Vaginal pH as a marker for bacterial pathogens and menopausal status
Vaginal pH as a marker for bacterial pathogens and menopausal status
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DOI：
10.1016/s0002-9378(97)70345-4
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发表时间：
1997-06-01
影响因子：
9.8
通讯作者：
Roy, S
中科院分区：
文献类型：
--
作者：
Caillouette, JC;Sharp, CF;Roy, S
目的：我们的目的是确认绝经前妇女细菌性病原体患者阴道pH值升高的预期，并检查未接受和接受激素替代治疗的绝经患者血清促卵泡激素和雌二醇水平与阴道pH值的关系。研究设计：用苯那嗪（硝嗪）pH纸测定253例单独私人诊所例行窥镜检查患者阴道pH值。这些病人都没有怀孕。研究人员测量了172名患者的血清促卵泡激素和雌二醇水平，并对82名患者进行了阴道培养。阴道pH值与阴道培养及血清促卵泡激素和雌二醇水平相关。结果：所有记录有细菌性病原体的绝经前患者阴道pH值升高。绝经期患者血清雌二醇水平与阴道pH呈负相关，血清促卵泡激素水平与阴道pH呈直接统计学相关。结论：阴道pH值的测量是有用的，有效的，廉价的筛查目的。阴道pH值为4.5与绝经前血清雌二醇水平和细菌病原体的缺失是一致的。阴道pH值在5.0至6.5范围内升高提示诊断为细菌性病原体或血清雌二醇降低。对于pH值升高的患者，应进行阴道培养以确定诊断。在没有细菌病原体的情况下，阴道pH值为6.0至7.5强烈提示绝经。在雌激素替代治疗期间通过阴道pH值滴定雌二醇水平可以帮助更年期妇女避免副作用或停止治疗。
OBJECTIVES: Our purpose was to confirm the elevation of vaginal pH expected in patients with bacterial pathogens in premenopausal women and to examine the relationship of serum follicle-stimulating hormone and estradiol levels to vaginal pH in menopausal patients without and with hormone replacement therapy.STUDY DESIGN: Vaginal pH was determined by phenaphthazine (Nitrazine) pH paper in 253 patients seen in a solo private practice for routine speculum examination. None of the patients were pregnant. Measurements were made of serum levels of follicle-stimulating hormone and estradiol for 172 patients and vaginal cultures were taken from 82 patients. Vaginal pH was correlated with vaginal cultures and serum follicle-stimulating hormone and estradiol levels by use of statistical analysis.RESULTS: Vaginal pH was elevated in all premenopausal patients with documented bacterial pathogens. Serum estradiol levels showed an inverse and serum follicle-stimulating hormone levels a direct statistical correlation with vaginal pH in menopausal patients.CONCLUSIONS: Measurement of vaginal pH is useful, effective, and inexpensive for screening purposes. A vaginal pH of 4.5 is consistent with a premenopausal serum estradiol level and the absence of bacterial pathogens. An elevated vaginal pH in the 5.0 to 6.5 range suggests a diagnosis of either bacterial pathogens or decreased serum estradiol. In patients with an elevated pH, vaginal culture should establish the diagnosis. In the absence of bacterial pathogens, a vaginal pH of 6.0 to 7.5 is strongly suggestive of menopause. Titration of estradiol level by vaginal pH during estrogen replacement therapy may help menopausal women avoid side effects or cessation of therapy.