{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:50:13Z","timestamp":1790725813625,"version":"4.1.0"},"reference-count":84,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>In modern society, 75% of all women worldwide have had vaginitis at least once in their lives. The vagina has a dynamic microbial ecosystem with varying vaginal pH levels. An imbalance in that ecosystem can alter the vaginal pH and tip the scale to the point of causing issues, such as vaginitis, that require medical attention. Although vaginitis is not an incurable disease, it causes discomfort and pain that disrupt women\u2019s daily lives. The most common causes of vaginitis include bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis. In this review, we discuss the causes, diagnostic methods, and symptoms of different types of vaginitis, the relationship of vaginitis to the prevalence of other diseases, issues associated with recurrent vaginitis and the immune system, and a variety of effective available treatments. In our article, we summarize the relationship of pH with the vaginal ecosystem, discuss the associated factors of vaginal pH, and finally introduce the different available vaginal pH self-test products.<\/jats:p>","DOI":"10.3390\/diagnostics11111996","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T22:00:23Z","timestamp":1635372023000},"page":"1996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":109,"title":["Vaginal pH Value for Clinical Diagnosis and Treatment of Common Vaginitis"],"prefix":"10.3390","volume":"11","author":[{"given":"Yen-Pin","family":"Lin","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6515-0996","authenticated-orcid":false,"given":"Wei-Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan"},{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyaun 333, Taiwan"},{"name":"Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung 204, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8644-1960","authenticated-orcid":false,"given":"Chao-Min","family":"Cheng","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9975-4210","authenticated-orcid":false,"given":"Ching-Ju","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00003081-199303000-00016","article-title":"Vaginal flora in health and disease","volume":"36","author":"Larsen","year":"1993","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1046\/j.1525-1497.1998.00101.x","article-title":"Evaluation and management of vaginitis","volume":"13","author":"Carr","year":"1998","journal-title":"J. Gen. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00404-005-0740-4","article-title":"Relation between vaginal and endocervical pH in pre- and post-menopausal women","volume":"272","author":"Murta","year":"2005","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/S0002-9378(99)70595-8","article-title":"Epidemiologic determinants of vaginal pH","volume":"180","author":"Herrero","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.3389\/fmicb.2016.01936","article-title":"Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?","volume":"7","author":"Miller","year":"2016","journal-title":"Front. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.resmic.2017.04.004","article-title":"Aerobic vaginitis: No longer a stranger","volume":"168","author":"Donders","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0002-9343(83)91112-9","article-title":"Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations","volume":"74","author":"Amsel","year":"1983","journal-title":"Am. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J. Clin. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"120.e121","DOI":"10.1016\/j.ajog.2010.07.010","article-title":"Contemporary perspectives on vaginal pH and lactobacilli","volume":"204","author":"Linhares","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/jcla.20273","article-title":"Use of vaginal pH in diagnosis of infections and its association with reproductive manifestations","volume":"22","author":"Kerkar","year":"2008","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.bpobgyn.2007.01.002","article-title":"Definition and classification of abnormal vaginal flora","volume":"21","author":"Donders","year":"2007","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/0002-9378(72)90533-9","article-title":"Observations on candidal vaginitis: Vaginal pH, microbiology, and cytology","volume":"112","author":"Peeters","year":"1972","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_14","first-page":"321","article-title":"Vaginitis: Diagnosis and Treatment","volume":"97","author":"Paladine","year":"2018","journal-title":"Am. Fam. Physician"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1155\/2005\/935684","article-title":"Diagnosis of bacterial vaginosis from self-obtained vaginal swabs","volume":"13","author":"Strauss","year":"2005","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_16","first-page":"1095","article-title":"Diagnosis of vaginitis","volume":"62","author":"Egan","year":"2000","journal-title":"Am. Fam. Physician"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.jmwh.2006.07.005","article-title":"Etiology, diagnosis, and management of vaginitis","volume":"51","author":"Mashburn","year":"2006","journal-title":"J. Midwifery Women\u2019s Health"},{"key":"ref_18","first-page":"111","article-title":"Role of pH as a regulator of vaginal physiological environment","volume":"52","author":"Melis","year":"2000","journal-title":"Minerva Ginecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1016\/S0002-9378(97)70345-4","article-title":"Vaginal pH as a marker for bacterial pathogens and menopausal status","volume":"176","author":"Caillouette","year":"1997","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Krauss-Silva, L., Almada-Horta, A., Alves, M.B., Camacho, K.G., Moreira, M.E., and Braga, A. (2014). Basic vaginal pH, bacterial vaginosis and aerobic vaginitis: Prevalence in early pregnancy and risk of spontaneous preterm delivery, a prospective study in a low socioeconomic and multiethnic South American population. BMC Pregnancy Childbirth, 14.","DOI":"10.1186\/1471-2393-14-107"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1037\/0003-066X.44.2.249","article-title":"Adolescent sexual behavior","volume":"44","author":"Furstenberg","year":"1989","journal-title":"Am. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0015-0282(16)49468-9","article-title":"Buffering capacity of human semen","volume":"46","author":"Dony","year":"1986","journal-title":"Fertil. Steril."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/infdis\/jiv488","article-title":"Loss of Innate Host Defense Following Unprotected Vaginal Sex","volume":"213","author":"Nakra","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3109\/03009734.2014.896438","article-title":"Antibiotics in the environment","volume":"119","author":"Larsson","year":"2014","journal-title":"Upsala J. Med. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1159\/000314013","article-title":"Management of aerobic vaginitis","volume":"70","author":"Tempera","year":"2010","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1093\/infdis\/jiv079","article-title":"Rapid and Profound Shifts in the Vaginal Microbiota Following Antibiotic Treatment for Bacterial Vaginosis","volume":"212","author":"Mayer","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.2105\/AJPH.87.7.1207","article-title":"Vaginal douching and adverse health effects: A meta-analysis","volume":"87","author":"Zhang","year":"1997","journal-title":"Am. J. Public Health"},{"key":"ref_28","first-page":"993","article-title":"Vaginal douching as a risk factor for cervical Chlamydia trachomatis infection","volume":"91","author":"Scholes","year":"1998","journal-title":"Obstet. Gynecol."},{"key":"ref_29","first-page":"601","article-title":"Vaginal douching as a risk factor for acute pelvic inflammatory disease","volume":"81","author":"Scholes","year":"1993","journal-title":"Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/epirev\/mxf004","article-title":"Vaginal douching: Evidence for risks or benefits to women\u2019s health","volume":"24","author":"Martino","year":"2002","journal-title":"Epidemiol. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.anireprosci.2010.08.030","article-title":"The normal menstrual cycle in women","volume":"124","author":"Mihm","year":"2011","journal-title":"Anim. Reprod. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"609488","DOI":"10.3389\/fcimb.2020.609488","article-title":"The Interaction between Microorganisms, Metabolites, and Immune System in the Female Genital Tract Microenvironment","volume":"10","author":"Li","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1136\/sti.2005.014621","article-title":"Factors affecting vaginal pH levels among female adolescents attending genitourinary medicine clinics","volume":"81","author":"Brabin","year":"2005","journal-title":"Sex. Transm. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1056\/NEJM199712253372607","article-title":"Vaginitis","volume":"337","author":"Sobel","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"ACOG Practice Bulletin (2006). Clinical management guidelines for obstetrician-gynecologists, Number 72, May 2006: Vaginitis. Obstet. Gynecol., 107, 1195\u20131206.","DOI":"10.1097\/00006250-200605000-00049"},{"key":"ref_36","first-page":"807","article-title":"Vaginitis","volume":"83","author":"Hainer","year":"2011","journal-title":"Am. Fam. Physician"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1001\/archinte.1990.00390200111021","article-title":"The limited value of symptoms and signs in the diagnosis of vaginal infections","volume":"150","author":"Schaaf","year":"1990","journal-title":"Arch. Intern. Med."},{"key":"ref_38","first-page":"555","article-title":"Advances in diagnostic testing for vaginitis and cervicitis","volume":"34","author":"Eschenbach","year":"1989","journal-title":"J. Reprod. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/j.jgyn.2016.09.014","article-title":"Bacterial vaginosis and spontaneous preterm birth","volume":"45","author":"Brabant","year":"2016","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/0002-9378(93)90339-K","article-title":"The microbiology of bacterial vaginosis","volume":"169","author":"Hill","year":"1993","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Coico, R. (2005). Gram staining. Curr. Protoc. Microbiol.","DOI":"10.1002\/9780471729259.mca03cs00"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S0733-8635(05)70044-9","article-title":"Recurrent bacterial vaginosis","volume":"16","author":"Hay","year":"1998","journal-title":"Dermatol. Clin."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1001\/jama.291.11.1368","article-title":"Evaluation of vaginal complaints","volume":"291","author":"Anderson","year":"2004","journal-title":"JAMA"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1471-0528.1994.tb13580.x","article-title":"A longitudinal study of bacterial vaginosis during pregnancy","volume":"101","author":"Hay","year":"1994","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/S0015-0282(99)00310-6","article-title":"Bacterial vaginosis and past chlamydial infection are strongly and independently associated with tubal infertility but do not affect in vitro fertilization success rates","volume":"72","author":"Gaudoin","year":"1999","journal-title":"Fertil. Steril."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/j.1471-0528.2002.01297.x","article-title":"Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility","volume":"109","author":"Wilson","year":"2002","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1258\/ijsa.2009.009193","article-title":"Bacterial vaginosis: A cause of infertility?","volume":"20","author":"Kerkar","year":"2009","journal-title":"Int. J. STD AIDS"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ejogrb.2012.10.031","article-title":"Bacterial vaginosis and infertility: Cause or association?","volume":"167","author":"Salah","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1093\/humrep\/dew026","article-title":"Abnormal vaginal microbiota may be associated with poor reproductive outcomes: A prospective study in IVF patients","volume":"31","author":"Haahr","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0301-2115(03)00096-4","article-title":"An epidemiological survey of vulvovaginal candidiasis in Italy","volume":"110","author":"Corsello","year":"2003","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/j.1552-4604.1992.tb03833.x","article-title":"Evolving pathogens in vulvovaginal candidiasis: Implications for patient care","volume":"32","author":"Horowitz","year":"1992","journal-title":"J. Clin. Pharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3810\/pgm.2010.11.2229","article-title":"Vaginitis: Diagnosis and management","volume":"122","author":"Quan","year":"2010","journal-title":"Postgrad. Med."},{"key":"ref_53","unstructured":"Workowski, K.A., and Berman, S.M. (2010). Sexually Transmitted Diseases Treatment Guidelines, 2010, Centers for Disease Control and Prevention."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1086\/509934","article-title":"Trichomonas vaginalis infection: The most prevalent nonviral sexually transmitted infection receives the least public health attention","volume":"44","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1128\/CMR.11.2.300","article-title":"Clinical and microbiological aspects of Trichomonas vaginalis","volume":"11","author":"Petrin","year":"1998","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/S0002-9378(12)90730-9","article-title":"Trichomoniasis: Trends in diagnosis and management","volume":"165","author":"Lossick","year":"1991","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/00002030-199301000-00015","article-title":"Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: Results from a cohort study","volume":"7","author":"Laga","year":"1993","journal-title":"AIDS"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Oduyebo, O.O., Anorlu, R.I., and Ogunsola, F.T. (2009). The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD006055.pub2"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"507","DOI":"10.2217\/fmb-2017-0270","article-title":"Secnidazole: Next-generation antimicrobial agent for bacterial vaginosis treatment","volume":"13","author":"Nyirjesy","year":"2018","journal-title":"Future Microbiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"705692","DOI":"10.1155\/2010\/705692","article-title":"Treatment of bacterial vaginosis: A multicenter, double-blind, double-dummy, randomised phase III study comparing secnidazole and metronidazole","volume":"2010","author":"Bohbot","year":"2010","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_61","first-page":"CD000262","article-title":"Antibiotics for treating bacterial vaginosis in pregnancy","volume":"1","author":"Brocklehurst","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1093\/clinids\/20.Supplement_1.S80","article-title":"Treatment Options for Vulvovaginal Candidiasis, 1993","volume":"20","author":"Reef","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1007\/BF01974616","article-title":"Fluconazole versus ketoconazole in the treatment of oropharyngeal candidiasis in HIV-infected children. Multicentre Study Group","volume":"13","year":"1994","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1056\/NEJMoa033114","article-title":"Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis","volume":"351","author":"Sobel","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1136\/sti.79.2.151","article-title":"Use of urine polymerase chain reaction to define the prevalence and clinical presentation of Trichomonas vaginalis in men attending an STD clinic","volume":"79","author":"Wendel","year":"2003","journal-title":"Sex. Transm. Infect."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1128\/CMR.00109-16","article-title":"Strategies for Prevention and Treatment of Trichomonas vaginalis Infections","volume":"30","author":"Bouchemal","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Forna, F., and G\u00fclmezoglu, A.M. (2003). Interventions for treating trichomoniasis in women. Cochrane Database Syst. Rev., Cd000218.","DOI":"10.1002\/14651858.CD000218"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/OLQ.0000000000000537","article-title":"Single-Dose Compared With Multidose Metronidazole for the Treatment of Trichomoniasis in Women: A Meta-Analysis","volume":"44","author":"Howe","year":"2017","journal-title":"Sex. Transm. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"654","DOI":"10.4103\/0253-7613.194843","article-title":"Randomized, double-blind, comparative study of oral metronidazole and tinidazole in treatment of bacterial vaginosis","volume":"48","author":"Raja","year":"2016","journal-title":"Indian J. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1086\/323034","article-title":"Tinidazole therapy for metronidazole-resistant vaginal trichomoniasis","volume":"33","author":"Sobel","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ejogrb.2012.05.001","article-title":"Studies on the effects of probiotic Lactobacillus mixture given orally on vaginal and rectal colonization and on parameters of vaginal health in women with intermediate vaginal flora","volume":"163","author":"Strus","year":"2012","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/LGT.0b013e31829156ec","article-title":"Effects of probiotics on the recurrence of bacterial vaginosis: A review","volume":"18","author":"Homayouni","year":"2014","journal-title":"J. Lower Genit. Tract Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ajog.2019.09.001","article-title":"Noncandidal vaginitis: A comprehensive approach to diagnosis and management","volume":"222","author":"Neal","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1600-0897.1987.tb00147.x","article-title":"Immunology of recurrent vaginitis","volume":"15","author":"Witkin","year":"1987","journal-title":"Am. J. Reprod. Immunol. Microbiol. AJRIM"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/0091-6749(88)90909-8","article-title":"A localized vaginal allergic response in women with recurrent vaginitis","volume":"81","author":"Witkin","year":"1988","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"De Bernardis, F., Arancia, S., Sandini, S., Graziani, S., and Norelli, S. (2015). Studies of immune responses in Candida vaginitis. Pathogens, 4.","DOI":"10.3390\/pathogens4040697"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/13693780500096898","article-title":"Immunotherapeutic approaches to enhance protective immunity against Candida vaginitis","volume":"43","author":"Wozniak","year":"2005","journal-title":"Med. Mycol."},{"key":"ref_78","unstructured":"Friedmann, T. (1999). The origins, evolution and directions of human gene therapy. The Development of Human Gene Therapy, Cold Spring Harbor Laboratory Press."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1111\/j.1471-0528.1985.tb04874.x","article-title":"The relation between vaginal pH and the microbiological status in vaginitis","volume":"92","author":"Hanna","year":"1985","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0020-7292(99)00057-0","article-title":"Vaginal fluid pH as a screening test for vaginitis","volume":"66","author":"Thinkhamrop","year":"1999","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/0002-9378(90)90839-Y","article-title":"Statistical evaluation of diagnostic criteria for bacterial vaginosis","volume":"162","author":"Thomason","year":"1990","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_82","unstructured":"U.S. Food and Drug Administration (2018, September 27). Vaginal pH, Available online: https:\/\/www.fda.gov\/medical-devices\/home-use-tests\/vaginal-ph."},{"key":"ref_83","unstructured":"Touch, H. (2021, June 30). Hergeia\u2014Screening Kit for Vaginal Infections. Available online: http:\/\/www.hergeia.com\/en\/index.html."},{"key":"ref_84","unstructured":"Biosynex (2021, June 30). D\u00c9COUVREZ NOS PRODUITS. Available online: https:\/\/www.biosynex.com\/catalogueotc\/."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/1996\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:21:11Z","timestamp":1760167271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/1996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,27]]},"references-count":84,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["diagnostics11111996"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11111996","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,27]]}}}