Relation of sexual behavior with extra-genital Candida colonization in women with recurrent Candida vulvo-vaginitis (RVVC).
Grinceviciene, S1; Ruban, K2; Bellen, G2; Donders, GGG3
1: Vilnius University, Lithuania; Femicare vzw, Tienen, Belgium; 2: Femicare vzw, Tienen, Belgium; 3: Femicare vzw, Tienen, Belgium; Department of OB/Gyn Antwerp University, Belgium
Objective. Certain sexual habits may contribute to the severity of the RVVC. Candida migration to the vagina from the rectum and saliva during sex are described in the literature. Fluconazole maintenance therapy is recommended for RVVC patients, but relapse during the therapy. Should clinicians advise couples to change their sexual practice during maintenance treatment? In this study we correlated the presence of extragenital Candida colonized sites, such as mouth, perineum and anus, and the sexual behavior to the response rate to treatment in women with RVVC.
Material and Methods. Before inclusion, 117 women with RVVC (treated according to ReCiDiF study protocol) were tested for Candida in mouth, nose, anus, perineum. Patients were not asked to change their sexual behavior during therapy. relapses and sub-optimal with one relapse at the phase) and the non-responders (with two relapses at the They received oral fluconazole degressive regiment (200 mg weekly for 2 months, then biweekly for 4 months and monthly for 6 months). The sexual behavior was compared with presence of extra-genital Candida in different body sites.
Results. Most respondents (78.6%, 92/117) identified themselves as heterosexuals, one was homosexual and one - bisexual. All but one women practiced vaginal sex. Regular oral sex was not a risk factor to have multiple site colonization (OR = 1.27; CI95% 0.36-4.48), nor for non-response to therapy (OR = 1.3; CI 95% 0.41 – 4.73). There was no relation between masturbation and response to therapy (OR 0.8; CI95% 0.31 - 1.84). Patients receiving anal sex were not more likely to have multiple site colonization than women who never did (OR = 3.13; CI95% 0.63-15.66) and was not associated with the level of response to fluconazole maintenance therapy (OR = 0.54; CI95% 0.11-2.72).
Conclusion. Sexual transmission is not a crucial risk factor for non-response to fluconazole maintenance therapy in RVVC patients.
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