The vaginal environment, in layman’s terms, is the relationship between the various substances that exist in the small “world” of the vagina and each other. If the vaginal environment is normal, then the vagina has the ability to “cleanse itself and fight disease”, while if the vaginal environment is disturbed, then the vagina will become sick and inflammation will occur leading to vaginitis. The main factor that affects the vaginal environment is the type of bacteria in the vagina. A normal vagina contains lactobacilli, which do not cause inflammation, but rather keep the pH of the vagina in the right state to inhibit the invasion and reproduction of harmful bacteria. Lactobacillus converts the glycogen contained in vaginal cells into lactic acid, which keeps the vagina in an acidic environment and is not conducive to the survival of pathogenic bacteria. Some patients casually douche their vaginas with “potions” which change the vaginal acidity and alkalinity, which can lead to vaginitis. Some people get vaginitis after using antibiotics because they kill the “good bacteria” in the vagina and the “bad bacteria” take advantage of the situation. Estrogen levels also affect the vaginal environment. When estrogen levels are low, vaginal cells have less glycogen and less lactic acid to convert, which changes the pH of the vagina in favor of pathogenic bacteria, which is an important cause of vaginitis. As we can see, normal bacteria, proper pH and normal estrogen levels are important mechanisms to ensure the stability of the vaginal environment and maintain the health of the vagina.