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Cytolytic vaginosis is a type of vaginosis generally caused by excessive growth of lactobacilli inside the vagina. Lactobacilli usually form part of the vagina's normal flora, and there are many different strains of lactobacilli inside the normal vagina. This condition often causes the pH inside the vagina to be lower than normal, and can lead to symptoms including itching, redness, and discharge. Symptoms often worsen as the menstrual cycle progresses, with most women experiencing relief from symptoms once the menstrual flow starts. Cytolytic vaginosis is not a sexually transmitted disease, and most doctors don't even consider it an infection, because it occurs when excessive amounts of normal vaginal lactobacilli accumulate.
Many women, and even physicians, aren't aware that cytolytic vaginosis exists. The condition is often misdiagnosed as candidiasis vaginitis, or vaginal yeast infection. Women who continue to suffer from symptoms of vaginal itching, inflammation, and discharge, despite attempted treatment with anti-fungal preparations, may in fact be suffering from cytolytic vaginosis.
Common symptoms of this condition can include itching and inflammation of the vulva. Discharge may be lumpy and thick, or thin and watery. In severe cases, pain with urination or pain with intercourse can occur.
The symptoms of cytolytic vaginosis often occur cyclically. Symptoms usually appear after the menstrual flow ceases, and may steadily worsen until the menstrual flow begins again. The menstrual flow can relieve symptoms because it changes the vaginal pH.
Physicians often can't pinpoint a cause for this condition. Factors that can contribute to the overgrowth of lactobacilli inside the vagina can include hormonal changes, sexual activity, pregnancy, or use of contraception. Treatment generally seeks to restore the vaginal pH to a normal level.
While other types of vaginosis may be treated with antibiotics or anti-fungal medications, cytolytic vaginosis is usually treated with baking soda suppositories, vaginal douches, or sitz bathes. Women are generally advised to try sitz baths first, since these are least irritating to the inflamed vulvar tissues. Two to four spoonfuls of baking soda are usually dissolved in a bathtub filled with a few inches of warm water. Patients are generally advised to sit in this solution for at least 15 minutes, twice a day, to help restore normal vaginal pH.
If sitz baths aren't successfully, baking soda douches or suppositories might help. Douches can be made by mixing one or two spoonfuls of baking soda in a 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 might be used to relieve external itching and inflammation.