Epidemiologic characteristics of women with idiopathic recurrent vulvovaginal candidiasis

Objective: To evaluate risk factors related to anamnestic variables, sexual behavior, feminine hygiene habits, and microbiologic findings in women with idiopathic recurrent vulvovaginal candidiasis. Methods: We conducted a multivariate observational study comparing sociodemographic, anamnestic, clinical, and microbiologic variables between 86 patients with recurrent vaginal candidiasis and 180 controls with nonrecurrent infection. Results: In logistic regression analysis, women with recurrent candidal vaginitis were more likely than controls to use contraceptive pills (adjusted odds ratio 2.0, 95% confidence interval [CI] 1.02-3.91; P =.04) and commercially available solutions for either vulvoperineal cleansing (adjusted odds ratio 2.2, 95% CI 1.25-3.88; P = .007) or vaginal douching (adjusted odds ratio 1.8, 95% CI 1.0-3.26; P = .05). The rate of isolation of non-albicans candida species was significantly higher among cases than controls (adjusted odds ratio 3.0, 95% CI 1.50-6.04; P =.005). Finally, increasing frequency of monthly sexual intercourse was significantly correlated (χ² for trend = 4.87; P = .027) with recurrent infection. Conclusion: Several behavioral factors seem to influence the occurrence of relapses in recurrent vulvovaginal candidiasis. Appropriate counseling about contraception, sexual activity, and personal hygiene habits could be an important preventive measure in these cases.