To evaluate risk factors related to sociodemographic and clinical variables, oral contraception and sexual behavior of women with recurrent vulvovaginal candidiasis, we conducted a case-control study comparing 153 patients with recurrent vulvovaginal candidiasis with both asymptomatic women with negative vaginal cultures and patients with nonrecurrent symptomatic vulvovaginal candidiasis. In logistic regression analysis, patients with recurrent Candida vaginitis were more likely than negative controls to have used any contraceptive method in the year before evaluation, to have used antibiotics in the month preceding the visit, and to have a higher number of lifetime sex partners. Compared to patients with nonrecurrent Candida vaginitis, patients with recurrent infection were more likely to use oral contraception and to have a higher frequency of monthly intercourse. The proportion of recur rent disease attributable to the pill averages 11-12%. We conclude that oral contraceptives may influence the recurrence of symptomatic vulvovaginal candidiasis.
PIP: Researchers in Italy compared data on 153 patients with recurrent vulvovaginal candidiasis (cases) with data on 306 asymptomatic patients (control group A) and data on 306 patients with nonrecurrent symptomatic vulvovaginal candidiasis (control group B). They wanted to examine the sociodemographic and clinical characteristics, sexual habits, and contraceptive histories of women with recurrent vulvovaginal candidiasis. Cases were more likely than asymptomatic women to have previously used any contraceptive method (odds ratio [OR] = 2.08 for the pill, p = 0.0032; OR = 4.15 for the IUD, p = 0.0019; OR = 2.55 for barrier methods, p = 0.014). They were also more likely to have used antibiotics in the last month before the visit (OR = 2.1; p = 0.009) and to have more lifetime sexual partners than asymptomatic women (OR = 3.82 for 7 partners; p = 0.009). Patients with recurrent vulvovaginal candidiasis were more likely than those with nonrecurrent vulvovaginal candidiasis to have used low-dose oral contraceptives (OCs) (OR = 1.59; p = 0.036) and to have a higher rate of monthly intercourse in the last 6 months (OR = 2.51 for 10 times; p = 0.048). The attributable risk of OC use for recurrent vulvovaginal candidiasis was insignificant (11-12%). These results suggest that OCs may contribute to the recurrence of symptomatic vulvovaginal candidiasis.