/cytolytic vaginosis/dysesthetic vulvodynia

[Guest guest]

I already sent a mail to this effect, but I'm writing again cos I feel

strongly that this is something that anyone should look into if they have

an irritating discharge but the docs do not find yeast or pathogenic

bacteria.

I had an irritating discharge and my symptoms were also somewhat relieved

by wearing tampons, and it turned out that i had cytolytic vaginosis (thank

you Dr for the diagnosis!). This is an overgrowth of the

lactobacilli that normally live in your vagina and it causes your vaginal

and vulval " skin " cells to break open (possibly because of excess hydrogen

peroxide prouced by the lactobacilli).

Many (probably most) gynocologists do not look for cytolytic vaginosis, and

the two vulval specialists I saw before Dr did not spot it. Your

cultures will come back negative because the only bacteria that are growing

there are the ones that are supposed to be there anyway - they are just

present in larger numbers.

The treatment for cytolytic vaginosis is a course of baking soda douches.

I have been cured of CV with this course and by not eating live yoghurt

(the one time my CV flared up after starting the douches was the day after

i drank a drink that I late realised had been made with live yoghurt). I

still have other problems - vestibulitis and a tendency to get yeast

infections, but I can tell you that my discharge no longer irritates me.

Of course there are other things that can cause an irritating discharge

(like yeast infections, cervicitis, etc), but CV is definitely worth

looking into.

I have one other comment - this is an opinion only BUT - I am thinking that

a positive response to tricyclics doesn't necessarily mean that you have

dysesthetic vulvodynia. The reason is that tricyclics also have

antihistamine properties (below I have pasted one abstract from medline

attesting to this - but there are many more out there). Someone (I forget

who) posted a while back that they had been to a conference where Dr

Willems said he thinks that the effectiveness of tricyclics is due to their

antihistamine properties, and he now prescribes antihistamines instead cos

they have less side effects. So, then I get to thinking antihistamines

suppress allergic responses, bla bla - FOOD ALLERGIES????? Or allergies to

other things causing vulval problems - is a recent case pointing us

to the possible importance of this. I also wonder ... I know that my

hayfever responds initially to antihistamines but then their effect wears

off, so perhaps it is the same for people who initially respond to

tricylics but then the effect wears off - maybe this means that these

people are allergic to something, but if you don't stop your exposure to

the allergen, after a while the effect wears off? I'm not trying to say

that dysesthetic vulvodynia doesn't exist, but I just wonder if there is a

lot more to this than the medical profession currently recognises.

Anyone who wants more info on CV or baking soda douches should feel free to

e-mail me.

xxx

Rao et al (1988) Duration of the suppressive effect of tricyclic

antidepressants on histamine-induced wheal-and-flare reactions in human skin

J Allergy Clin Immunol 82: 752-7

The antihistaminic properties of the tricyclic antidepressants have been

recognized since these compounds were first developed. Antidepressants,

which are equally effective for treating depression or used in the

treatment of chronic urticaria, have varying in vitro antihistaminic

properties. We compared the duration of H1-receptor blockade by two

tricyclic antidepressants, doxepin (the most potent antihistamine) and

desipramine (the least potent antihistamine), in a single dose,

double-blind, noncrossover study. After baseline prick test with histamine

phosphate 1:1000 by Multitest (Lincoln Diagnostics, Decatur, Ill.), the

suppression of cutaneous histamine-induced wheal-and-flare responses were

measured daily for 7 days in 33 healthy volunteers who were randomly

administered a single 25 mg dose of oral desipramine or doxepin.

Significant differences in the suppression of the wheal-and-flare responses

to histamine between the two drugs were noted (p less than 0.05) during the

first 3 days. Desipramine suppressed the wheal for 2 days and flare for 1

day. Doxepin suppressed the wheal for 4 days and flare for 6 days. Our

results suggest doxepin should be withheld for at least 7 days before

allergy skin testing.