pH‐balanced tampons: do they effectively control vaginal pH?

Objective  To determine if tampons lubricated with pH-balanced gel are effective at maintaining normal vaginal pH. Design  Randomised controlled trial. Setting  Urban family planning clinic and teaching hospital. Population  Healthy volunteers using the combined oral contraceptive pill. Methods  Women were randomised to use an existing lubricating gel (pH 5.1) or a lactic acid-buffered gel (pH 3.8–4.2) with regular size, non-applicator tampons. In the preceding control cycle, women used identical tampons without gel. Main outcome measures  Vaginal pH ≤ 4.5, microbiology (candida and bacterial vaginosis [BV]) and colposcopic appearance within 72 hours of tampon use, subject acceptability and symptoms. Results  Eighty-one out of 98 (83%) women completed the study. No significant difference was observed between tampons with the standard gel formulation, the pH-balanced gel and nonlubricated tampons in terms of vaginal pH, microbiological evidence of candida or BV, or colposcopic appearance. Acceptability scores were significantly higher for lubricated tampons compared with nonlubricated tampons (P < 0.05), although there was no difference in reported symptoms. Conclusions  Tampons lubricated with pH-balanced gel do not control vaginal pH. There was no evidence of measurable health benefits of lubricated tampons, but women preferred tampons without lubrication.