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Bacterial vaginosis (BV) is caused by a variety of organisms, and occurs in half of women with a vaginal discharge. Because diagnosis through cultures is costly and time-consuming, BV currently is defined clinically when four signs are present: a vaginal pH greater than 4.5, many clue cells seen on wet smear of the discharge, a positive amine odor when discharge is mixed with potassium hydroxide, and a homogeneous discharge. This study evaluated how good vaginal pH alone was for diagnosing BV in asymptomatic pre- and postmenopausal women.
Forty-six premenopausal women had both vaginal pH determinations and cultures (women with yeast were excluded). Of the 34 with a vaginal pH above 4.5, 33 were culture-positive for a bacterial pathogen. In c…