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Background  H 2 O 2  produced by vaginal lactobacilli is believed to protect against infection, and H 2 O 2 -producing lactobacilli inactivate pathogens  in vitro  in protein-free salt solution. However, cervicovaginal fluid (CVF) and semen have significant H 2 O 2 -blocking activity.    Methods  We measured the H 2 O 2  concentration of CVF and the H 2 O 2 -blocking activity of CVF and semen using fluorescence and  in vitro  bacterial-exposure experiments.    Results  The mean H 2 O 2  measured in fully aerobic CVF was 23 ± 5 μM; however, 50 μM H 2 O 2  in salt solution showed no  in vitro  inactivation of HSV-2,  Neisseria gonorrhoeae ,  Hemophilus ducreyii , or any of six BV-associated bacteria. CVF reduced 1 mM added H 2 O 2  to an undetectable level, while semen reduced 10 mM added H 2 O 2  to undetectable. Moreover, the addition of just 1% CVF supernatant abolished  in vitro  pathogen-inactivation by H 2 O 2 -producing lactobacilli.    Conclusions  Given the H 2 O 2 -blocking activity of CVF and semen, it is implausible that H 2 O 2 -production by vaginal lactobacilli is a significant mechanism of protection  in vivo .

Cervicovaginal fluid and semen block the microbicidal activity of hydrogen peroxide produced by vaginal lactobacilli