What Is a Vaginal pH Test?

A vaginal pH test measures how acidic or alkaline your vagina. Your vaginal pH is a key indicator of overall vaginal health and can tell you if you’re in dysbiosis (the medical term for an imbalanced microbiome). Keep scrolling to learn more about vaginal pH tests, how they work, how they differ from a vaginal microbiome test, and — more importantly — whether you should bother taking one. 

What is vaginal pH?

The pH scale measures the acidity or alkalinity of a water-based solution, including within the human body. It ranges from zero to 14, with seven being neutral. Anything below seven is acidic (like vinegar or lemon juice), while anything above seven is alkaline or basic (for example, bleach or ammonia).

Most healthy people will have a vaginal pH of between 3.8 and 4.5. This means that the environment is moderately acidic, and it's important for the bacteria in your vaginal microbiome. The acidity is determined by lactic acid-producing bacteria called Lactobacillus, the "good" bacteria that help prevent unwanted infections. However, any shift in your microbiome's normal balance can alter your pH. While the bacteria in your vagina work overtime to keep your pH balanced, there are plenty of things that can throw a spanner in the works, such as:

• Your period: Menstrual blood is slightly alkaline, which can temporarily elevate your pH and put you at a higher risk of developing a vaginal yeast infection or bacterial vaginosis. 
• Unprotected sex: Semen has a high pH, which can raise the risk of infection. Sex can also introduce bad bacteria or other pathogens that mess with your natural balance.
• Douching: Using a vaginal douche can wash away protective bacteria and mess up your pH. Remember, your vagina cleans itself!
• Menopause: Lower levels of the hormone estrogen in menopause can alter your vaginal pH levels and make vaginal infections more likely. 
• Antibiotics: Although they get rid of harmful bacteria, they can also kill off the good bacteria that help keep your vagina acidic.

How do you know if your pH balance is off?

There are a few key signs that your vaginal pH is off. If you notice any of the following signs, it could indicate an imbalance in your vaginal pH:

• Bad odor: While it's normal for your vagina and discharge to have a mild odor, any sudden or noticeable changes in vaginal odor could indicate a pH imbalance. Foul, rotten, or fishy-smelling discharge can be a symptom of bacterial vaginosis (BV) or a sexually transmitted infection like trichomoniasis. 
• Unusual vaginal discharge: Any changes in the color, consistency, smell, and quantity of vaginal discharge could mean your vaginal pH is off. Grey, watery discharge that has a fishy smell could be a sign of BV or trichomoniasis, while white, thick, and clumpy discharge could be a sign of a yeast infection or chlamydia. See your healthcare provider if you're experiencing unusual vaginal discharge.
• Itching or discomfort: If you're feeling itchy, irritated, or red around the vagina and vulva, it might be a sign of a pH imbalance. This could be due to a vaginal yeast infection or chlamydia. It's best to see your healthcare provider if you experience symptoms like these.
• Burning sensation: Feeling a burning sensation when you pee or have sex could mean your pH level is off. This discomfort could be due to a yeast infection or sexually transmitted infections such as chlamydia or gonorrhea. 

How to test vaginal pH

Vaginal pH tests are over-the-counter kits that let you check how acidic your vagina is. 

You can easily find an over-the-counter vaginal pH test kit at your local pharmacy or drugstore, and they're really simple to use. Different brands may have slight variations, but typically each kit includes a vaginal swab, pH test paper, and a chart to help you understand the results.

To collect a vaginal fluid sample, gently swab the inside of your vagina and then wipe the cotton swab on the test area of the pH test strip. The color of the test area will start changing right away. You'll then need to match the color to the closest color block on the test pouch’s color chart. If you're color-blind, it's best to have someone help you read the results. Depending on the test outcome, you may need to see your healthcare provider for further diagnosis and treatment of a vaginal infection.

Vaginal pH is only an approximation of the amount of lactic acid produced in the vagina, so a vaginal pH test is more like a health metric rather than a diagnostic tool. A vaginal pH test will tell you how acidic your vagina is, but it won't tell you whether or not you have a vaginal infection, or what kind of infection you have.

Vaginal pH test vs vaginal microbiome test

Another type of at-home vaginal test is a vaginal microbiome test, which detects levels of certain bacteria and other microbes present in your vagina. 

The vaginal microbiome is the complex ecosystem of microorganisms, including bacteria and fungi, that live inside the vagina (aka the vaginal microbiota or vaginal flora). Everyone’s vaginal microbiome is unique, but research suggests that a “healthy” microbiome is one dominated by Lactobacillus. Lactobacilli protect you from infections by producing lactic acid and keeping your vaginal pH acidic. So your vaginal pH will change based on the bacterial makeup of your microbiome. That’s why an elevated pH can indicate a vaginal infection like BV. 

So what’s the difference between a vaginal pH test and a vaginal microbiome test? A pH test can't reveal which bacteria are present in your vaginal microbiome nor their levels. A vaginal microbiome test, on the other hand, can. 

There are different types of vaginal microbiome tests out there, and how comprehensive and accurate a test is depends mainly on the sequencing technology used (aka, how they analyze the results). But for the most part, all vaginal microbiome tests can give you an insight into what bacteria and fungi are present in your vagina. Evvy’s vaginal microbiome test uncovers over 700 bacteria and fungi, including those missed by traditional testing. That way, you can get a high-fidelity breakdown of your microbiome and get to the bottom of any unusual vaginal symptoms you might be experiencing, like itching, odor, and discharge. 

Although vaginal pH tests are nowhere near as comprehensive as vaginal microbiome tests, they’re a lot more accessible and usually stocked in most drugstores — they can be a helpful starting point if you’re in a pinch. For example, you start noticing some unusual vaginal symptoms and want to know ASAP if something’s off down there. They can offer some peace of mind, or, on the flip side, confirmation that you should schedule that OBGYN check-up. But other than telling you whether your pH is out of whack, they’re not particularly useful. 

FAQ

What is the normal vaginal pH?

A healthy vagina typically has a pH level between 3.8 and 4.5 (on a scale from one to 14). A pH higher than 4.5 is usually a sign of an imbalanced microbiome and is often a symptom of a vaginal infection like bacterial vaginosis. Vaginal pH tests can show if your vagina is acidic enough to fight off bacteria and reduce the risk of infection. 

What pH is a yeast infection?

Vaginal pH levels range anywhere between 3.8 and 4.5. When you have a vaginal yeast infection (also known as vaginal candidiasis), the vaginal pH is around 4.0 to 4.7 but it usually sits at around 4.5. That means you might take a vaginal pH test and think you're in the clear because your pH isn't too elevated. A vaginal pH test isn't comprehensive enough to tell you whether you have a yeast infection, so if you notice any unusual vaginal discharge, itching, or a burning sensation, you should see your healthcare provider. They can do a pelvic test and take a vaginal swab sample to test for any yeast present.

How can I test my pH level at home? 

Vaginal pH tests are pretty accessible, and you can find them in most drugstores or pharmacies. Each test comes with a vaginal swab, pH test paper, and a chart to help you understand the results. To test your pH at home, use the swab to collect a sample of your vaginal fluid, then wipe it on the pH paper. The color of the paper should start changing immediately. 

What does a vaginal swab test for?

A vaginal swab tests for specific bacteria or fungi present in your microbiome. There are different technologies used to analyze the vaginal microbiome, and the type of technology will directly affect how comprehensive (how many species it can test for) and accurate (the levels of those species) the test will be. This is because the technology determines how many bacteria and fungi you can look for at one time, and which kinds of bacteria or fungi you can accurately test for. Evvy’s vaginal microbiome test can test for over 700 bacteria and fungi, including those missed by traditional testing.