Are Your Ladyparts pH Balanced?

Recently we received a reader question on the pH balance of your vagina—does it matter? How is it regulated? We reached out to David Shobin, MD (who helps us figure out the best birth control for skincare and how estrogen impacts your skin) for the answer: Numerous foods and commercially available products are marketed to restore or maintain "normal vaginal balance." The implication is that, if the vagina is unbalanced, it can lead to a variety of problems, such as infections, discomfort, odor, and discharge. That, then, raises the question of exactly what is normal in the moist confines of the vagina? Normality usually refers to the vagina's pH reading. The vagina is the perfect environment for many species of lactobacilli, which cause a rather acidic ph of 4.0-4.5 (7.0 is neutral; above 7.0 is considered alkaline.) Blood, on the other hand, has a strictly maintained pH of 7.4. At the time of menstruation, therefore, the vaginal pH goes up slightly. But after menses ceases, and under the influence of estrogen, lactobacilli proliferate to restore vaginal acidity. pH is important, but it is normally self-regulating and not under a woman's control. Several things besides menses can affect an acidic pH. Among them: 1. Excessive douching, especially with fragrance enhanced-douches 2. Intercourse (semen has a pH of 7.1-7.8.) Please do not misconstrue this fact to mean "don't have sex," 3. Tampons, by absorbing blood as a culture medium and promoting overgrowth of harmful bacteria 4. Breastfeeding and menopause. Reduced estrogen levels during these times can reduce helpful lactobacilli 5. Antibiotics may kill lactobacilli and allow overgrowth of organisms like yeast. When patients talk about restoring vaginal balance, what they generally mean is, "I have this funky vaginal smell. What can I do about it?" The normal vagina should have no smell whatsoever. Commonly, vaginal odor can be caused poor hygiene, menses, foreign bodies (like a forgotten tampon) or vaginal infections and/or discharges. A bad smell is an indication to see your healthcare provider. But after the problem is resolved, many patients wonder if they can somehow restore and maintain their "vaginal balance" by eating certain foods of food supplements. These oral fixes usually center around eating eating acidic foods, an acidic diet, or consuming probiotics like those in yogurt. Here's what happens when you eat these foods: they get into your GI tract, where they're broken down into essential nutrients. Any acid they contain is largely broken down, but some travels through your intestines—where they may be helpful for intestinal disorders like irritable bowel syndrome, irregularity, etc. A tiny amount of foodstuff acid may wind up in the bloodstream, where it is immediately buffered into the blood's pH of 7.4. None of it reaches the vagina. Bottom line: Acidic diets or probiotics may help your tummy, but they'll have no impact on your twiddle. That being said, probiotics or acidic creams and gel products might be of benefit if inserted directly into the vagina via applicators, but clear evidence for this is still being debated. My best advice is not to become preoccupied about vaginal balance. Instead, if you're worried about odor, discharge, or infection, skip the food truck and call your healthcare provider instead.

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We recently spent 6 weeks training our vaginas with The Elvie. It's a kegel-training device that hooks into your iPone. This is what we learned. We have also tried vaginal steaming—and we can kind of see why Gwyneth loves it so much. Sort of.

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