17 March 2023

Vaginal pH: How to keep a healthy balance

Vaginal pH
Consultant Gynaecologist
Dr Mireia Galian

IVI Birmingham


Vaginal pH measures how acidic or alkaline the environment in your vagina is, with a normal vaginal pH being between 3.8 and 4.5. It’s the slightly acidic end of the pH scale of 0 – 14, with pure water coming in the middle at 7.

Why is vaginal pH balance important, and what happens if it becomes imbalanced? This article explores why your pH levels may become imbalanced, and to what extent an out-of-kilter vaginal pH balance can reflect your overall vaginal health, including your potential fertility. We also explore how you can protect yourself against any imbalance, how to know if yours is out of balance, including how to use and interpret a vaginal pH test, and the steps you can take to fix an imbalanced vaginal pH.

What is vaginal pH?

PH refers to potential Hydrogen, with the lower numbers being on the acidic side and above 7 being alkaline. For comparison purposes, a healthy skin surface is slightly acidic, at between 4 and 7, with the ideal skin surface balance being just under 5. So, the ideal vaginal pH of 3.8 – 4.5 is slightly more acidic than the skin’s surface. A slightly acidic pH helps ward off bacterial and fungal infections.

Before reaching for the testing kit, it’s worth bearing in mind that a person’s vaginal pH can vary throughout their lifetime, even through the monthly menstrual cycle. For example, during your period, the presence of blood will raise the pH, while semen, with a pH of 7.1 to 8, would also increase the level. Before puberty and after menopause, you could expect it to be slightly higher, usually over 4.5.

What causes an imbalanced vaginal pH?

Both external and internal factors can easily disrupt the natural pH balance of your vagina. If the environment is too alkaline or too acidic, healthy vaginal flora decrease and infections like thrush and bacterial vaginosis may develop. Signs of these include:

  • Burning or itching in the vagina
  • A thicker-than-normal discharge
  • Changes in odour
  • Frequent vaginal infections

There are many possible causes of a vaginal pH imbalance. It’s well-known that a course of antibiotics, while effective in the short term at killing off harmful bacteria, also destroys friendly bacteria, frequently resulting in an episode of thrush or another fungal infection. Other causes of an imbalance can include:

  • Douching: Although it may make sense to ‘cleanse’ the inside of the vagina, most medical specialists advise against douching. Using a douching tool inside your vagina actually increases the pH and raises the likelihood of an overgrowth of harmful bacteria.
  • Dietary and lifestyle factors: Fast foods, sugar, tobacco, caffeine, and alcohol can all throw off your natural pH balance.
  • Stress: High stress levels can affect your immune system and make you more susceptible to infection.
  • Obesity: Being overweight can make you more susceptible to yeast infections.

Can the wrong vaginal pH lead to infertility?

When your vagina has the optimum level of acidity, it protects you from bacteria. But too much acidity around the vagina and cervix can weaken and even kill sperm, which may be a factor behind a difficulty conceiving. A lowered level of acidity allows the sperm, which are more alkaline, to survive and move into the fallopian tubes to fertilise an egg.

An imbalanced vaginal pH is only one of many possible causes of infertility. Unless it is associated with other obstacles to conception, it should be easy to remedy. If you need to know more about the causes of infertility, you can find lots of information on our website. There you’ll also find guidance on accessing a fertility assessment, which could help you to identify the underlying cause of any problems.

How to protect and restore your vaginal pH balance

There’s plenty you can do in terms of diet and lifestyle that should protect your delicate pH balance and keep a healthy vaginal environment. Some of these include:

  • Avoiding douching and washing with harsh soaps: A gentle cleanser or soap, and no soap inside the vagina, is all you need.
  • Probiotic supplements: These can help keep a healthy balance both in your gut and your vagina. Some foods behave as natural probiotics, such as yoghurt, kombucha (fermented tea), miso, and any fermented foods such as sauerkraut.
  • Using barrier protection during sex (unless you’re trying to get pregnant!): Barrier methods such as condoms protect you from unintended pregnancy and STDs, but also prevent upsetting your pH levels.
  • Change your tampons regularly: If you use tampons, changing them regularly during your period can help maintain the correct vaginal pH. Blood is slightly alkaline, so prolonged contact can disrupt your balance.
  • Natural remedies: Many natural health advisors recommend natural remedies such as garlic tablets and diluted apple cider vinegar.
  • Reduce stress: Reducing stress can also have an impact. Activities such as exercise, deep breathing, listening to music, or focusing on a favourite activity can reduce stress and help restore your natural balance.

Taking a vaginal pH test

You can find over-the-counter kits that will test your vaginal pH balance. Most involve placing a strip of treated paper against the vaginal wall for a few seconds. Kits contain a colour chart which allows you to compare your results with the chart to show you the balance and indicate whether it is too alkaline, too acidic, or just right.

But a word of caution – a home test can tell you if the balance is wrong, but can’t help you identify the cause of the imbalance or whether you have any infection that needs treatment. If you have any doubts or are showing any signs of infection, it’s best to consult your medical advisor.

If you are concerned that your vaginal pH may be affecting your fertility, you can also talk to us. Just contact us at IVI using our online contact form.

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