels in the vagina.
Increase estrogen or DHEA. Doctors can also prescribe creams, such as estrogen or DHEA creams, which may help to reduce the vagina’s pH levels.
Treating Bacterial vaginosis (BV). BV is a bacterial overgrowth condition that causes a “fishy” odor, along with an unusual gray, white, or yellow vaginal discharge. It can also result in vaginal itchiness and burning during urination.
BV isn’t necessarily harmful in itself, but women who have this condition are at increased risk for more serious infections, like human papilloma virus (HPV) herpes simplex virus, and HIV.
Treating Trichomoniasis (trich). Trichomoniasis is a sexually transmitted disease (STD) caused by the parasite Trichomonas vaginalis. In the United States, it affects an estimated 3.7 million people.
Trichomoniasis usually doesn’t cause symptoms in the majority of those infected, but it can increase your risk for other, more serious STDs, like HIV.
To treat a BV or trichomoniasis infection, your doctor might prescribe one of these antibiotics by pill or cream:
clindamycin (Cleocin) for BV
metronidazole (Flagyl) for BV or trichomoniasis
tinidazole (Tindamax) for BV or trichomoniasis
Even though antibiotics can affect vaginal pH, clearing up the infection is necessary.
How to maintain a healthy vaginal pH
Don’t douche. It can increase the pH level in your vagina. Wash only the outside of your vagina with a mild soap and water when you shower.
Maintain a healthy diet for vaginal health. You may not realize it, but following a balanced, nutritious diet and drinking plenty of fluids are both key to vaginal and reproductive health.
Eat yogurt. In addition to helping you reach your daily quota of calcium and vitamin D, yogurt is a plentiful source of the beneficial bacterial species of Lactobacillus. Yogurt can potentially help prevent yeast infections and help in their treatment. “Yogurt is rich in probiotics, especially plain Greek yogurt, so if a woman is prone to yeast infections, taking a probiotic that is rich in [the bacteria] Lactobacilli, or eating plain Greek yogurt every day can be helpful
Practice safe sex.
Using condoms — either the male or female kind — during sex helps to protect against sexually transmitted infections (STIs) and maintain a more acidic environment of the vagina. You should change condoms when switching from oral or anal sex to vaginal sex, to prevent the introduction of harmful bacteria into the vagina. You should also avoid sharing sex toys with your partner.
Treat infections when they arise.
Three types of vaginal infections are common: yeast infection, bacterial vaginosis, and trichomoniasis.
Use enough lubricant, but not petroleum jelly.
Lubrication is an important part of intercourse. Without it, the skin of the labia and vagina can become irritated and chafed. While vaginal lubrication usually occurs naturally during female arousal, some women do not produce enough natural lubricant. In this case, they should use an artificial lubricant to reduce friction and to enhance pleasure. If you’re trying to get pregnant, certain lubricants can interfere with the sperm and make it difficult to conceive; a pH balanced lubricant should be used. If you’re not trying to get pregnant, water-based, silicone-based, and oil-based lubricants are fine, depending on what your needs are. If you’re using condoms for protection, do not use an oil-based lubricant — they can cause the latex in condoms to break down.
Choose clothing carefully to stay dry.
Your vagina should stay clean and dry — and what you wear can affect that. Certain types of fabrics and tight-fitting clothing create warm, moist conditions in which yeast thrive. Wear breathable cotton underwear and avoid thongs. If you’re prone to yeast infections, change out of wet swimsuits and sweaty workout clothes as quickly as possible. If you experience a lot of discharge and dampness during the day, change your underwear during the day.
Follow good hygiene
Common sense can go a long way in protecting the health of your vagina. After a bowel movement, wipe from front to back to avoid bacterial contamination of the vagina and to lower the risk of bladder infection. Change sanitary pads and tampons regularly during your period. Panty liners may be worn to absorb normal vaginal discharge as long as you change them frequently; however, some women who wear them all the time may experience some vulvar irritation.
When to see your gynecologist
See your doctor between scheduled visits if you have these symptoms:
itching
burning
foul odor
unusual discharge
Summary
Keeping vaginal pH levels in balance can help to reduce infections and prevent complications.
Women can take steps, such as using probiotic supplements and not douching, to help keep their vaginal pH levels balanced.
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