State-of-the-art of vulvovaginal candidiasis: etiopathogenesis, diagnosis, and treatment

Abstract

During the reproductive age, 75% of women experience at least one episode of vulvovaginal candidiasis (VVC) and 40–50% of women experience two or more episodes. Recurrent VVC is referred to as at least four episodes of the disease within a 12-month period. The aim of this paper is to review the etiology, pathogenesis, clinical signs, diagnosis, and treatment for VVC. Both domestic and foreign published data are analyzed. It is now recognized that urogenital disorders and systemic comorbidities are the key predisposing factors to recurrent VVC. Other risk factors include the use of broad-spectrum antibiotics, immunosuppressants, and hormone replacement therapy, endocrine disorders, and intestinal Candida persistence. Intravaginal medications are the preferred treatment for VVC. A 6-month maintenance therapy reduces the rate of VVC recurrences by 90%. Further studies on the etiopathogenesis of recurrent VVC will improve treatment efficacy. KEYWORDS: vulvovaginal candidiasis, recurrent vulvovaginal candidiasis, vulvovaginal candidiasis, Candida albicans, non-albicans Candida, Candida spp., Lactobacilli, vaginal colonization resistance. FOR CITATION: Murakov S.V., Vladimirova E.V., Kovalyk V.P. et al. State-of-the-art of vulvovaginal candidiasis: etiopathogenesis, diagnosis, and treatment. Russian Medical Inquiry. 2020;4(10):625–631. DOI: 10.32364/2587-6821-2020-4-10-625-631.