Introduction: Cytolytic vaginosis (CV) is an underrecognized vaginal disorder affecting approximately 5-7% of women with vulvovaginal complaints. It is characterized by excessive proliferation of Lactobacilli, leading to hyperacidity and epithelial cell lysis. Misdiagnosis with vulvovaginal candidiasis often results in ineffective antifungal treatment, underscoring the need for more targeted therapeutic strategies. Methods: This review synthesizes current and emerging approaches to CV management, focusing on advanced drug delivery systems, controlled-release formulations, and novel therapeutics. The literature on microbiome modulation, pH-responsive technologies, mucoadhesive systems, biofilm-disrupting methods, and the integration of digital and personalized medicine was critically assessed. Results: Nanotechnology-based carriers, including liposomes, solid lipid nanoparticles, and polymeric systems, demonstrate enhanced drug delivery and residence time. Mucoadhesive formulations prolong vaginal contact and improve patient adherence. Combination therapies involving pH modulators, probiotics, and topical agents show synergistic effects in restoring microbial balance. Innovative technologies such as AI-assisted formulation design, smart biomaterials, and gene-editing strategies hold the potential for breakthroughs. Emerging clinical evidence supports the use of in vitro/ex vivo models, randomized controlled trials, and patientreported outcomes for safety and efficacy evaluation. Discussion: Advanced formulations and integrated therapeutic approaches offer significant promise in overcoming current limitations in CV treatment. Personalized and digital health interventions may improve diagnostic accuracy, patient compliance, and long-term outcomes. However, standardization of diagnostic criteria, optimized clinical endpoints, and regulatory clarity remain unmet needs. Conclusion: Nanotechnology-driven, patient-centered therapeutics have the potential to redefine CV management. Future research should validate these strategies through clinical studies, establish treatment guidelines, and explore long-term safety to ensure effective and individualized care.
Chauhan et al. (Mon,) studied this question.