What happens when your vaginal pH balance is off?

Research has indicated that vaginal health and bladder health are interconnected, meaning if vaginal health is compromised it can negatively impact urinary tract health. Because of this, the health of the vaginal ecosystem is an important factor to consider when looking at your overall urinary health.

Here we explore the complexities of vaginal pH and why it’s important to keep it balanced.

The pH of something indicates how acidic or basic it is. A low pH is acidic, a high pH is basic or alkaline.

The body has various pH levels. Our blood, for example, has a somewhat neutral pH of 7.4. But the acid in our stomachs has and acidic pH of 2. A healthy vaginal pH falls between 3.8 and 4.5

A healthy vaginal pH is moderately acidic. This just means that the healthy bacteria (lactobacilli) are doing their job to protect us against harmful bacteria. Our bodies house an array of lactobacilli strains, and the ones that promote a healthy vaginal pH are strains Lactobacillus Acidophilus, Lactobacillus Rhamnosus and Lactobacillus Reuteri. These bacteria eat the glycogen found in vaginal mucus. In exchange, they produce lactic acid and hydrogen peroxide. Ever wonder why your underwear gets those tiny bleached out patches? This process is the reason!

The lactic acid and hydrogen peroxide byproducts make the vagina moderately acidic, which inhibits the growth of harmful bacteria and yeast which can cause bacterial vaginosis (BV) and yeast infections. When your pH balance is off, that means lactobacilli levels are low and can’t keep opportunistic pathogens in check. So, the harmful bacteria can flourish and colonize the vagina.

• Using scented soaps and body wash on and near your vulva. The chemicals in these products kill off lactobacilli.
• Antibiotics. While they kill off the bad bacteria that’s causing an infection, they also wipe out the good bacteria too.
• Douching or using feminine sprays.
• Scented tampons, wipes, and pads.
• Changes in hormones during menopause means less estrogen which leads to a loss in vaginal lactobacilli causing an imbalance
• Sex. Individuals have very different bacterial microbiomes on their skin. Exposing those microbiomes to the vagina can disrupt the balance.
• Semen’s alkalinity (pH 7.1-8) can alter vaginal pH.
• Tampons that have been inside the vagina for too long.
• Oil-based lubricants like petroleum jelly can remain in the vagina for too long, and disrupt the pH and causing an infection.
• Stress. Fitness expert and trainer Kim Lyons, tells Bustle "Stress can affect your pH balances as much as a poor diet.”

Identifying symptoms is the first step towards seeking medical support and recovery. So, how do you know if your pH balance is off? You may experience BV, yeast infections, or UTI symptoms — all of which are symptoms of unbalanced pH levels.

BV symptoms include:

• Burning or painful urination
• A strong fish-like or foul smelling odor
• Gray or white discharge
• Itching or burning pain in the vagina
• Itching around the vagina

Yeast infection symptoms include:

• Itching
• White, thick, cottage cheese-like discharge
• A yeasty odor
• Redness and swelling of the vulva
• Vaginal dryness
• Painful urination and intercourse

UTI symptoms include:

• A strong, constant or recurring urge to urinate
• A burning sensation when urinating
• Only urinating small amounts when you do urinate
• Cloudy urine instead of transparent
• Blood in the urine, which often looks red, bright pink, or brownish
• Pungent urine
• Pelvic pain, especially in the center of the pelvis and around the area of the pubic bone
• Feeling under the weather with possibly having a fever, chills, or body aches

If you’re experiencing any of these symptoms, contact your physician as soon as possible. They’ll be able to figure out exactly what’s going on, and find a solution best suited to you.

Vaginal odor is completely natural and normal. Dr. Lauren Streicher is an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine tells SELF, “When you look at what’s normal, it can have a mild or slight odor that’s not unpleasant.” Vaginas are like sweat, everyone has their own scent. So if something smells off (strong or fishy) it could be from:

• Bacterial vaginosis
• Forgetting to take out a tampon
• Having sex without a condom
• Your period
• Yeast infection
• Trichomoniasis, which is caused by a tiny parasite that moves between people during sex
• Gonorrhea or chlamydia

Paying attention to what’s normal or not normal for you is important. If you’re experiencing a stronger than usual vaginal odor, see your gynecologist so they can run tests and properly diagnose you.

You can test your pH level with an at-home vaginal pH test kit. The kit includes a pH test paper that you place against the wall of your vagina for a few seconds. The kit also provides a color chart to determine your results. If your pH is above normal, a common cause is BV. If your pH is below normal, it could be a yeast infection.

An abnormal vaginal pH indicates an infection. However, not all vaginal infections cause changes to vaginal pH. So having a normal pH test doesn’t necessarily mean you’re infection-free.

If you struggle with BV, yeast infections, or UTIs it can seem like it’s a never-ending saga of treatments and trips to the clinic or pharmacy. Managing pH balance is a key component of preventing these infections. These tips are a good starting point to keep your vaginal pH balanced:

Try vaginal wipes.

For some women, vaginal wipes can provide relief and cleanliness, especially post-intimacy, after workouts, during a heavy flow, or if you don’t have access to a shower. While your vagina is pH-balanced and cleans itself, some women swear by the effectiveness of pH-balanced wipes.

Take a probiotic for vaginal health.

Taking a probiotic capsule daily will restore lactobacilli levels, your body’s natural defense against harmful bacteria and infections.

Look at your diet.

Besides cutting down on sugary and processed foods, eating foods that are rich in probiotics like kombucha and yogurt. Consuming apple cider vinegar can prevent imbalance, as well as garlic which is a natural anti-fungal. Learn more about the best and worst foods for vaginal pH here.

Avoid antiseptics, scented soaps, or body wash.

Because the vagina self cleans with natural vaginal secretions (discharge) you might be wondering “how do you wash your vagina?” as in, the vulva, labias and the region outside of your vagina. Gently use warm water and hypoallergenic, paraben-free, unscented mild soaps.