Information on the incidence of vulvovaginal candidiasis (VVC) is incomplete since VVC is not a reportable entity. Most studies suggest a VVC prevalence of 5-15 percent depending on the population studied. Infection caused by candida species affects 70-75 percent of women at least once during their lives, and 40 to 50 percent with experience at least one recurrence. A small subpopulation, fewer than 8 percent, will experience recurrent vulvovaginal candiosis (RVVC), defined as four or more mycologically proven episodes within 12 months. The incidence of VVC increases dramatically in the second decade of life, corresponding to the onset of sexual activity. VVC peaks in the third to fourth decade, declining in females older than 40 years of age.
A number of studies have shown that sexual transmission of candida organisms occurs during sexual intercourse, although the role of nonsexual practice in introducing candida organisms in the lower genital tract has not been appraised. Pregnancy, recent antibiotic use, immunosuppressive illness such as diabetes mellitus and HIV, prolonged or chronic corticosteroid treatment, prolonged wearing of damp clothing, and frequent douching are included as generally-recognised risk factors for developing VVC.
Although the detailed mechanisms of VVC pathogenesis remain a controversial issue, it appears that when the balance between the microorganisms in the vaginal microbiota is disrupted, overgrowth of candida is facilitated.
In a recent study (2014) undertaken at the University of Trieste, Italy, researchers evaluated the effect of the application, lactobacillus plantarum P17630, in restoring the vaginal microbiota and prevention of relapses among women with acute VVC. Interestingly, lactobacillus plantarum P17630 is able to adhere to human vaginal cells thereby interfering with adherence of candida albicans. In the foregoing study, 40 Patients (Probiotic group) were administered vaginal application of a capsule containing lactobacillus plantarum P17630 once a day for 6 days, and then once a week for 4 weeks, post conventional azole-based protocol. Results showed that intravaginal administration with lactobacillus plantarum P17630 was capable of reducing the re occurrence of VVC compared to controls. This study reinforces and expands on previous research that has shown lactobacillus rhamnosus GR-1, L. reuteri RC-14 and lactobacillus plantarum can suppress the growth of VVC causing C. albicans on abiotic surfaces.
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Mark Hinchey Naturopathy, 601 Glebe Road Adamstown, NSW, Australia