Vaginal pH as a marker for the perimenopause : A comparison with follicle-stimulating hormone (FSH)‎

Abstract EN

Background Despite the important implications for women's health and reproduction, little is known about the mechanisms that control and regulate vaginal pH. Aim : the aim of this study is to determine if whether vaginal pH can replace serum Follicle Stimulating Hormone (FSH) as an initial screening test for per menopause. Methods : A cross-sectional com-purgative study was performed on 80 premenopausal women with menopausal symptoms.

Vaginal pH was measured with hydroid strip (range 4.5-7) and serum FSH and oestradiol levels were assayed. Results : All premenopausal women were more evenly distributed across pH categories of 5-6.5.

When vaginal pH was assessed as a predictor for oestradiol status, the sensitivity was 80.88%, specificity 58.33%, positive predictive value (PPV) 91.67%, and the diagnostic accuracy was 77.5%.

The average oestradiol value for women with pH > 4.5 was 22.18 ± 5.98 pg /ml.

When FSH was used as a predictor of oestradiol levels, the sensitivity was 82.35%, specificity 33.33%, PPV was 87.5% and diagnostic accuracy was 75%.

The average FSH value for perimenopausal women with oestradiol <40 pg /ml was 44.24 ±7.4 MIU/ml.

Serum oestradiol showed a significant negative correlation (r = - 0.96 P=0.0001), whereas, serum FSH showed a significant positive correlation (r=0.92, P = 0.0001) with vaginal Ph. Conclusion : vaginal pH is a simple, accurate and cost-effective diagnostic tool for the per menopause.

In the absence of vaginitis, an elevated vaginal pH < 4.5 and serum FSH ≥ 20 MIU/ml are good predictors of low oestradiol level (<40 pg /ml) with nearly similar sensitivity and accuracy.

Hence, vaginal Ph can be a suitable alternative to serum FSH as an initial screening test for per menopause