Vaginal pH as a Diagnostic Tool for Menopause: A Preliminary Analysis

INTRODUCTION: Menopause is defined as the permanent cessation of menstruation, as a result of decrease in ovarian follicles and the loss of ovarian activity. There is decrease in inhibin B level which causes decrease in negative feedback on the serum follicle-stimulating hormone (FSH), which in turn increases the level of serum FSH. Serum FSH is routinely used as a marker of menopause. Decline in the estrogen level causes thinning of vaginal epithelium, resulting in less exfoliation of the vaginal epithelial cells, lesser available glycogen, and decreased substrate for acid production, leading to increase in vaginal pH. AIMS: The aim of this study is to compare the sensitivity of vaginal pH versus serum FSH level to diagnose menopause. SETTINGS AND DESIGN: This is a cross-sectional study, performed in obstetrics and gynecology outpatient department of a teaching hospital of central Gujarat. SUBJECTS AND METHODS: A total of 120 women who had their last menstrual period >1 year back (menopause) were included in the study. Vaginal pH was measured and serum sample was taken to measure FSH level. Sensitivity of both vaginal pH and serum FSH to diagnose menopause was compared. McNemar test was used to analyze the convergence of the two methods for the diagnosis of menopause. RESULTS: In the absence of vaginal infection, sensitivity of vaginal pH to diagnose menopause was 90%, while sensitivity of the serum FSH was 85%. CONCLUSIONS: Sensitivity of the vaginal pH is similar to the serum FSH for diagnosis of menopause.