Cytolytic vaginosis

What is cytolytic vaginosis?

Cytolytic vaginosis is a condition that consists of the destruction of the cells of the vaginal walls. This disease is caused by an overgrowth of bacteria that are naturally found in the vagina. Its existence as a specific diagnosis is debated.

What is the cause of cytolytic vaginosis?

Lactobacilli are bacteria that are found in low quantities in the vaginal flora of women of reproductive age. In fact, it is considered that these microorganisms are essential for the maintenance of the normal PH of the vagina.

However, under certain hormonal or external conditions, an excessive growth of lactobacilli may occur. In these cases, this overpopulation of bacteria can cause cytolysis of the epithelial cells of the vaginal mucosa.

Cytolytic vaginosis has been diagnosed when there is an overgrowth of lactobacilli. It has been suggested that they can irritate the cells that make up the vaginal lining, causing them to rupture. The damaged or fragmented cells are shed with normal vaginal secretions.

What are the symptoms of cytolytic vaginosis?

Many women with cytolytic vaginosis don't know it. It can be reported after a vaginal swab or cervical smear. It has been associated with the following symptoms:

• Abundant whitish vaginal discharge, which can be thin and watery or thick and curdled
• Vaginal and/or vulvar itching (pruritus vulvas)
• Burning (vulvodynia), especially when urinating (dysuria)
• Discomfort during sexual intercourse (dyspareunia)
• Acid vaginal pH (3.3 to 5.5).

The symptoms are similar to those of vaginal candidiasis. Like candidiasis, they have been reported to worsen in the second half of the menstrual cycle. Oral antifungal and antifungal agents are not effective.

How is the diagnosis of cytolytic vaginosis made?

Cytolytic vaginosis is diagnosed in women with vaginal symptoms that have not subsided or have recurred after treatment for candidiasis.

The laboratory reports numerous lactobacilli and epithelial cells in vagina wet mount. There are few inflammatory cells, no yeast and no other infections organisms.

What is the treatment for cytolytic vaginosis?

If cytolytic vaginosis is diagnosed, no specific treatment is required if there are no symptoms. Antifungal medications should be discontinued.

Some women find it helpful to use pads instead of tampons for menstruation.

Symptoms can be reduced by using sodium bicarbonate (baking soda) to increase vaginal pH. This discourages the growth of lactobacilli. Treatment options include:

• 30 to 40 g of baking soda in 1 liter of water as a daily shower for 2 weeks and then as needed.
• 2 to 4 tablespoons of baking soda in 5 cm deep water in a warm bath, several times during the first week, then once or twice a week.