What are the other Names for this Condition? (Also known as/Synonyms)

• Doderlein’s Cytolysis
• Lactobacillus Overgrowth Syndrome

What is Cytolytic Vaginosis? (Definition/Background Information)

• Cytolytic Vaginosis is a form of bacterial vaginosis that is characterized by the overgrowth of Lactobacillus bacteria and epithelial cell disintegration (lysis) resulting in abnormally large amounts of vaginal discharge in women. In many cases, the condition is misdiagnosed as a yeast infection
• The condition may present itchiness, painful sex, burning sensation on urination, and general discomfort. Mild cases of Cytolytic Vaginosis may not require any treatment, although for moderate to severe cases, douching with sodium bicarbonate (baking soda solution) is usually recommended

Who gets Cytolytic Vaginosis? (Age and Sex Distribution)

• Cytolytic Vaginosis is largely observed in adult women
• Worldwide, there is no racial or ethnic preference observed
• According to some studies, Cytolytic Vaginosis may constitute between 1.5 to 2% of all gynecological health issues

What are the Risk Factors for Cytolytic Vaginosis? (Predisposing Factors)

• Presently, the risk factors for Cytolytic Vaginosis are unknown

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cytolytic Vaginosis? (Etiology)

• Cytolytic Vaginosis is caused from an overgrowth of lactobacilli, which is a naturally-occurring bacteria (termed ‘good bacteria’) within the vaginal tract. The bacteria help maintain the pH value of vagina and protects it from infections by producing the antiseptic agent hydrogen peroxide
• In Cytolytic Vaginosis, the lactobacilli rapidly multiply and increase in quantity, which results in the cells lining the vaginal tract to disintegrate due to cell wall rupture. These are then shed as vaginal discharge along-with other vaginal secretions

What are the Signs and Symptoms of Cytolytic Vaginosis?

The signs and symptoms of Cytolytic Vaginosis are seen in a cyclic manner and may be similar to a yeast infection (such as vaginal thrush). It may also be mild or severe. Mild cases are usually asymptomatic, and the affected women may not be aware of the condition.

Some of the signs and symptoms include:

• Off-white or white vaginal discharge, which may be watery thin or thick as curd
• Often, the discharge is in large quantities
• Feeling of discomfort, irritation, and itchiness in the region
• Burning sensation on passing urine
• Difficulty in having sex

The signs and symptoms get worse (after ovulation) prior to the next menstrual period, and this continues cyclically.

How is Cytolytic Vaginosis Diagnosed?

A diagnosis of Cytolytic Vaginosis may involve the following exams and procedures:

• Physical (vaginal) examination and medical history evaluation
• pH value test of the vagina, by placing a strip of litmus paper
• Examination of vaginal discharge or fluids (wet prep test), to test for other infection types
• Whiff test, to test odor of the vaginal discharge
• Culture of vaginal discharge

A differential diagnosis may be considered to eliminate other infections/conditions, such as vaginal thrush, that may present similar signs and symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cytolytic Vaginosis?

The possible complications due to Cytolytic Vaginosis include:

• Emotional stress
• Misdiagnosis leading to an inappropriate treatment
• Recurrence of the condition
• Treatment complications

How is Cytolytic Vaginosis Treated?

• Mild and asymptomatic cases of Cytolytic Vaginosis may not be treated, based on the healthcare provider’s assessment
• Use of baking soda solution (by sitting in a tub of warm water) to increase pH value can help improve the symptoms by stopping the uncontrolled growth of lactobacillus. This method forms the mainstay of treatment. However, it is important that the duration of this technique be according to the recommendations of a healthcare expert
• Discontinuation of antifungal medications if a diagnosis of vaginal thrush is mistakenly made

Regular follow up visits with the healthcare provider is important and recommended.

How can Cytolytic Vaginosis be Prevented?

• Currently, there are no available guidelines to prevent Cytolytic Vaginosis
• It is informed that the use of pads during menstruation may be more helpful in managing the symptoms than the use of tampons

What is the Prognosis of Cytolytic Vaginosis? (Outcomes/Resolutions)

The prognosis of Cytolytic Vaginosis is generally good with adequate treatment.

Additional and Relevant Useful Information for Cytolytic Vaginosis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/womens-health/