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Vaginal pH

a simple assessment highly correlated with vaginal morphology and symptoms in postmenopausal women

Tucker, Kelly M. MD1; Godha, Keshav BS2; Mirkin, Sebastian MD2; Archer, David F. MD1

doi: 10.1097/GME.0000000000001081
Original Articles

Objective: The aim of the study was to determine the utility of vaginal pH as a marker of menopause and vulvar and vaginal atrophy (VVA) before and after local estrogen treatment.

Methods: Vaginal pH was determined using standard pH paper strips in two clinical trials involving postmenopausal women with signs and symptoms of VVA evaluated before and after intervention with vaginal estradiol in softgel capsules. The utility of vaginal pH was evaluated as a screening method for VVA due to menopause and correlations were analyzed between vaginal pH and VVA symptoms, physical changes, and maturation of the vaginal epithelium.

Results: Changes in vaginal pH were significantly correlated with changes in superficial and parabasal cell counts; vaginal epithelial changes of color, integrity, thickness, and secretion; and the VVA symptoms of vaginal dryness and dyspareunia (vaginal pain with intercourse).

Conclusions: Vaginal pH consistently correlated with parabasal and superficial cells and the visual vaginal epithelial changes and symptoms of dryness and dyspareunia, and is thus a simple outpatient procedure that reflects the hormonal milieu and its effects on the vaginal epithelium.

1CONRAD Clinical Research Center, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA

2TherapeuticsMD, Boca Raton, FL.

Address correspondence to: David F. Archer, MD, 601 Colley Avenue, Suite 227, Norfolk, VA 234507. E-mail:

Received 7 December, 2017

Revised 23 January, 2018

Accepted 23 January, 2018

Funding/support: The studies and analyses described were funded by TherapeuticsMD, who also supported editorial assistance before journal submission provided by Kathleen Ohleth, PhD, of Precise Publications.

Financial disclosure/conflicts of interest: KMT, none; KG and SM are employees of TherapeuticsMD; SM has stock/stock options for TherapeuticsMD; DA (within the past 3 y) has received research support from Actavis (previously Allergan, Watson Pharmaceuticals, Warner Chilcott), Bayer Healthcare, Endoceutics, Glenmark, Merck (previously Schering Plough, Organon), Radius Health Inc, Shionogi Inc, and TherapeuticsMD, and has served as a consultant to AbbVie (previously Abbott Laboratories), Actavis (previously Allergan, Watson Pharmaceuticals, Warner Chilcott), Agile Therapeutics, Bayer Healthcare, Endoceutics, Exeltis (previously CHEMO), InnovaGyn, Merck (previously Schering Plough, Organon), Pfizer, Radius Health Inc, Sermonix Pharmaceuticals, Shionogi Inc, Teva Women's Healthcare, and TherapeuticsMD.

© 2018 by The North American Menopause Society.