There is so much hype about vaginal pH these days, and for good reason, specifically when it comes to intimate, feminine health. In this article we’ll talk more about what vaginal pH is, what can happen when vaginal pH balance is off, as well as discuss a few ways to maintain a normal vaginal pH if you’re finding your levels are out of whack.
Understanding Vaginal pH
The vagina is unique; we gynecologists often refer to it as “self-cleaning”. In general, the vagina has a complex microbiome, an environment of carefully balanced and harmonious bacteria, yeast and other organisms. One predominant organism that keeps all this in check is Lactobacilli. These “good bacteria” come in many strains, all of which play a role in keeping the vaginal pH acidic.
So, what’s considered to be normal when it comes to a healthy vaginal pH? A normal vaginal pH should be between 3.7-4.5. An acidic vaginal pH means a happy vagina free of annoying symptoms and potential infection.
What Causes a Vaginal pH Imbalance?
Hormone changes can play a role in vaginal pH imbalance. Pregnancy, lactation, hormonal contraception, and perimenopause and menopause are notable causes of altered estrogen levels. Estrogen helps to maintain a normal, healthy vaginal pH, therefore, if estrogen levels are lower, vaginal pH can be off. As our vaginal pH rises, symptoms of dryness, irritation, itching, painful sex and general day-to-day vaginal discomfort can occur.
Not everyone is able to or willing to use estrogen replacement in these instances, however. Revaree®, a hormone-free treatment option that uses hyaluronic acid for addressing vaginal dryness, can help maintain vaginal moisture and minimize these symptoms, when used regularly. In fact, the hyaluronic acid in Revaree, has been shown in clinical studies to play a role in repairing vaginal tissue and maintaining a healthy vaginal pH.1 These results were similar to those seen in women using vaginal estriol and conjugated vaginal estrogen.2
Risks Associated with Vaginal pH Imbalance
Sex and exposure to ejaculate, particularly from multiple partners, can alter vaginal pH as well, and increase the risk of bacterial vaginosis (BV). BV isn’t considered to be a traditional sexually transmitted infection passed back and forth between partners, but rather an imbalance of the usual vaginal flora, which contributes to a vaginal pH imbalance. This imbalance can lead to discharge, a fishy odor and discomfort. BV is typically treated with an antibiotic, but prevention is key. Condoms may help prevent BV.
Medical issues left uncontrolled, such as diabetes, along with frequent antibiotic courses, and steroid use, might increase your risk of a vaginal pH imbalance, in addition to creating an environment more susceptible to vaginal yeast infections. Diets high in sugar and alcohol can fuel yeast infections for those who are prone.
How to Check Vaginal pH
If you think you may be dealing with a vaginal pH imbalance, an at-home testing kit may help. These tests typically come with pH paper strips (or a small, insertable device with pH paper attached, that you can briefly press on the wall of your vagina) in addition to a pH color scale, which you can use to base your results off of. The provided test pH paper will change color based on your current vaginal pH. You can then match the color of your test strip to the color on the provided chart to find out your current vaginal pH.4
At-home vaginal pH testing kits are easy to find in drugstores or online, however, it’s important to keep in mind that a higher- or lower-than-typical vaginal pH alone doesn't indicate that you have an infection. Additionally, the presence of any vaginal blood will render an over-the-counter test kit, inaccurate, so it’s important to be mindful of that as well. Always check-in with your healthcare provider if a vaginal pH test comes back abnormal, as they can help determine the best management option to address your vaginal pH imbalance and get it back on track.
How to Restore Vaginal pH
Check-in with your healthcare provider if chronic or recurrent yeast or BV and odor are issues for you – this could be related to a vaginal pH imbalance. Consider taking a daily oral probiotic with at least 5 billion CFU of the most important strains of lactobacilli aimed at supporting vaginal health.
Finally, be mindful of lifestyle habits we often take for granted. Highly fragrant and heavy chemically-laden soaps, detergents, feminine wipes, menstrual products and personal lubricants are often the culprit when it comes to a vaginal pH imbalance. If you are sensitive, a hypoallergenic regimen, free of these potentially caustic ingredients, might do the trick to help you better manage and maintain a healthy vaginal pH.
Remember a normal vaginal pH means a healthy vagina!
- Chen J, et al. J Sex Med. 2013;10:1575-1584
- Jokar A, et al. IJCBNM. 2016;4:69-78
- Russo R, Edu A, De Seta F. Arch Gynecol Obstet. 2018; 298(1):139-145