02/12/2025
We know in research and through clinical application the benefits of Lactobacilli in a healthy vaginal ecosystem. In some individuals, an elevated amount of Lactobacilli may have a part to play in their symptom picture, or it may be their regular level of Lactobacilli with other microbes and factors are driving the symptoms. It is important to understand the differentiation in symptoms, and what may be driving them.
Two considerations of when Lactobacilli are part of the problem are: Cytolytic vaginosis (CV) and Lactobacilliosis.
Both presentations have the ability to influence and increase the production of lactic acid, creating a higher acidic environment that may cause vaginal tissue to become irritated, swollen, alongside a white, profuse or paste-like discharge.
Cytolytic vaginosis (CV) is referred to as lactobacillus overgrowth, where we see a dominance of L. crispatus (>75-90% + on NGS) in the microbiome (rather than L. iners, this is a different scenario all together!). Typically CV will present with cellular debris/inflammation, and as a result you may see a culture reflect elevated epithelial cells, elevated bacilli and cytolosis (damaged cells).
Lactobacilliosis is more specific, it presents under the microscope as what is referred to as Leptothrix, Lactobacilli in abundance with long-rods (elongated) and segmentation. Often individuals may feel a more of a wet discharge compared to CV, and antibiotics may be recommended in those with confirmed elongated rods.
Things to consider when differentiating between symptoms, is if RVVC has or is present, if there is current use, or a history of fluconazole or antibiotic usage, age, a decline in oestrogen, autoimmunity and even blood sugar imbalances. Lots of nuances that extend past results on a page. You need a whole clinical picture, microscopy and potentially microbiome sequencing to provide the insight needed to address.
Intimate Ecology practitioners are trained in understanding symptoms and investigating to find the cause. Book in for a Naturopathic appointment via the link in BIO