Cytolytic vaginosis (CV) is an overgrowth of Lactobacillus in the vagina, causing irritation and breakdown of the vaginal mucosa (lining). Symptoms include copious white vaginal discharge, itching, and a burning sensation, especially with urination.
Lactobacilliare bacteria that are part of the normal vaginal flora, helping to maintain a healthy pH balance and prevent infection through the production of lactic acid and hydrogen peroxide. While lactobacilliare typically a sign of a healthy vaginal environment, an overabundance of Lactobacillus can lead to CV.
Treatment of CV is usually managed by a gynecologist or other women's health provider, and involves reducing the quantity of lactobacilliand correcting pH imbalance in the vagina. Treatment may involve vaginal suppositories or sitz baths with baking soda.
Common symptoms
The main symptoms of CV are:
- Copious amounts of white vaginal discharge that may be thin and watery or thick and sticky;
- Vulvar or vaginal itching;
- A burning sensation of the vulva, especially with urination;
- Pain or discomfort during or after sex.
Symptoms of CV often become more intense in the days leading up to menstruation.
It is important to consult a gynecologist or your primary care provider if you experience symptoms of CV, as symptoms are very similar to those of a yeast infection and can be easily confused. Treatment for CV is different than treatment for a yeast infection, so it is important to see a provider to receive the correct diagnosis and treatment.
Learn more about a vaginal yeast infection.
Confirming a diagnosis
The diagnosis of CV is made by a healthcare provider based on symptoms and a physical exam. Your provider will ask you about the color, consistency, and amount of vaginal discharge you are experiencing and may perform a pelvic exam.
A vaginal pH test will be done to help confirm the diagnosis. The typical vaginal pH in cases of CV is between 3.5 and 4.1.
Your provider may also take a small sample of your vaginal discharge (wet mount) and look at it under a microscope to help confirm the diagnosis of CV and rule out other conditions like a yeast infection or bacterial vaginosis. While there is currently no "gold standard" for diagnosing CV, studies have suggested certain criteria for identifying CV on wet mount microscopy.
A pap smear or testing for sexually transmitted infections (STIs), like trichomoniasis, may also be recommended as part of the workup.
Also recommended: Bacterial Vaginosis: Symptoms, Causes & Treatment tuasaude.com/en/bacterial-vaginosisPossible causes
CV is caused by an overgrowth of lactobacilli in the vagina, causing vulvar and vaginal irritation and a lowered vaginal pH. Breakdown of the cells lining the vagina leads to an increase in vaginal discharge as the body attempts to clean cellular debris out of the vagina.
It is not yet understood why some people are more likely than others to develop CV. Studies to determine risk factors for CV and to establish evidence-based guidelines for diagnosis and treatment are ongoing.
Treatment options
Treatment involves a visit to the gynecologist or other women's health provider. The goal of treatment is to increase vaginal pH and reduce the number of lactobacilli in the vagina.
Treatment will be aimed at restoring the vaginal flora and managing symptoms. Your provider may recommend vaginal suppositories or a baking soda douche or sitz bath.
It is important to contact your provider if your symptoms do not improve. Further assessment or reevaluation of the treatment plan may be indicated.