The Influence of Estrogenic Hormone on the H-Ion Concentration and Bacterial Flora of the Vagina of the Immature Monkey *

The introduction of estrin in the treatment of gonorrheal vulvovaginitis in young children by Lewis4 has led to much speculation as to the method by which the hormone overcomes this infection. The development of the infantile vaginal mucosa into a structure resembling the adult tissue, under the influence of estrin, was at first considered as the factor important in the eradication of the gonococci, but further investigation of the mechanism of this form of therapy led Hall and Lewis2 to conclude that the hormone was capable of changing the H-ion concentration of the monkey vagina, usually about neutral, to a markedly acid reaction. This observation was confirmed in female children by Lewis and Weinstein,5 who found that the vaginal secretions become definitely acid in cases of vulvovaginitis treated with estrogenic hormone and that Gram-negative diplococci disappeared from the genital tract when the pH was depressed to about 6.0, thus indicating that the efficacy of hormone treatment of this disease depends largely on the production of an acid reaction of the vaginal secretions. Weinstein and Howard,7 administering estrin intramuscularly in a group of individuals in the post-climacterium, were able to induce the same type of change as that seen in children. Many other investigators have confirmed these findings. In a study of the vaginal hydrogen ion concentration in monkeys treated with estrogenic hormones Ranson and Zuckerman' could not obtain the results reported by the investigators cited above. They studied ovariectomized animals and carried out pH determinations using a glass electrode to ascertain the reaction of washings of the vaginal tract, finding that, "the vaginal pH which falls between