Do you have any advice for maintaining a balanced vaginal pH?

Dear Anonymous,

My advice is mainly to leave your vagina alone. It’s gonna do its thing most of the time. You can use warm water regularly to rinse the vulva [reminder: that’s the outer part of the vagina], and maybe even a mild soap if you’re not sensitive. But otherwise, most people won't need to do much. That said, some things should be common sense, like… 

Don’t: put weird stuff in your vagina or sit in non-breathable leggings all day. 

Do: let things air out and wear loose cotton. 

There are some cases in which you may want to work with a gynecologist to either preserve “good” vaginal bacteria or reintroduce it. [“Good” bacteria is what keeps your vaginal pH balanced and not too high]. 

Altering vaginal pH 

For example, if you’re experiencing chronic vaginal issues like yeast infections, a vaginal suppository like boric acid may help restore a healthy pH level in the vagina. But I think it can be problematic when you’re using boric acid on your own without a clinician’s input because you may not do it correctly. When used too much, boric acid suppositories can cause irritation. I usually advise patients to use boric acid vaginal suppositories for a few days following their period, many months in a row, to help the pH rebalance. 

Reintroducing "good" bacteria 

This may be necessary in cases where you’ve used an antibiotic to eradicate problematic bacteria. The issue is that antibiotics also kill the necessary bacteria and can be overused. When that happens, you can consider taking a probiotic to help repopulate some of the bacteria the vagina needs. 

Preserving “good" bacteria 

Probiotics can also help people who are engaging in unprotected vaginal sex with multiple partners. In these cases, probiotics may help prevent the vaginal flora from getting out of whack. But there isn’t a lot of conclusive research about probiotics for vaginal issues, so it's really important to work with a clinician on these matters.