Any woman who has an undiagnosed vaginal discharge should consider Cytolytic Vaginosis as a possible culprit. It is not as common as bacterial vaginosis or yeast infection (candida) but is sometimes confused with them.
A low vaginal pH allows the normally useful Lactobacilli to run riot!
Various members of the Lactobacilli family make up the usual vaginal microflora and Lactobacilli are normally a wonderful bacteria to have in the urogenital area. They repel pathogens such as e coli, candida, Gardnerella vaginalis and Mobilincus species by producing H2O2 and other inhibitory substances such as acidolin, and also by competing for nutrients.1
But occasionally, the Lactobacilli get a taste for power and an overgrowth of them results in a destruction of vaginal cells.
This is called Cytolytic Vaginosis, (also called cytolytic vaginitis, cytolysis vaginosis, cytolysis vaginitis) or Doderlein's cytolysis.
You can read about a simple treatment for CV lower on the page - but first let's look at symptoms.
A vaginal swap taken by your doctor will show no signs of yeast infection but will show too many Lactobacilli and epithelial vaginal cells. Vaginal pH will be low 3.5-4.5.
Treatment is by raising the pH of the vagina which will make it a slightly less desirable place for all those Lactobacilli. Your doctor will probably suggest something like taking a Sitz bath. Check out that link for a good recipe for CV.
You can also hear how one reader has kept herself free of CV for over a year now using that simple recipe. This is very encouraging news for any woman wanting to treat cytolytic vaginosis.
Douching may be suggested by your doctor. This always carries the risk of introducing further bacteria into the upper reproductive tract, so don't go down this road unless your doctor advises it.
Stop taking/using antifungals - they can not help Cytolytic Vaginosis because it is not caused by a fungi.
According to several studies Lactobacilli build up a barrier against candida overgrowth (yeast infection) by blocking the adhesion of yeasts to epithelial cells through competition for nutrients.2 This is a good thing.
Unfortunately, some women within the reproductive age group may get an overgrowth of Lactobacillus strains and develop CV.
A 2004 study3 looking into the diagnosis of CV came to this conclusion:
1. The rate of Cytolytic Vaginosis cases among women with symptoms similar to vulvovaginal candidiasis was found to be 7.1%.
2. The results of this study, much like the previous studies in the literature, show how important it is for doctors to be careful when evaluating women with presumed vaginal thrush.
This report appeared to be complaining that a misdiagnosis can lead to the patient "pestering their gynecologist again and again" in order to resolve their complaint, and, of course, means that women are first of all treated with drugs that are useless for CV.
Maybe, if the doctors got it right the first time, you wouldn't have to "pester" your gynecologist again and again!
1. Sharp HC, Kronh MA, Klebanoff SJ, et al. The relationship of hydrogen peroxide producing lactobacilli vaginosis and genital microflora in pregnant women. Obstet Gynecol 1992;79:369 — 73
2. Sobel JD. Pathogenesis and treatment of recurrent vulvovaginal candidiasis. Clin Infect Dis 1992;14(Supp 1):48 — 53
3. Cytolytic vaginosis: misdiagnosed as candidal vaginitis. Nilgun Cerikcioglu1 and M. Sinan Beksac2Infect Dis Obstet Gynecol 2004;12:13 — 16