This common condition has many of the same symptoms as yeast infections, bacterial vaginosis, and trichomoniasis. Here’s how to tell cytolytic vaginosis apart and more.
Cytolytic vaginosis, also known as Lactobacillus overgrowth syndrome, involves an overgrowth of Lactobacilli bacteria inside the vagina.
Lactobacillus is a natural part of the vaginal environment. This bacteria produces lactic acid, which helps stabilize the vagina’s pH balance, and hydrogen peroxide, which acts as an antiseptic agent.
Too many Lactobacilli in the environment can disrupt the natural vaginal flora and affect the vagina’s PH balance, along with other symptoms.
Cytolytic vaginosis can be difficult to diagnose because it shares many of the same symptoms as other vaginal conditions.
Take vaginal discharge, for example. You may notice an unexpected increase in white or yellow discharge, which may vary in consistency. The discharge could be thick and curd-like or watery and thin.
Although cytolytic vaginosis can cause changes in vaginal discharge, it’s more
Cytolytic vaginosis may also cause:
- itchiness of the vulva and the vagina
- a sensation of burning of the vulva, especially during urination
- pain or discomfort during or after penetrative vaginal sex
- symptoms that worsen on the days closest to the start of menstruation
Unlike other common yeast or bacterial infections, cytolytic vaginosis won’t respond to antifungal treatments.
It’s unclear what exactly causes Lactobacilli bacteria overgrowth, or cytolytic vaginosis. The vagina is naturally warm and wet, which is the perfect environment for bacteria to multiply and disrupt the natural balance.
Lactobacillus alone or with other bacteria
A doctor or another healthcare professional may ask about the color, consistency, and amount of vaginal discharge you’re experiencing, if any, to help make a diagnosis.
One 2021 study found that people were more likely to experience increased discharge with cytolytic vaginosis than with other vaginal conditions. Researchers also noted that the discharge was white, thin, and paste-like, unlike the thicker discharge seen with yeast infections.
Your clinician may also perform a pelvic exam and swab the inside of the vagina to get a discharge sample. They may test this sample for trichomoniasis or order a full STI panel with blood and urine tests.
They may also use a vaginal pH test to help differentiate between cytolytic vaginosis and other vaginal conditions.
The same 2021 study found that most participants with cytolytic vaginosis had a pH between 3.5 and 4.1, whereas most participants with recurrent yeast infections had a pH between 4.1 and 4.4.
Bacterial vaginosis, on the other hand, should return a pH reading of 4.5 or more.
A typical care plan involves using sodium bicarbonate (commonly known as baking soda) to reduce the number of Lactobacilli bacteria and increase the vagina’s overall pH.
This may include a combination of:
- topical pastes
- sitz baths
You can purchase baking soda at your local grocery store and DIY or pick up a premade product.
To make a topical paste, mix equal parts baking soda and water, and apply as needed to the affected external area. Do not use baking soda paste internally.
A sitz bath may also help with burning and itching. Dissolve 2 to 4 tablespoons of baking soda in 2 inches of warm water in a bathtub. Sit in the tub and soak for 15 to 20 minutes up to twice daily, a few times a week.
People use gelatin capsules to make suppositories that are available at most health food stores. Fill a capsule with baking soda and insert it into the vagina twice weekly for 2 weeks.
To douche, mix 1 to 2 tablespoons of baking soda with 4 cups of warm, distilled water in a bottle or bag. Spray or squirt the solution upward into the vagina twice weekly for 2 weeks.
Avoid having vaginal sex until your symptoms improve.
A host of things can disrupt the delicate environment of the vagina. Lubricants, fragrant soaps and wipes, and menstrual products can all upset the flora and trigger an overgrowth of rogue bacteria.
You can minimize the risk of bacterial disruptions in the vagina by:
- washing the vulva and vagina with water only
- changing out of wet clothing as soon as possible
- limiting or avoiding scented “feminine” products, including powders, sprays, pads, and tampons
- opting for cotton underwear over lace and other less breathable fabrics
- sleeping without underwear — occasionally or frequently!
If your symptoms don’t improve after 1 to 4 weeks of consistent treatment or worsen, it’s important to get medical attention. A doctor or another healthcare professional can perform a pelvic exam and confirm your diagnosis.
Proper diagnosis is the key to relieving your symptoms and improving your overall quality of life. A clinician can also review your individual risk factors for cytolytic vaginosis and make specific recommendations for prevention.
Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.