The clinical presentation is strikingly similar to candidal vaginosis, characterized by dyspareunia, dysuria, abundant whitish discharge and pruritus [1] [2]. A cyclical appearance of symptoms, most likely during the luteal phase of the menstrual cycle is observed [1].

• Fishing

  It is sold for fish. I found an article that indicated doxy was the treatment. Maybe your doctor will write you a script but if not, you have to take matters into your own hands. [wisegeek.com]

  Discharge has a strong fish odor and is more noticeable after intercourse or washing with soap. 3. Any usual discharge should be checked to rule out gonorrhea or chlamydia infections. 4. There may or may not be vaginal itching or irritation. 5. [womens-health-advice.com]

  […] discomfort and protect it from any irritation my fluids will cause *avoiding processed foods (junk food, fast food etc) and trying to eat lots of fresh fruits and vegetables. im not a vegetarian, but i normally dont eat very much meat. i mostly have fish [healthboards.com]

• Unconsciousness

  […] vilitigo vulgaris[L] 【尋常性疣贅】*verruca vulgaris[L] 【尋常性痒疹】*prurigo vulgaris[L] 【尋常性狼瘡】*lupus vulgaris[L] (靭) 【靭帯炎】*syndesmitis 【靭帯疾患】【靭帯病】*desmopathy 【靭帯断裂】*desmorrhexis 【靭帯痛】*desmodynia 【靭帯内妊娠】*intraligamentary pregnancy (人) 【人畜共通感染症】*zoonosis 【人事不省】*unconsciousness [medo.jp]

• Chronic Fatigue Syndrome

  Stay logged in ProHealth Fibromyalgia, ME/CFS and Lyme Disease Forums Forums Home Forums Conditions Fibromyalgia Forums Fibromyalgia Main Forum ProHealth Store View Cart 800-366-6056 Contact Us Help Fibromyalgia Chronic Fatigue Syndrome & M.E. [forums.prohealth.com]

• Halitosis

  口蓋垂炎】*uvulitis *staphylitis 【口蓋垂裂】*cleft uvula *uvula bifida[L] 【口蓋乳頭嚢胞】*cyst of papilla palatina 【口蓋裂】*cleft palate *palatoschisis 【口腔乾燥症】*xerostomia 【口腔真菌症】*oral mycosis *stomatomycosis 【口腔病巣性粘液沈着症】*oral focal mucinosis 【口臭】*bad breath *foul breath *halitosis [medo.jp]

• Excoriation

  Vulva appears normal, i.e. no erythema, swelling edema,, or excoriations 2. Vaginal discharge is white and tends to be thick or pasty 3. Thew it no odd associated with (he discharge. If a whiff test is performed it is negative 4. [sexualhealthmedicine.com]

  Baking soda sitz baths offer relief by removing irritating acid secretions from contact with the vulvar tissues and also just a local soothing effect to excoriated tissue from itching. [encognitive.com]

• Formication

  Several species of lactobacilli ferment both glycogen and glucose to lactic acid, carbon dioxide, alcohol, formic acid, acetic acid, and hydrogen peroxide. It is these acids that cause the problem. [encognitive.com]

• Vaginal Discharge

  METHODS: Fungal cultures, 10% potassium hydroxide (KOH) and Gram stained preparations and pH measurements were performed on the vaginal discharge material of each patient. [ncbi.nlm.nih.gov]

  The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. [unboundmedicine.com]

  The most important diagnostic aides are microscopic examination of the vaginal discharge and culture for Trichomonasvaginalis and Candida (). Interestingly, there are relatively few white blood cells (WBC) present in the vaginal discharge. [sexualhealthmedicine.com]

• Vulvar Burning

  However, the patient with cytolytic vaginosis can complain of vaginal pruritis and burning, dyspareunia, and vulvar burning when micturating (vulvar dysuria). The patient’s symptoms intensify during the luteal phase of the menstrual cycle. [sexualhealthmedicine.com]

  I purchased a PH balanced lubricant and have been taking baking soda baths, which seem to help the vulvar burning from time to time. [vulvodyniasirenblog.wordpress.com]

  They typically complain of a thick, odorless, white vaginal discharge and intense pruritus; dysuria and dyspareunia along with a sensation of vulvar burning or discomfort may also be present. [prognosisapp.com]

  The most common symptom is itching, but vulvar burning, dysuria, and entry dyspareunia are often present as well. [encognitive.com]

• Bladder Pain

  Interstitial Cystitis (IC) is a urinary bladder disease of unknown cause characterised by pelvic and intense bladder pain, urinary frequency (as often as every 10 minutes), and pain with urination. [dailystrength.org]

  I mentioned IC and she said that because the vulval pain occured everytime and was the main symptom with the bladder pain coming slightly later, that it was likely the vulval and vaginal inflammation was the cause of the bladder discomfort, which is why [mumsnet.com]

• Cheesy Vaginal Discharge

  The pH was 3.5 to 5.5 and the clinical symptoms were profuse vaginal discharge (VD) especially whitish-cheesy vaginal discharge and other symptoms of vaginal candidiasis. [ncbi.nlm.nih.gov]

  The women presenting with cytolytic vaginosis complain of a thick or thin white cheesy vaginal discharge, pruritus, dyspareunia, vulvar dysuria, and a cyclic increase in symptoms that are more pronounced in the luteal phase ( 11, 37, 49 ). [ispub.com]

• Vulvar Pain

  So that issue on top of vulvar pain really shut down any version of a sex life for my husband and I during most of the pregnancy. I think for my husband, causing me pain during sex has been quite traumatic for him. [vulvodyniasirenblog.wordpress.com]

  Vulvodynia: a complex syndrome of vulvar pain. Acta Obstet Gynecol Scand. 1995;74(4):243-247. 11. Bibbo M, Harris MJ. Leptothrix. Acta Cytol. 1972;16(1):2-4. 12. Ferris DG, et al. [nursing.advanceweb.com]

  Vulvodynia: a complex syndrome of vulvar pain. Acta Obstetricia ET Gynecologica Scandinavica 1995;74:243-7. 53. Hatcher RA, Trussell J, Stewart FH, Stewart GK, Kowal D, Guest F, et al. Contraceptive technology. 16th ed. [ispub.com]

A presumptive diagnosis can be made based on clinical findings and reported complaints, but because numerous pathogens may cause a similar presentation, it is necessary to perform a vaginal smear and subsequent microscopic examination [1]. The proposed criteria for cytolytic vaginosis are evidence of cytolysis, abundance of lactobacilli, absence of Trichomonas vaginalis, Gardnerella vaginalis or Candida sp. on wet smear and pH of the smear between 3.5-4.5 [4].

• Cytolytic Vaginosis

  Abstract Cytolytic vaginosis, a not uncommon condition, is frequently misdiagnosed because it is confused with Candida. [ncbi.nlm.nih.gov]

  The good news is that once the disease is recognized the simple natural remedy for cytolytic vaginosis is baking soda. What is Cytolytic Vaginosis? Cytolytic vaginosis is an overgrowth of the bacteria lactobacilli. [earthclinic.com]

  What is cytolytic vaginosis? Cytolytic vaginosis is one of the causes of vaginal discharge. Its existence as a specific diagnosis is debated. What is the cause of cytolytic vaginosis? The normal vagina of an adult woman is colonised by lactobacilli. [dermnetnz.org]

• Gram-Positive Rods

  rods, now referred as lactobacillus species. [ncbi.nlm.nih.gov]

  Definition / general Presence of gram positive rods (lactobacilli) with cytolysis of intermediate cells Terminology Also known as bacillus vaginalis, bacillus Doderlein Epidemiology Lactobacilli are the most abundant bacteria found in normal vaginal flora [pathologyoutlines.com]

  Historical Perspectives In 1892, Doderlein first identified the presence or absence of gram-positive rods in normal vaginal flora ( 16 ). He named these organisms Doderlein's bacilli. [ispub.com]

• Gram-Positive Bacteria

  Clindamycin will also have an inhibitory effect on Gram-positive bacteria, except the enterococci. Additionally, clindamycin would not have a suppressive effect on the Gram-negative facultative bacteria. [sexualhealthmedicine.com]

Once the diagnosis is confirmed, the main goal of therapy is elevation of vaginal pH through douching with sodium bicarbonate solution or through the use of a vaginal sodium bicarbonate suppository [1] [4]. In most cases, intravaginal douching is performed for twice weekly for 2-3 weeks, while antibiotic therapy is not necessary [1].

The condition is self-limiting and easy to treat, but the diagnosis is often made erroneously as chronic candidal vulvovaginitis that does not respond to therapy [3], which is why the diagnostic workup should be properly conducted [2] [6].

Lysis of vaginal epithelial cells is caused by overgrowth of lactobacilli, but the exact cause remains unclear [2].

The exact rates of this condition in women is unknown, but cytolytic vaginosis is almost exclusively encountered in women during childbearing age [2]. Because lactobacilli convert glucose to lactic acid, it is hypothesized that women suffering from diabetes mellitus are more prone to this condition due to a higher circulating level of glucose [1].

Under physiological conditions, Lactobacilllus species provide numerous beneficial effects as normal vaginal flora, predominantly by acidification of the local environment through production of lactic acid from glucose and the influence of estrogen [1]. An additional function is the production of hydrogen peroxide (H2O2), a potent free radical that prevents the ability of pathogenic microogranisms, such as Escherichia coli, Gardnerella vaginalis, but also Candida sp., to grow and cause an infection [2] [5]. Competition for nutrients and secretion of acidolin, which also inhibits growth of other organisms, are additional mechanism of protection [2]. In some women during reproductive age, however, a phenomenon of Lactobacillus overgrowth in this environment can occur and cause lysis of vaginal epithelial cells due to excessive acidification [1].

Apart from adequate hygiene, no other preventive measures are currently known regarding prevention of vaginal infections.

Cytolytic vaginosis is a term that describes lysis of vaginal epithelial cells as a result of abundant growth of Lactobacillus sp., which normally reside in the vagina as normal flora [1]. As a protective mechanism against harmful pathogens, lactobacilli produce hydrogen peroxide (H2O2) and preserve the vaginal microenvironment, but for still undisclosed reasons, abundant growth of this bacterial organism can occur in women during childbearing age and cause marked lysis of epithelial cells, primarily due to profound acidification during the process of glucose conversion to lactic acid [1]. The clinical presentation includes dysuria, whitish discharge, dyspareunia and pruritus, with symptoms most commonly appearing in cyclic fashion [1] [2]. To make the diagnosis, it is necessary to obtain a vaginal smear and perform a microscopic examination that will exclude other pathogens that present with similar complaints, most notable being Trichomonas vaginalis, Gardnerella vaginalis and Candida species [3] [4]. Cytolytic vaginosis is treated by increasing pH, most commonly through the use of sodium bicarbonate, either in the form of vaginal suppositories or douching [1].

Cytolytic vaginosis is a condition characterized by overgrowth of Lactobacillus species, which normally comprise normal vaginal flora and protect from various harmful microorganisms via several mechanisms. For some reason, abundant growth of this bacteria reduces normal pH of the vagina, causing a profoundly acidic environment in which destruction of epithelial cells (cytolysis) occurs. Symptoms such as painful urination, itching, whitish discharge and pain during intercourse are most frequently reported. This condition is almost exclusively seen in women during childbearing age and symptom often appear in cyclical fashion. The diagnosis can be made by obtaining a vaginal swab for microscopic examination. Increasing vaginal pH is the main principle of therapy, which is achieved by douching with sodium bicarbonate or use of vaginal suppositories containing sodium bicarbonate for 2-3 weeks. Cytolytic vaginosis is self-limiting and does not pose a risk for women, but it is often not recognized due to striking similarities of more common conditions such as vulvovaginitis caused by Candida, which is why careful examination is necessary to make the right diagnosis.

1. Suresh A, Rajesh A, Bhat RM, Rai Y. Cytolytic vaginosis: A review. Indian J Sex Transm Dis. 2009;30(1):48-50.
2. Cerikcioglu N, Beksac MS. Cytolytic vaginosis: misdiagnosed as candidal vaginitis. Infect Dis Obstet Gynecol. 2004;12(1):13-16.
3. Hu Z, Zhou W, Mu L, Kuang L, Su M, Jiang Y. Identification of cytolytic vaginosis versus vulvovaginal candidiasis. J Low Genit Tract Dis. 2015;19(2):152-155.
4. Cibley LJ, Cibley LJ. Cytolytic vaginosis. Am J Obstet Gynecol. 1991;165(4 Pt 2):1245-1249.
5. Hillier SL, Krohn MA, Klebanoff SJ, Eschenbach DA. The relationship of hydrogen peroxide-producing lactobacilli to bacterial vaginosis and genital microflora in pregnant women. Obstet Gynecol. 1992;79(3):369-373.
6. Demirezen S. Cytolytic vaginosis: examination of 2947 vaginal smears. Cent Eur J Public Health. 2003;11(1):23-24.