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Williams Gynecology
| Section 1 Benign General Gynecology > |
Chapter 3. Gynecologic Infection
Sections: Normal Vaginal Flora, Antibiotics, Pathogens Causing Genital Ulcer Infections, Pathogens Causing Infectious Vaginitis, Pathogens Causing Suppurative Cervicitis, Pathogens Causing Mass Lesions, Pathogens Causing Pruritus, Urinary Tract Infections, Pelvic Inflammatory Disease, Postoperative Infection, References.
Topics Discussed: gynecological infections.
Excerpt:"Vaginal flora of a normal asymptomatic reproductive-aged woman includes multiple aerobic or facultative species as well as obligate anaerobic species (Table 3-1). Of these, anaerobes are predominant and outnumber aerobic species approximately 10 to 1 (Bartlett, 1977).Typically, the vaginal pH ranges between 4 and 4.5. Although not completely understood, it is believed to result from Lactobacillus species' production of lactic acid, fatty acids, and other organic acids. In addition, amino acid fermentation by anaerobic bacteria results in organic acid production as does bacterial protein catabolism. Glycogen present in healthy vaginal mucosa is believed to provide nutrients for many species in the vaginal ecosystem. Accordingly, as glycogen content within vaginal epithelial cells diminishes after menopause, this decreased substrate for acid production leads to a rise in vaginal pH (Chap. 21, Lower Reproductive Tract Changes). Specifically, Caillouette and associates (1997) showed that a vaginal pH of 6.0 to 7.5 was strongly suggestive of menopause in the absence of symptoms. Moreover, serum follicle-stimulating hormone (FSH) levels and vaginal pH were positively correlated, whereas an inverse relationship was noted between those two and serum estradiol levels.
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