First things first: What is the vagina, what is the vulva, and what is the difference between the two? In medical terms, the vagina refers to the internal muscular tract extending from the cervix to the vaginal opening.

 

The vulva is the external part of the female genital tract, which includes:

 

To maintain vulvar and vaginal health, a person must ensure that two important aspects remain balanced: their pH, which is a measurement that denotes somethings acidity or alkalinity, and their bacterial balance.

 

Studies indicate that vulvar pH is usually 3.5–4.7, while vaginal pH varies according to a persons age and the stage of their menstrual cycle.

 

So, before a person reaches reproductive age and starts menstruating, their vaginal pH will be 7 (neutral), whereas a person of reproductive age may have a vaginal pH of 3.8–4.4. At menopause, depending on whether or not a person undertakes hormone replacement therapy, their vaginal pH may be 4.5–5 or 6.5–7.

 

When it comes to understanding what constitutes a balanced microbiome in the vagina versus the vulva, however, matters become less clear.

 

In the vagina, bacterial populations shift depending on the phase of the menstrual cycle and, according to some studies, people of different ethnicities also have different vaginal microbiota.

 

As for the vulvar microbiota, specialists have conducted only a few studies with the aim of determining what a normal vulvar bacterial population should look like. That said, existing research does suggest that the vulva naturally features bacteria present in the vagina as well as some species present in a persons feces.

 

However, as one study that names these characteristics concludes, “the vulva is more complex than originally thought,” as vulvar bacterial populations appear to vary greatly among people.