What to Know About Cytolytic Vaginosis

Medically Reviewed by Melinda Ratini, MS, DO on July 21, 2022
4 min read

Cytolytic vaginosis, which is sometimes called "lactobacillus overgrowth syndrome" or "Doderlein's cytolysis," is thought to happen when too much of a certain type of bacteria grows in your vagina.

The bacteria, which experts called lactobacilli, is normal to have in your vagina. It can help protect you against things like yeast. But if there’s too much, some doctors believe that you can develop cytolytic vaginosis, which leads to uncomfortable and sometimes painful symptoms.

Cytolytic vaginosis is a controversial diagnosis in the medical community. Many doctors do not believe that it is a legitimate diagnosis. Others believe that it is a condition that has to do with a pH balance issue in your vagina.

Your vaginal pH value plays a large role in the health of your vagina. It measures the acidic level and can shift based on your age, diet, health conditions, and other factors. The pH scale ranges from 0 to 14. Anything less than 7 is “acidic.”

Typical vaginal pH levels can range between 3.8 and 5. But with cytolytic vaginosis, a change in pH leads to a shift in your vagina’s natural balance of bacteria. This causes the lactobacilli to be too high and your vagina’s pH to be more acidic. With the condition, you might have a vaginal pH level between 3.5 and 4.5.

Doctors often notice that when someone has chronic discharge from their vagina, they treat it with many different antifungals or antibiotics. But these treatments can lead to a change in your vagina’s pH and cause the overgrowth of bacteria.

In addition to these treatments, other things can trigger cytolytic vaginosis. Your body may be sensitive to certain products. Some examples are:

  • Soaps
  • Menstrual pads
  • Wipes
  • Lubricants

The symptoms of this condition can be like a yeast infection or bacterial vaginosis. But with cytolytic vaginosis, the symptoms are usually worse in the week before your period. This is because your body has higher levels of lactobacilli during this part of your menstrual cycle.

Similarly, the side effects of this condition tend to ease during your period. This happens because period blood is less acidic on the pH scale. So on your period, the acidic levels will tend to even out while you bleed.

With this condition, you might notice:

  • Itching in your vagina or on your vulva, which is the skin outside of your vagina.
  • Burning on your vulva, which might get worse when you pee. Sometimes this feels like the burn you’d feel if you pee with a urinary tract infection (UTI).
  • Pain or burning during sex or a sore feeling after sex.
  • More yellowish or white discharge from your vagina. This might change in consistency.

To find out if you have cytolytic vaginosis, your doctor will first do a pelvic exam. They’ll take a sample of discharge from your vagina to look at under a microscope. They’ll look for cellular changes, a high number of lactobacilli, and a low level of white blood cells. If they find all these things, it may mean you have cytolytic vaginosis.

They’ll test your vaginal pH to see if it’s in the range that’s typical for cytolytic vaginosis cases. Your doctor may perform a Pap smear to diagnose you with cytolytic vaginosis.

To confirm that this condition is what causes your symptoms, there should be no signs of yeast, bacterial vaginosis, or trichomoniasis (a common sexually transmitted infection from a parasite).

To get rid of cytolytic vaginosis, you’ll need to raise your vaginal pH and get your lactobacilli amounts back to normal. To do so, your doctor may recommend a baking soda treatment. It’s also important that you stay away from products that trigger you.

Baking soda treatment can include a:

Vaginal suppository. You can make a suppository with baking soda. Fill an empty gelatin capsule (you can buy these at health food stores) with baking soda. Put one capsule into your vagina twice a week for 2 weeks.

Douche. Dissolve 1 heaping teaspoon of baking soda into 20 ounces of warm water. Use this mixture as a douche for 7-14 days.

You can buy a douche bag at your local pharmacy. If you don’t want to make your own, you can also buy an over-the-counter baking soda douche in stores.

Paste. If you have itching or burning on the skin outside of your vagina, a paste may help. You can use water and baking soda to create a watery mixture. Apply this on your skin daily.

Sitz bath. Mix 2 to 4 tablespoons of baking soda in 2 inches of warm bath water. Soak inside the water for 15 to 20 minutes twice a day or a few times a week. To try to avoid another case of cytolytic vaginosis, do this once or twice a week afterward.

If your symptoms don’t go away within 2 weeks of treatment, go back to your doctor.

To avoid cytolytic vaginosis, you can adopt some lifestyle changes:

  • Don’t use soap on or around your vagina. Just wash that area with water or use a pH-balanced, unscented bar soap.
  • Use pads instead of tampons during your period because menstrual blood heightens your vaginal pH.
  • Don’t use scented vaginal hygiene products like vaginal powders, sprays, toilet paper, pads, or other things.
  • Always change out of wet clothes as soon as you can. This includes bathing suits, gym clothes, and other wet clothing.
  • Stay away from tight clothes.
  • Use cotton underwear during the day. Sleep without underwear, if possible.
  • If you have cytolytic vaginosis, avoid sex until your symptoms go away.