Vaginal pH and what you need to know

You know, pH is a measurement of how acidic or alkaline (base) a substance is. Vaginal pH levels – whether the vagina is acidic or basic – plays an important part in determining if that vagina is healthy. Keep reading to learn more about healthy pH levels, how to correct imbalances, and how to maintain overall vaginal health.


1. What is vaginal pH?

PH is a scale with a value from 0-14 to evaluate the acidity or base of a substance. A pH less than 7 is considered acidic, a pH greater than 7 is alkaline.

The vagina is a smooth muscular tube that connects the vulva to the cervix. The vaginal mucosa is an epithelial, pleated, elastic tissue that is very sensitive to the female hormone estrogen.

In the vagina there is a very rich resident microflora including beneficial and harmful microorganisms. The intimate symbiotic relationship between the vagina and the bacterial community creates a balanced relationship. In which, Doderlein bacillus, also known as Lactobacillus sp . are the predominant bacteria in the flora. They belong to the group of lactic acid bacteria. They have the ability to convert lactose and other sugars into lactic acid for energy.

It is lactic acid that maintains a low pH of the vagina. Thus, Lactobacillus sp. It plays a key role in maintaining vaginal pH.

Vaginal pH and what you need to know

Illustration of the pH scale

2. What is the normal vaginal pH?

Indeed, the vaginal environment is moderately acidic, normally between 3.8-4.5. This is a normal vaginal pH level and is an important indicator of whether the vagina is healthy.

Doderlein bacilli use glycogen from the epithelial cells of the vagina and produce lactic acid. The amount of this glycogen depends on the body's estrogen levels, so vaginal pH will depend on age and estrogen levels.

In short, "normal" pH levels can vary slightly depending on your age and estrogen levels.

  • Girls who have not yet reached puberty and women who have gone through menopause often have a high vaginal pH, possibly up to 6 - 8. The reason is that the vagina does not receive estrogen from the ovaries. So the vocal environment is a glycogen-poor environment. This results in less Lactobacillus bacilli, so less lactic acid.
  • Women of reproductive age (from 15 to 49 years old) pH is maintained in the normal range of 3.5 - 4.5.
  • PH during menstruation is usually 5.4.

In fact, about one-quarter of women have a Lactobacillus-deficient microflora but remain completely normal, healthy, and asymptomatic. In this type of bacteriophage state, the diversity in the composition of the bacteriophage allows a functional environment to be maintained. These women have a high vaginal pH, which can be as high as 5.

The image of Lactobacillus sp.

3. The role of vaginal pH

A normal vaginal pH is very important for the health of the reproductive system in particular and for overall health in general. That is:

Create a protective barrier for the body

This protective barrier prevents unhealthy bacteria and yeast in the body from multiplying too quickly and causing infection. As well as pathogens that enter the body from outside.

A high vaginal pH level – above 4.5 – creates the perfect environment for unhealthy bacteria to thrive. Having a high pH puts you at risk of infections such as bacterial vaginosis, Trichomonas vaginalis infection, etc.

  • Bacterial vaginosis (BV) is an overgrowth of bacteria. Causes symptoms of an unusual gray, white, or yellow vaginal discharge with a fishy odor. It can also lead to vaginal itching and burning while urinating. Women with this condition have an increased risk of more serious infections such as human papillomavirus (HPV), herpes simplex virus, and HIV.
  • Trichomonas vaginalis infection is a sexually transmitted disease. It usually causes no symptoms for the majority of people who are infected. But it can increase your risk of other, more serious STIs, like HIV.

Vaginal pH and what you need to know

Pictures of Trichomonas vaginalis

Vaginal pH is also linked to fertility

Acid levels rise too much, it can reduce your fertility. Sperm thrive in an alkaline environment. The optimal pH for them to swim is between 7.0 and 8.5.

During sex, the pH level inside the vagina temporarily increases. Make the normally acidic environment more alkaline to protect the sperm so they can find their way to the egg. If the vaginal pH is out of balance, it can make conception difficult in many cases.

4. What causes vaginal pH imbalance?

Any of the following can alter the pH level in your vagina:

Unsafe sex.

Because semen is alkaline, it can increase the growth of certain bacteria in the vaginal environment.


These medications not only kill the bad bacteria that cause illness, but they also kill the good bacteria that you need to maintain a healthier, more acidic vaginal pH level. Therefore, you need to use antibiotics exactly as prescribed by your doctor.

Vaginal douching

Although not recommended, about 20% of women regularly wash their vagina with a mixture of water and vinegar or salt. Douching not only raises the pH, but also encourages the growth of harmful bacteria in general.

Menstrual periods.

Menstrual blood is alkaline, so it raises the pH in the vagina. When blood flows through the vagina and gets soaked in tampons or tampons and stays in place, it can raise the pH of the vagina.

Hormonal changes due to age

Chronic illness: diabetes, immunodeficiency...

Radiation treatment

5. Symptoms and signs of vaginal pH imbalance

High pH levels lead to Bacterial Vaginosis or other infections that can cause symptoms such as:

  • Unusual white, gray or green discharge
  • Bad or fishy smell
  • Vaginal itching
  • Burning when you pee

6. What to do when the vaginal pH is out of balance?

If you have symptoms of Bacterial Vaginosis or another condition associated with high vaginal pH, see your doctor. Don't try to douche – it will only unbalance your pH even more.

To treat bacterial vaginosis or trichomoniasis, your doctor may prescribe one of the following antibiotics in pill or cream form:

  • Clindamycin (Cleocin) for Bacterial Vaginosis
  • Metronidazole (Flagyl) for the treatment of bacterial vaginosis or trichomoniasis
  • Tinidazole (Tindamax) for the treatment of Bacterial Vaginosis or Trichomonas

Although antibiotics can affect the pH of the vagina, clearing up the infection is necessary.

7. How to Maintain a Healthy Vaginal pH

To keep the pH of the vagina at a stable level, you can refer to the following tips:

7.1. Use condoms when having sex

Use condoms when having sex. Condoms help you avoid unwanted pregnancy. This barrier will not only protect you from sexually transmitted diseases, but it will also prevent alkaline semen from messing with the pH levels in your vagina.

Vaginal pH and what you need to know

Use condoms when having sex

7.2. Do not douche the vagina

Vaginal douching can inadvertently remove beneficial bacteria, disrupt the vaginal flora and cause changes in vaginal pH. It can raise the pH level in your vagina.

Because your vagina is already naturally self-cleaning. So, you just need to clean the outside of the vagina with clean water or a suitable cleaning solution. Then dry, avoid getting wet.

7.3. Keeping the intimate area clean

During menstruation, it is advisable to change tampons regularly. Helps reduce the risk of infection and reduce the risk of increased vaginal pH, because blood has a higher pH than vaginal pH.

Dry the genital area after using the toilet. When washing only wash the outside, avoid the habit of douching inside the vagina, dry when finished.

Avoid getting wet in the genital area (such as sweat, often soaking in water, not drying after washing, wearing wet underwear, etc.).

Avoid wearing underwear that is too tight, avoid fabrics that do not have high permeability. Should wear loose and airy and should choose cotton material with high sweat absorption.

7.4. Healthy lifestyle

Incorporate foods like fresh fruits, vegetables, yogurt, whole grains into your daily diet. Drink enough water every day. Do not use too much tea, coffee, carbonated drinks, greasy foods.

Daily exercise to strengthen the immune system, make health more supple.

Vaginal pH and what you need to know

Daily physical exercise to improve health

7.5. Eat yogurt

In addition to helping you hit your daily limit of calcium and vitamin D, yogurt is a rich source of the beneficial bacteria Lactobacillus.

7.6. Probiotics

Probiotics can restore a balance of healthy bacteria to your system. Please consult your doctor about using probiotics!

7.7 Periodic gynecological examination

Regular check-ups can help you maintain the health of your intimate area. When there are phenomena such as abnormal vaginal discharge, do not arbitrarily put vaginal drugs. You should see a specialist for proper treatment.

Maintain routine gynecological examination

Thus, we have learned the basics of vaginal pH. Normal vaginal pH ranges from 3.5 to 4.5. And that can vary depending on age and estrogen levels. Vaginal pH can be an indicator of the health of the vagina. So you should maintain good habits to keep yourself a normal vaginal pH level!

Doctor Nguyen Thanh Xuan

Vaginal pH and what you need to know

Vaginal pH and what you need to know

Article by Doctor Nguyen Thanh Xuan about Vaginal pH - the vagina has a very rich resident microflora including beneficial and harmful microorganisms

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