An overgrowth of normally protective Lactobacillus that causes vaginal discomfort
Sometimes, it really isn’t “just another yeast infection”. Cytolytic vaginosis (CV), also known as Lactobacillus overgrowth syndrome or Doderlein's cytolysis, is a cause of vaginal discomfort caused by the overgrowth of lactobacilli.
The result? Yeast infection-like symptoms that don’t respond to traditional anti-fungal treatments. In fact, without an accurate diagnosis, the wrong treatment can even make symptoms worse [5,6].
But there’s good news, too. While certainly uncomfortable and disruptive, CV is not a sexually transmitted disease, nor is it an infection. There are actually some simple and effective treatment options available .
Since CV is often confused with other conditions, we don’t have enough information about how many people have it.
CV is caused by an overgrowth of one of the good bacteria called Lactobacillus. It produces lactic acid which maintains an acid pH and physically pushes out competitors [1,2]. You definitely want this one around, since it offers serious protection from pathogens like Trichomonas and E. coli, effectively warding unwanted visitors like yeast infections and certain STIs [2,3].
However, sometimes there can be too much of a good thing. When lactobacilli get out of control and overgrow, these bacteria start to irritate the cells in the vaginal wall. Those dead or damaged cells then make their way out of the body alongside other normal vaginal secretions .
No one is sure about exactly what causes an overgrowth of Lactobacillus, but certain conditions and lifestyle factors can increase your risk . These include:
As mentioned earlier, you might experience symptoms that mimic a yeast infection, a.k.a thrush. These include :
CV is difficult to diagnose and is based primarily around self-reported symptoms and a process of ruling out other conditions that have similar symptoms such as bacterial vaginosis and yeast infections (thrush). This involves testing for common pathogens such as Trichomonas, Chlamydia or Candida [5,7].
Your doctor can then check to see if there is an overgrowth of lactobacilli and might also see if your vaginal pH is low.
With so little known about CV, there is no formal standard of care . While Juno Bio is working to gather more information about conditions like CV so that this can change, there are some widely used treatment options available.
The goal with treatment is to reduce the number of lactobacilli by elevating your vaginal pH. Here are a few examples of methods using a simple baking soda solution :
Douching: Douche daily for 2 weeks with a mixture of 30 to 40g of baking soda in 1 liter of water
Vaginal suppository: Fill empty gelatin capsule with baking soda. Insert into the vagina twice a week for two weeks.
Treatment should provide some immediate relief with symptoms resolving over the course of your cycle. However, if after three weeks your symptoms have not improved, have changed, or have worsened, you should stop all treatment and seek a re-evaluation from a trusted healthcare provider .
Even after treatment, CV can come back. More research needs to be done to find out why this happens, when, and how often.
There are no known complications from CV.
There are no known ways to prevent CV.
We think it’s ridiculous that millions of women around the world are experiencing problems due to a disrupted vaginal microbiome.
Juno Bio is working to help women take control of their vaginal microbiome wellness.
1. O'Hanlon D, Moench T, Cone R. Invaginal fluid, bacteria associated with bacterial vaginosis can be suppressedwith lactic acid but not hydrogen peroxide. BMC Infectious Diseases.2011;11(1).
2. Boris S, Barbés C. Role played bylactobacilli in controlling the population of vaginal pathogens. Microbes andInfection. 2000;2(5):543-546.
3. Phukan N, Parsamand T, Brooks A,Nguyen T, Simoes-Barbosa A. The adherence ofTrichomonas vaginalisto hostectocervical cells is influenced by lactobacilli. Sexually TransmittedInfections. 2013;89(6):455-459..
4. Bhat R, Rai Y, Suresh A, Rajesh A.Cytolytic vaginosis: A review. Indian Journal of Sexually Transmitted Diseasesand AIDS. 2009;30(1):48.
5. Cerikcioglu N, Beksac M. CytolyticVaginosis: Misdiagnosed as Candidal Vaginitis. Infectious Diseases inObstetrics and Gynecology. 2004;12(1):13-16.
6. Yang S, Zhang Y, Liu Y, Wang J, ChenS, Li S. Clinical Significance and Characteristic Clinical Differences ofCytolytic Vaginosis in Recurrent Vulvovaginitis. Gynecologic and ObstetricInvestigation. 2016;82(2):137-143.
7. XuH, Zhang X, Yao W, Sun Y, Zhang Y. Characterization of the vaginal microbiomeduring cytolytic vaginosis using high-throughput sequencing. Journal ofClinical Laboratory Analysis. 2018;33(1):e22653.
Keep up-to-date with all things Juno, vaginal microbiomes and the gender health gap.