Recurrent vulvovaginal candidiasis

Am J Obstet Gynecol. 2016 Jan;214(1):15-21. doi: 10.1016/j.ajog.2015.06.067. Epub 2015 Jul 9.

Abstract

Recurrent vulvovaginal candidiasis (RVVC) is a common cause of significant morbidity in women in all strata of society affecting millions of women worldwide. Previously, RVVC occurrence was limited by onset of menopause but the widespread use of hormone replacement therapy has extended the at-risk period. Candida albicans remains the dominant species responsible for RVVC, however optimal management of RVVC requires species determination and effective treatment measures are best if species-specific. Considerable progress has been made in understanding risk factors that determine susceptibility to RVVC, particularly genetic factors, as well as new insights into normal vaginal defense immune mechanisms and their aberrations in RVVC. While effective control of RVVC is achievable with the use of fluconazole maintenance suppressive therapy, cure of RVVC remains elusive especially in this era of fluconazole drug resistance. Vaccine development remains a critical challenge and need.

Keywords: Candida vaginitis; antifungals; antimycotics; vaginal candidosis; vulvovaginal candidiasis.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Candidiasis, Vulvovaginal* / diagnosis
  • Candidiasis, Vulvovaginal* / drug therapy
  • Candidiasis, Vulvovaginal* / genetics
  • Candidiasis, Vulvovaginal* / immunology
  • Candidiasis, Vulvovaginal* / microbiology
  • Drug Resistance, Fungal
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Probiotics
  • Recurrence

Substances

  • Antifungal Agents