What is cytolytic vaginosis?

Cytolytic vaginosis is a type of vaginosis usually caused by an overgrowth of lactobacilli inside the vagina. Lactobacilli are usually part of the normal flora of the vagina, and there are many different strains of lactobacilli within the normal vagina. Cytolytic vaginosis often causes the pH inside the vagina to be lower than normal and can cause symptoms including itching, redness, and discharge. Symptoms often worsen as the menstrual cycle progresses, and most women experience symptom relief once menstrual flow begins. Cytolytic vaginosis is not a sexually transmitted disease, and most doctors don't even consider it an infection, because it occurs when excessive numbers of normal vaginal lactobacilli build up.

Many women, and even doctors, are not aware that cytolytic vaginosis exists. The condition is often misdiagnosed as candidiasis vaginitis or vaginal yeast infection. Women who continue to experience symptoms of vaginal itching, inflammation, and discharge, despite attempted treatment with antifungal preparations, may in fact be suffering from cytolytic vaginosis.

Common symptoms of cytolytic vaginosis can include itching and swelling of the vulva. The discharge may be clumpy and thick, or thin and watery. In severe cases, pain during urination or pain during intercourse may occur.

Cytolytic vaginosis symptoms often occur cyclically. Symptoms usually appear after the menstrual flow stops and may steadily worsen until the menstrual flow starts again. Menstrual flow can relieve symptoms because it changes the vaginal pH.

Doctors are often unable to determine the cause of this condition. Factors that can contribute to overgrowth of lactobacilli within the vagina may include hormonal changes, sexual activity, pregnancy, or use of birth control. Treatment generally seeks to restore the vaginal pH to a normal level.

While other types of vaginosis can be treated with antibiotics or antifungal medications, cytolytic vaginosis is usually treated with baking soda suppositories, douches, or sitz baths. In general, women are advised to try sitz baths first, as these are the least irritating to inflamed vulvar tissues. Typically, two to four tablespoons of baking soda are dissolved in a bathtub filled with a few inches of warm water. In general, patients are advised to sit in this solution for at least 15 minutes, twice daily, to help restore normal vaginal pH.

If sitz baths are unsuccessful, baking soda douches or suppositories may help. Douches can be made by mixing one to two tablespoons of baking soda in one pint (0.47 liters) of warm water. Suppositories can be made by filling gelatin capsules with baking soda. A paste of baking soda and water can be used to relieve external itching and inflammation.

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