Vulvodynia Remedies

Simple vulvodynia remedy/solution/cure (that worked for me) I'm so excited to have finally solved my problem that I need to share it with all of you, because I, like you, suffered SO VERY MUCH and I was so desperate for a solution! Unfortunately there are too many wrong, confusing, even dangerous suggestions online about crazy or expensive treatments, like surgeries, anti-depressants, oxalate diet, etc., when the solution is so simple, yet it eludes everybody. I am proof that vulvodynia can be treated very naturally, easily and FREE at home. If my story can help somebody, at least my pain has had a purpose. I had vulvodynia for almost a year, so bad I couldn't wear underwear/pants, sit down or go by bicycle. [As if it wasn't enough, months after it all began I ALSO started experiencing what I can only explain as urethral spasms (those are actually worse than the vulvodynia pain, because they always came unexpected). I thought there was something wrong w/ my urethra, I even went to a urologist who couldn't understand what I had and didn't find anything wrong w/ me but nonetheless gave me antibiotics which turned out to be totally useless & unnecessary because, as my gyno confirmed, I didn't have whatever strange invisible infection the urologist thought I had. Brilliant!] Anyway, after lots of research online, I realized it was possible that vulvodynia could simply be a muscle problem, so I finally went to a pelvic floor therapist, who confirmed lots of things to me. She did some manual trigger point therapy (which you can do yourself), but mostly what I got out of my experience with her was hope that it could be treated, which was the most important thing to me as the pain was driving me insane. Therapy helped a lot, but as I am unemployed I couldn't afford more sessions. Well, at least I knew for sure it was a muscle problem and nothing else, as I had already experienced a major improvement thanks to her. See, the reason that doctors can run millions of tests on all of you and find nothing wrong/related to the pain is because vulvodynia is simply caused by the SHORTENING of your pelvic muscles due to the trauma of, say, an infection, accident, bad posture, bad habits, scoliosis, or even just stress...you name the cause, you're probably right. Those poor, stressed muscles have contracted to the point of causing internal chronic spasms (whether you feel them or not), which tug at your nerves, thus giving you pain! The secret to reverse it, then, it's simply to LENGHTEN the muscles back to their original shape, by stretching them. I, by the way, requested a fantastic book from the library ("Heal Pelvic Pain" by Amy Stein) which explains all of this in detail. You should look into it, too, if you are looking for more info about how numerous pelvic disorders are simply caused by the shortening of the muscles & by trigger points (she explains how to do trigger point therapy -which I love- on yourself, however I found that the stretch I "invented" was enough to make the trigger points go away on their own!). One of her most useful pieces of advice was the part about "dropping the pelvis": until I read her book I never thought/realized how super tense my pelvis always was. Catch yourself anytime and you'll see that if you have vulvodynia your pelvis is all tensed up, drop it! (It's the same feeling as when you have finally reached a bathroom after holding it in for a long time.) Make a conscious effort to drop it/relax it/let go of it as often as possible until it will become normal to you again. (To better understand what I'm talking about, see her book.) I did the long routine of stretching exercises (for different parts of the body) that Amy recommends however I felt none of them were really specific enough to solve the problem, or at least I wasn't feeling any difference fast enough (I'm kinda impatient)...so, as I am unemployed and I have a lot of time on my hands, I started mulling over where the problem was specifically arising from...I thought: it's not my back, or my butt, or my thighs,... my urethral spasms & vulvodynia pain MUST stem from the front of my pelvis (the area below my navel). Well, then! Those are the muscles I have to lengthen! So I created my own (easy) specific stretch exercise, which amazingly accomplished the job very quickly! I felt immediately better the first morning (I had no more urethral spasms! What a miracle!). After 2 days I was already MUCH better, and after a week my vulvodynia was virtually all gone! The longer you do it, the better. It's something you can do as a tune-up once in a while, too. THE SOLUTION: This is done in bed for as long as possible while you read or watch a movie (you'll know when you've had enough), you can get up once in a while if you really need to move around. (I guess you could try it on a table too, I used the bed as it's more comfortable and you can stay there longer.) On the VERY EDGE(<-important!) of the bed, without falling, put as many pillows as possible under your pelvis (it depends on how high your bed is, mine is pretty low), make sure you have some support for your back, too, if necessary, in order to be as comfortable as possible (you'll figure it all out on your own), but the important thing is that your pelvis needs to be a little HIGHER than your back TO CREATE AN ARCH! Then, let your legs hang from the edge of the bed, creating as much of a backward arch --between your thighs & your pelvis-- as possible. Simply lie there and feel the muscles of your pelvis and lower abdomen S-T-R-E-T-C-H. It's very easy. I even extended alternately my legs for further stretch of the pelvis, one leg at the time as much as possible. I did all of this while reading, so it's no big deal, it actually feels good. (I have a tile floor so I used a towel under my feet to made the sliding easier). This is all folks! Let me know if it works for you. If not, get Amy's book and try her stretches, maybe the muscles that you need to lengthen are not the same as mine. It depends on where your pain is, I guess. FURTHER ADVICE: #1 Months ago, when my pain was the worst, I noticed that the only thing that cut my pain in half was drinking a whole stalk of celery juice. Within hours it gave me so much relief! It might be for the same reason that celery is good for rheumatism (I don't have it), I'm not sure why it worked, all I know is that celery juice surely was a huge help! And it went to prove that my vulvodynia had nothing to do with too much oxalates, as celery is high in oxalates! If you strongly believe that your vulvodynia is caused by oxalates (very unlikely from what I've read) I highly recommend that before embarking on such a restricted, crazy diet at least you bother to get a test to confirm whether your oxalates are off, most likely you'll see that everything is normal! #2 As my therapist and Amy Stein say, do NOT do kegel or similar strengthening exercises until the pain goes away first! The problem is that exercises such as kegel actually tend to further contract/shorten the muscles which, in the case of vulvodynia, are already too tensed up to begin with! The exact OPPOSITE needs to be done, instead: RELAX them! #3 Do NOT constantly touch/mess with the area that bothers you! As my therapist said: if you keep on pressing on a bruise, you are preventing it from healing! #4 Also, as much as possible, try NOT to think about it, I know it's really hard, but you need to rewire your brain so that you DON'T constantly EXPECT pain from that area! Otherwise you're keeping the pain alive through a self-fulfilling prophesy.

However, little was I to know that I was only beginning a hell ride that would continue for months and ultimately end with me researching and finding my own resolve for this matter. Not the Physicians, 6 of whom I would end up seeing for this. Following the course of Bactrum I went back to my normal routines. I had intercourse with my husband one evening and when I woke up to urinate in the middle of the night I had burning and stinging unlike ever before. I thought to myself I must be dreaming. I was better. I had such intense burning I had difficulty falling back to sleep. I called the clinic the next day, still unable to see a physician. So I spoke to the nurse of a Doc I work with and she called and said that they would prescribe a course of Cipro for my stubborn UTI, however, I was to provide a urine sample to the lab. Lab was neg. I began the Cipro and within 2 days experienced severe itching and was given Diflucan to treat. The itching resolved, however, this awful burning feeling that I had, had not. Frustrated again I made an appointment to see a Nurse Practioner. She examined me and tested for everything under the sun. Yeast, Bacteria, STDs, etc. With no hard proof of anything to me she would give me a course of Doxycyclin. Desperate for healing I went ahead and took the script. My burning intensified to the point where I could cry. Ice was not enough to cool. I felt as if heat were eminating for my vaginal area that could burn a hole in a glacier. Later I was given Metrogel vaginal gel for what was thought to be a case of BV. Clue cells were identified in a wet prep so they said, however, the vaginal gel added insult to injury. No odor/ no unsual discharge noted. I tried every natural substance I could find to calm my horrified bottom. Raw Honey, olive oil, cornstarch and baking soda powder, vit E oil, Petroleum Jelly, KY Jelly, Desitin, Vit A oil, plain yohurt(which cooled me)... I tried it all. Also tried, Clotrimozole/betamethasone ointment, clebasol, hydrocortisone, allergy ointment, Nystatin, Monistat yeast Med... To no avail. In fact it made me worse.

Months later and still battling I see my GYN for the 3rd time. She says "I'm sorry dear you have Vulvodynia. " In my research I had seen this term & had thought that this is the Fibromyalgia of the vaginal world. A term used to label unsolved mysteries. Angered.. I did more homework. Antibiotics upset vaginal Flora & PH. Antifungals also change vaginal PH, making the area acidic. Birth Control can also influence PH. Vulvodynia symptoms clearly parallel the symptoms of Cytolytic Vaginosis. A very CURABLE problem. Practioners forget to look at the very tool that got them into medicine... CHEMISTRY. When you make an environment normally slightly acidic extremely acidic two things occur, irritation of skin, and burn like symptoms(ACID).

The Vagina is a delicately balanced Microcosum of bacteria/yeast/lactobaccilli/ and numerous others microbes. When antibiotics are presented, they wipe out an already unbalanced(in my case) world. Antifungals to prevent/correct the yeast symptoms also make the vagina very acidic still. Ultimately you have a petrie dish of disorder in a very big way. I suggest all of you think about your starting symptoms and look closely at what may have precipitated them. Antibiotics for no matter what will start the ball rolling. Cytolytic Vaginosis is basically a Chemistry lesson that our providers are just overlooking.. And for what reason I am not certain. It is extremely basic. And the cure is Baking Soda douche. 1-2tablespoons/4 cups of warm water. , bathing in a Sitz of Baking soda water is also very helpful for the external symptoms of itch and burning until symtoms resolve.. And they will.

Please all of you look up CYTOLYTIC VAGINOSIS. The symptoms, of burning, and itching, rawness do not just occur by themselves. They have been precipitated by something. They can be balanced and harmony can once again occur. Demand that your practioner do a vaginal PH. CYTOLYTIC VAGINOSIS will be in the 3.5-4.5 range. Certain Cytologic indications will also be evident on the wet prep slide. Lactobacillis will be plentiful. I encourage you to fully trust your instincts, your body is an amazing creation and the answers lie in sometimes the most basic fundamentals. Good Luck to you. I wanted to share my experience to help others prevent the nightmare the Medical Professionals whom we all go to in times of need, can create.

God Bless, Khristine

This is to everyone but especially to the woman with the 12 year old with Vulvodynia. I got Vulvodynia this year at 22, and this was honestly the worst thing to ever happen to me, I couldn't imagine how hard it must be for such a young girl :( Please consider what I am saying here even if your daughter is not up to the idea, this is truly for her own good and she will thank you for it later.

If you are coming across websites/blogs/forums that are telling you to change your diet, DON'T IGNORE THEM. I've had Vulvadynia for four months, and it was getting worse and worse. I also began having early symptoms of IC. I was beginning to lose control of my bladder, I experienced a very painful burning sensation every time I peed, and I needed to urinate every 10 minutes even when I wasn't drinking any liquid. I started to become very depressed, I was crying any moment I was alone. I found myself sobbing in the bathroom stalls at work and school, I had to constantly fight tears in public because this was causing me so much pain. I was so behind in school because instead of studying or working on assignments, I would be on my laptop for hours with dozens of tabs about Vulvodynia on my screen. It was the only thing on my mind and I felt so alone since it's not something I wanted to share, and even when I did, it seemed that nobody understood what I was going through physically or emotionally. I was already suicidal, I can't believe when I read these forums and I see that these women have been dealing with this for years!! Idk how they have been able to cope, but bless them for enduring it for so long.

Last month I began a raw food diet, mostly raw green vegetables and green smoothies. I would say that within my first three days, my pain levels went from a 9 out of 10 to a 2 out of 10. After my first week, no more pain at all, just discomfort and my IC symptoms were completely gone! Then the discomfort from my Vulvodynia went from being constant to intermit. After a month into this diet, despite all the times I cheated, I have gone several days with no discomfort at all. PLEASE, start googling raw food detox or how to heal your body with raw food. This may seem difficult, but if you are determined to finally get rid of your pain rather than jumping from doctor to doctor and medication to medication just to "treat" these symptoms (which will actually eventually lead to more issues later in life), then this is going to do it and it will change your life in the process.

Doctors don't know or honestly care about Vuvlodynia, you have to take matters into your own hands and be your own advocate ladies! There is a lot of information online and in books as well as amazing people on youtube that have a vast knowledge of this stuff and they are not trying to sell you anything, they simply want to help people cure their diseases. My favorite Naturopath youtuber is Montrealhealthygirl!

I am not healed completely, but I am optimistic that I will eventually cure my Vulvodynia. There is even a woman online who says she got rid of her Vulvodynia, look up Laura Lehraupt on YouTube, specifically the video titled "how I healed Vulvodynia". In my case, I know that this diet is working because when I first started, I felt a much more severe pain when I cheated on the diet and now I barely do. For instance, yesterday I had my first true and real cheat day with three slices of pizza, 3 cocktails as well as smoking at the end of my night (all terrible, especially if you have any sort of chronic pain). As a result of my cheat day, I had very minor discomfort in the morning, if I did this in the beginning of my diet, I am certain that my pain would be severe and I would have to miss class or work like I have been doing often for the past few months.

Bottom line, even though I was skeptical, I was willing to try anything to CURE my Vulvodynia, not simply "treat it". If you open your mind to this, you will be so incredibly enlightened! Even if you don't believe this will work, what is the harm in trying this for one week? Worst case scenario, you're going to be nauseous or break out in the first few days which is actually a great sign because it tells you that your body is detoxing! You would need to power through despite these symptoms by the way.

Everybody's bodies work differently, so you will have to experiment. For instance, you might not be able to eat raw vegetables at first, your body might be so weak that it won't be able to break down raw food. If you have a chronic pain condition, this is likely the case and also a sure clear sign that you are currently at a very unhealthy state and you need to detox your body!! Once your gut is strong enough to handle raw vegetables, I suggest you stop cooking them since when the food is raw, it has it's highest levels of nutrients. Nutrients is what your body needs right now, you need to help your body get rid of these toxins by giving it a break and eliminating all the processed and unnatural chemicals we call "food" these days. You also need to be consuming the right amount of nutrients to help it fight off your disease. Your illness is a sign of bad health, so you need to get to the source and get your body back to optimum heath. I can't explain all of this on this post, so please do some research and begin to educate yourselves!

Also you need to start drinking A LOT of water, specifically water that is high in alkaline levels, I'm talking at least 2 liters a day. Also start looking into the alkaline diet! The best book I read on this is called "The Acid-Alkaline Diet for Optimum Health" by Christopher Vasey.

Whatever your doubts are, just think of it this way, what is earth's food? In other words, what are the foods that we know for certain humans should be eating? Raw and organic vegetables, fruits and nuts. This is what humans were meant to eat before we ruined it with all artificial food that we don't realize we are addicted to. Haven't you ever come across those articles about processed sugar being as addicting as cocaine? We don't fully understand the human body yet, but after this, I am convinced that our bodies were made perfect. On the other hand, I think chronic pain conditions like Vulvodynia are signs that you have slowly but surely made your body ill due to your environment, the number one factor in our environment is food since we are directly consuming it. And especially in the Western world, most of us have been consuming this food since we were kids.

I am praying that you consider taking this advice. What I went through in just a short few months was unbearable, no one should have to endure this for another second! So yeah here I am on this site sounding like a health freak, which I never in a million years though I'd become. I still love the bad food and I think it is important to allow yourself a portion of the foods you want from time to time. Overtime, you will stop craving them anyway. In my opinion, the results are better when you are not as high strung and stressed about your diet. Good luck ladies, I wish you the best in whatever route you decide to take!

Hello, Just wanted to write and say that I too have had almost complete success in treating vulvodynia. Sorry, this is a very very long post... But please take the time to read it, it might help you!! After 3 years of hell I have found a way of managing my pain, and learned a lot about my body in the process. I know how awful the condition is, and really want to help:

I had been suffering from provoked vulvodynia for three years, since age 17. It was ruining my life. I had pain-free sex for a year prior to this, and then after a minor back accident I started experiencing symptoms of nerve damage, such as spasming down my left leg and muscle contractions. Eventually this manifested itself into excrutiating vaginal and clitoral pain, and about a year after the vaginal pain began I started getting stinging bladder pain every time I urinated, which gradually got worse and worse. I would also be in pain at least three days after attempting to have sex - it would feel like I had been kicked repeatedly in the abdomen. I think because of my age doctors were even more reluctant to admit that I had a problem - I was told on many occassions that the pain was all in my head and that 'I just needed to have more sex'. Over the course of those three years I sunk into quite a depression, and was no longer confident about my sexuality. I viewed all men as predators, and was not able to experience the kind of life most of my friends were experiencing. University was horrible because I felt like I was the odd one out, who was in too much pain to date boys. And I used to internalise my pain as if it were a huge dark secret... I was too embarrassed to tell anybody, except a few close friends back home, and my mum. I was very lucky to have my mum's support - I would urge anybody who has this condition to speak to someone close about it, because it is too much of a burden to carry around on your own. There were times when I felt utterly hopeless and lonely and considered taking my own life - I don't know what I would have done without support from the people around me.

Anyway, I tried all the usual things... Estrogen cream, amitryptaline, gabapentin, acupuncture, a low oxalate diet etc. Nothing worked. I decided to see a chiropractor who specialised in pelvic pain that I had come across online, and she told me that my pelvis was severely misaligned, (due to my posture, my skeletal structure from birth and the minor back accident I had) and that this was probably affecting a nerve that supplied my genitals. She also suggested that I might have a tight piriformis muscle, which is the muscle that the pudendal (genital) nerve runs through - and this might be damaging the nerve. My left foot stuck out to one side when I was lying down, and this suggested piriformis syndrome. I had quite a few (expensive) sessions with her, but every week my pelvis would slip back into its old misaligned position because my core muscles were not strong enough to hold it in place, and the harsh chiropractic technique seemed to aggravate the nerve rather than help it - I was having bad flare-ups where my muscles would spasm a lot and pain would shoot down from my lower back into my left hip, down to my knee, my big toe... The sexual pain did not improve either - it was still literally extrutiating to attempt sex or any kind of sexual contact, and unfortunately I had no understanding partner who I could practice with -not many boys in their late teens would stick around with someone with my issues, I thought. If I got interest from a boy I would always push them away, and completely ignore my own feelings in the process. Sex became so scary and I not only worried about pain but also my own inexperience from all that time I was forced to be celebate.

After much pursuasion and a long time to-ing and fro-ing from surgery to hospital clinic I managed to convince a reluctant dermatologist ( - who told me that she had been seeing women with my condition for 40 yrs, and had not managed to cure one of them - she also told me that my pain was 'probably all psychological' -) to refer me to a neurologist. The neurologist carried out an EMG test on my back and yes - I did have a trapped nerve in the lumbar region of my spine. The neurologist said that this nerve could also be affecting the nerve that supplies the genitals, the pudendal nerve - so I am due for another EMG to find out if this is the case in about a weeks time.

Six weeks ago, despairing because my pain was still very bad and I had tried and failed at everything the doctors had suggested, I went to see a physical therapist. The man I see broke his back in a motorbike accident in his twenties and was told by doctors he would never walk again. He is now in his fifties and super fit. He trains many people and has a great knowledge of the human body.

I told him my symptoms and he agreed that a tight piriformis muscle might be constricting the pudendal nerve. After doing some stretches she identified that I did indeed have piriformis syndrome. Over the last six weeks he has been giving me a course of exercises to stretch out the piriformis muscle and realign my crooked pelvis, and I do stretches similar to those described in Amy Stein's book (I do have a copy of the book, but I think it was very important for me to be told exactly how to do these stretches properly, so as not to do more damage than good - I am also very lazy and it helps me to stay motivated seeing a personal trainer once a week. I think also, each body is different, and it is important to tailor your regime to suit your needs) and in that short time, I have completely eliminated my muscle spasms, I no longer have back pain that radiates into my leg and foot, and my bladder pain has disappeared. My vulval pain, that was at an 8.5 - 9 out of ten, is now at a 1 - 2. I am hoping this will continue to get better - I am also trying meditation in order to dispell any anticipated pain that my brain might be holding on to. Seeing a physical therapist is quite expensive but 100% worth it. Once I learn to do these exercises properly and integrate them into my daily regime, I will have them for life, and will no longer need to see the therapist.

In order to maintain this pain free life I have to do the stretches and exercises for at least half an hour every day. In modern life we are forced to sit at desks and slump in chairs a lot and this is so bad for our posture - it is amazing what stretching out the core muscles can do. Through exercise I have effectively cured my tight muscles and piriformis syndrome which were pressing down on a nerve. It is important that we have strong supportive core muscles before we can work on the superficial muscles, because it is the ones deep down that stabalize everything and make sure we do not get musculo-skeletal problems.

Having to deal with vulvodynia has completely changed me as a person. In a warped way it has actually benefitted me in that I was forced to examine myself as a person rather than just a sexual object - I used to play on my sexuality a lot, and having this condition has really taught me to not rely on these assets, and instead develop a strong character and personality that makes me valuable for more than just my physicality. Sorry if this sounds cheesy, and I'm not trying to peddle dime-store feminism or anything, but it's true! I couldn't rely on male attention for my self esteem anymore so I had to find it elsewhere, through developing hobbies and exploring more Buddhist ideas and accepting the bad things that happened to me. I have also got more male friends now, because I have been able to develop strong friendships without any sexual agenda. I am starting to speak up about my condition. I have told two close male friends and both have been sympathetic, and not treated me any differently. Any man that is seriously going to judge you for this is not worth your time of day.

For those of you in England, the Vulval Pain Society puts on some very inspiring talks about managing pain. I was so nervous about going to a talk but it made me feel optimistic. Many of the speakers are women who have managed to cure themselves though things like hypnosis and meditation. David Nunns, the head of VPS, also speaks, and gives a lot of valuable information about how to navigate the heath system with a condition that a lot of so-called 'health professionals' are completely ignorant about. The best thing about the day was meeting many women and their partners with the same issues as me. Vulvodynia is a very isolating condition and it is so comforting but also saddening to know that I am not alone, and there are many other women experiencing the same things as me. There were women of all ages at the talk - at least five women were in their early twenties like me, which was reassuring.

The last thing I will say is that I know from experience that the worst thing to do when you are feeling depressed about this awful condition is spend hours trawling the internet reading about people's experiences - most people that post online about this choose to be negative, sadly. This is not beneficial for the person writing the negative post, or the person reading it. I think as we are all going through this together we have a responsibility to try and offer helpful and encouraging advice to each other.

In the next few weeks I am going to try a method for neuropathy called Body Stress Release. It is supposed to be beneficial for vulvodynia - you can find out about it online. The pudendal neuralgia EMG test is very scary and invasive but hopefully it will give me even more answers when I have it. I wish you all the best of luck and hope that many of you will turn to exercise as a means of curing your pain. Thank you for reading this! There is always hope for the future no matter how desolate things seem now.

I was able to get some sleep and when I woke up all of the tearing, sores, and swelling were GONE! I kid you not! I was so excited nothing I've tried worked that quickly before. I don't really know why it worked but I have continuously applied it twice a day. Haven't had a flare up in over a month since doing this. I don't think it really "cured" anything, I worry if I stop it I could have another flare up. It did however stop the pain and keep it away since I've been using it. I've also been going to the chiropractor, stopped my birth control, and am taking herbal adrenal support remedies to help balance out my hormones. I've been doing that for about 6 months now and I feel it has helped tremedously but has not cured me yet. It does seem to slow down the frequency of flares I do have so I feel I am on the right track but for immediate pain relief the chap stick 100% took care of the issue. I hope this helps someone!

Cytolytic vaginosis(CV) is the current term for a condition of lactobacilli overgrowth. It is a little recognized but common cause of cyclic vulvovaginal complaints in women of reproductive age. CV is often misdiagnosed as candidiasis and most women have tried many antifungal medications both conventional and alternative, with little or no relief.

CV was first described as a clinical entity by Cibley and Cibley in 1982 and it was initially referred to as Doderlein's cytolysis (DC). They observed that the symptoms of CV were similar to Candida vaginitis, but when viewed under a microscope, there were differences.( 1,2) The name of Doderlein's was abandoned because these same authors realized that DC only refers to the Doderlein's species of lactobacilli when in fact there are approximately 80 different species of lactobacilli that have been described. CV was then proposed as the more accurate term that described the actual destruction of the epithelial cells caused by the overgrowth of lactobacilli. The experience of Cibley and Cibley was that the majority of the patients referred to them that thought they had chronic vulvovaginal candidiasis actually had CV instead.( 1)

The normal ecosystem of the vagina involves many different organisms that are involved in a system of checks and balances. No other concept in vaginal health is as important as the state of the ecosystem of the vagina. The flora that colonizes the vagina takes place in the birth canal during delivery, and the flora that is established in the newborn girl must therefore consist of the same strains as in the mother. The vaginal environment of a newborn changes during the first month, then again at prepuberty, puberty, during the reproductive years and post-menopausally. Additionally, the cyclic hormonal changes of the menstrual cycle also influence the vaginal ecosystem. It is a variable state throughout a woman's lifetime, but nothing is more key to this ecosystem than lactobacillus. The range of bacterial types isolated is immense, including Staphylococcus species, Garnerella vaginalis, Streptococcus species, Bacteriodes species, Lactobacillus species, Mobiluncus, Candida species, (most commonly Candida albicans), and more. The predominant organism isolated from the normal vagina are members of the Lactobacillus genus. One species of bacteria inhibits another and an elegant combination of pH, vaginal immunity, hormonal activity and the community of organisms that occupy the vagina interact in a manner in which bacterial overgrowth is controlled, unless the well-established mechanism of balance is thrown off by one factor or another.

Factors controlling this defense system include the health of the vaginal squamous epithelium, the dominance of Lactobacilli and the subsequent low or acid pH balance and hydrogen peroxide production, hormonal activity both over our lifetime as well as our monthly cyclic changes, pregnancy, contraceptive devices, feminine hygiene products, and vaginal sexual activity including friction, lubricants, foreign objects, and semen.

It has been proposed that lactobacilli and possibly other bacteria cause the symptoms of CV. Even though we lack full understanding about the exact mechanism of lactobacilli overgrowth, a clinical condition does exist with this overgrowth that manifests as chronic cyclic burning and itching. It appears that this is probably related to an overgrowth of lactobacilli that produces irritating acids.( 1)

Several mechanisms are possible for how Lactobacillus in normal amounts does its remarkable job of controlling the environment. A low vaginal pH is believed to be a primary mechanism controlling the composition of the vaginal micro flora. Lactic acid is produced by the metabolism of lactobacillus and although there may be other ways in which the vagina maintains its normal acidic environment, the role of lactobacilli seems evident. Lactobacilli thrive at an acidic pH of 3.5-4.5 and these values are indeed found in the normal vagina throughout the menstrual cycle.

Lactobacilli have also been shown to interfere with how pathogenic bacteria adhere and colonize the cells of the vagina.( 3) Hydrogen peroxide production is another well-recognized method of antagonism to problematic bacterial populations and there are strains of lactobacilli that produce hydrogen peroxide (H( 2)O( 2)). A lack of H( 2)O( 2) producing lactobacilli predisposes a woman to bacterial vaginosis by allowing the overgrowth of Gardnerella and other anaerobic bacteria. Lactobacilli also act directly as antibacterials( 4) and may function as an immune stimulant locally in controlling microbial levels in the vagina.

But what happens when there is too much Lactobacilli? 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. When lactobacilli overgrow, toe many acids are produced, causing vulvar irritation and itching.

Symptoms

Symptoms of CV usually mimic those of vulvovaginal candidiasis. The most common symptom is itching, but vulvar burning, dysuria, and entry dyspareunia are often present as well. Cyclical and recurrent symptoms typically occur during the luteal phase and worsen premenstrually, increasing in intensity and severity until the onset of menses. Once the onset of menstrual flow occurs, the blood raises the vaginal pH and there is often dramatic relief of symptoms.( 1)

The physical exam is not particularly different from candida vulvovaginitis. The vulva may appear red and slightly swollen. There may be a small amount of white and slightly clumpy discharge. The vulvar tissues may be a little tender with discomfort during the speculum exam. The cervix, vagina, uterus and adnexae are normal unless there is also some other kind of co-infection. Even the pH of the vagina is normal in CV.

Diagnosis

Diagnosis of CV is improved if the clinician has a high degree of suspicion of the condition. The history and physical exam basically mimics candida vulvovaginitis. The key is in the microscopic exam: 1) false clue cells with agglutination of lactobacilli to epithelial cells; 2) few white blood cells; 3) cytolysis of epithelial cells with pale or bare nuclei/cytoplasm and poorly defined cell borders; 4) absence of yeast, trichomonas, bacterial vaginosis, or other organisms.( 1)

Repeat microscopic exams that reveal the same findings is confirmation of CV. As you know, each episode of vaginitis symptoms may be due to a different cause.

Treatment

The goal of therapy is aimed at reducing the overgrowth of lactobacilli and providing relief of symptoms. Use of antifungal agents, both conventional and alternative, should be discontinued because these agents may contribute to the recurring nature of the condition. Use of lactobacilli in the form of yogurt, supplements and suppositories should be stopped. It may also be wise to discontinue use of tampons because unimpeded menstrual flow acts much like an alkalinizing agent, raising the vaginal pH and inhibiting the overgrowth of lactobacilli.

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. Mix 2 to 4 tablespoons of baking soda in 1 to 2 inches of warm bath water. Sit in the sitz bath twice a day for 15 to 20 minutes. Wash the tub after each use. Baking soda douches should be reserved for women whose symptoms do not respond to the sitz baths. This is because douching removes vaginal secretions and can disrupt the desired organisms in the vagina and create further problems in maintaining an ecological balance. Consider douching with baking soda once or twice a week during symptomatic phases when the sitz baths do not provide relief. Mix 1 to 2 teaspoons of baking soda in a pint of warm water and gently douche either in the bathtub or over the toilet.

Cytolytic vaginosis may coexist with candidiasis and may need to be managed by combining therapy for both. Using the local antifungal agent in the morning and the baking soda gentle douche in the evening for seven days would be an appropriate regime that may need to be repeated monthly in the premenstrual phase of the cycle.

Other recommendations may prove prudent:

Reduce dietary sugar.
Avoid soap in the genital area. Instead, wash with plain water, use pure unscented mineral oil on cotton balls as a cleanser
Wear white, all cotton underwear and launder with mild soap and hot water, rinsing thoroughly.
Avoid sexual intercourse during symptoms and initial therapy. Oral sex should also be avoided during symptomatic periods because bacteria in the partner's mouth may be irritating to the vulva.
Summary

As women and clinicians become aware of CV, women with cyclic vulvovaginitis will receive better health care and be managed more appropriately. With improved diagnosis of this condition and accurate treatment, fewer women will experience cyclic recurrences of their vaginitis. Success is especially seen when the wrong treatments are discontinued and something as simple as using menstrual pads are used instead of tampons. Treatment approaches to treat CV must be modified as necessary and practitioners must recognize the individual needs of each patient and be willing to be creative and somewhat experimental, utilizing the basic concepts and understanding of CV that we have discussed here.

References
(1.) Cibley J, Cibley J. Cytolytic vaginosis. Am J Obstet Gynecol 1991; 165: 1245-1248(supple 2).

(2.) Kaufman R, Friedrich E, Gardner H. Benign diseases of the vulva and vagina (ed 3). Chicago, III, Year Book Medical, 1989: 371-418.

(3.) Chan R, Bruce A, Reid G. Adherence of cervical, vaginal and distal urethral normal microbial flora to human uroepithelial cells and the inhibition of adherence of gram-negative uropathogens by competitive exclusion, J Urol/1984; 131: 596-601.

(4.) Andersson R, Daeschel M, Hassan H. Antibacterial activity of plantaricin SIK-83, a bacteriocin produced by Lactobacillus plantarum, Biochimie 1988; 70:381-90.

Townsend Letter for Doctors & Patients.

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By Tori Hudson

Organic Castor Oil is critical, not coconut oil. A holistic healer woman told me coconut oil is not the best for the vagina. I buy the castor oil by heritage in the brown glass bottle and it allowed me to soothe my vagina pain, stop itching at night. In combination with Baking soda, I dilute aluminum free sodium carbonate with distilled / or spring water, and then mix castor oil - ensure it's organic. I apply after I pee every time. This helped me alot. Castor oil can be used alone topically or inside the vagina. Wishing you wellness and strength.

Check oxalic acid level in your body (oxalates). Had a same problem for few years and naturopath discovered very high level of Mg oxalates. Frequent urination, itchy genital area, burning, increased discharge, genital tissue was cut with crystals ... Cherry juice helps, avoid food rich with oxalic acid

I have had extreme (like on fire) pain in my vagina since I was 25 years old (I am 58). Many doctors, no answers. About 2 years ago I got very raw lesions in my mouth, inside my right cheek and had them biopsied. Just looking at the white striations and irritated area he had guessed it was Oral Lichen Planus, and he was right. It is an autoimmune condition and can show up in your vagina too. It basically means the mucus membranes in your body are breaking down. I'm not sure if I am allowed to post a link but this doctor has really clear easy to understand explanation of it and some food and vitamin ideas that are supposed to help. I also had one blue mole about the size of a grain of rice show up on my leg just like he says. Mine doesn't hurt unless I provoke it, thank goodness, so I don't know if his ideas work but it does seem eating chickpeas (garbanzo beans) helps me. https://draxe.com/health/lichen-planus/

Since then I've had a few minor and short relapses with the burning. I've noticed now what brings it on, and what soothes it quickly.

Too much sugar, caffeine, or alcohol, combined with being dehydrated from not drinking enough water will definitely bring on a flare-up. Yes, diet is extremely important. I already eat mostly vegan and have had a very clean diet for many years. I notice when I start to eat too acidic or unhealthy processed foods or am dehydrated the pain comes.

What I have found that heals it quickly are tea tree oil suppositories. (can find on Amazon) One fully inserted and one hanging out at the vaginal opening for direct exposure. Within 30 minutes the burning will be gone, only to return whenever my diet, hydration, or stress levels become unbalanced.

Everyone's triggers and cures may be different, but this is what has worked for me. After having the immediate relief with tea tree oil suppositories I'm beginning to believe that it is some sort of yeast or bacteria that may be deep in the skin, not necessarily in the secretions that are typically tested.

My mom mentioned that one of her friends had IC, with the same burning sensations, and drinking baking soda to alkalize her bladder worked for her.

2 months before my symptoms started I did have a UTI with blood and when I peed I had nerve pain shoot down my leg! Never had such a pain with UTI before! I did take antibiotics and it cleared up, but I was reading how sometimes all the bacteria isnt killed off and remains stuck to the bladder walls. And this kind of imbalance in the bladder can be connected to causing nerve pain in the vulva. I'm suspecting some combination of all these things mentioned above is what triggered my vulvodynia.

I purchased a supplement called D-Mannose yesterday, It is a type of sugar related to glucose that your body does not absorb but pisses out. When it's in the bladder it prevents bacteria from sticking to the wall of the bladder, and then you can pee out the bacteria. I will try this over the next few weeks.. I'm hoping this last flare up I had last night will be my last one ever. SO YES. DIET and HYDRATION are SUPER IMPORTANT! and possibly look into creating an internal environment that is inhospitable to hidden yeast, candida, and bacteria.

At my worst, I also wore an estrogen patch. Also took plenty of Vit E, Vit D3, and some coconut capsules.

If this helps just one other person, glad I took the time to post.