Epidemiologic determinants of vaginal pH

Montserrat García-Closas, Rolando Herrero, Concepción Bratti, Allan Hildesheim, Mark E. Sherman, Lidia Ana Morera, Mark Schiffman

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


OBJECTIVES: This study was undertaken to evaluate the relationship between vaginal pH and factors related to cervical cancer. STUDY DESIGN: In a population-based sample of 9161 women from Guanacaste Province in Costa Rica women were categorized into 2 groups, those with vaginal pH in the reference range (4.0-4.5) and those with elevated vaginal pH (5.0-5.5). Odds ratios were used to estimate the relationship between elevated pH and its potential determinants. RESULTS: Aging was strongly associated with increasing vaginal pH, starting at around 45 years of age and continuing into old age. Menopause was responsible for an additional 1.7-fold increase in the odds of having an elevated pH (odds ratio 1.7, 95% confidence interval 1.4-2.0). Human papillomavirus infection and cervical intraepithelial neoplasia were not associated with changes in pH. CONCLUSIONS: Our data indicate that vaginal pH is strongly related to age and to menopausal status and thus could be a marker of age-related hormonal changes. Elevated pH does not appear to be associated with risk of high-grade intraepithelial neoplasia among women infected with human papillomavirus.

Original languageEnglish (US)
Pages (from-to)1060-1066
Number of pages7
JournalAmerican journal of obstetrics and gynecology
Issue number5
StatePublished - 1999


  • Aging
  • Bacterial vaginosis
  • Cervical neoplasia
  • Menopause
  • Vaginal pH

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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