Chronic vaginal candidiasis. Management in the postmenopausal patient

Area of Science:

• Medical Mycology
• Gynecology
• Infectious Diseases

Background:

• Vulvovaginal candidiasis (VVC) is a common condition in women of childbearing age.
• Literature on VVC prevalence in postmenopausal women is scarce, often presumed uncommon due to estrogen dependence.
• Risk factors like hormone replacement therapy, diabetes, and immunosuppression can predispose postmenopausal women to chronic or recurrent VVC.

Purpose of the Study:

• To review the current understanding of vulvovaginal candidiasis in postmenopausal women.
• To outline appropriate investigation and treatment strategies for VVC in this demographic.
• To highlight the efficacy of oral and topical antifungal agents.

Main Methods:

• Review of existing literature on VVC in postmenopausal women.
• Analysis of treatment guidelines for VVC applicable to all age groups.
• Evaluation of oral and topical antifungal regimens, including ketoconazole, itraconazole, fluconazole, clotrimazole, and miconazole.

Main Results:

• While VVC is less common in postmenopausal women, those with risk factors may experience chronic or recurrent infections.
• Investigation and treatment protocols for postmenopausal women should align with those for younger women.
• Oral antifungal therapy (e.g., ketoconazole, itraconazole, fluconazole) and topical treatments (e.g., clotrimazole, miconazole) are effective.

Conclusions:

• Postmenopausal VVC requires a similar diagnostic and therapeutic approach as in premenopausal women.
• Oral antifungal agents offer convenience and efficacy for treating VVC in older women.
• Maintenance therapy with oral or topical antifungals can be crucial for managing recurrent or chronic VVC in postmenopausal individuals.