The protective influence of progestogen only contraception against vaginal moniliasis

The incidence of Candida albicans (C.A.) infection of the vagina was evaluated in vaginal discharges obtained from 85 subjects using a large battery of culture media and confirmatory tests. Twenty women using DMPA 150 mg i.m. contraceptive injections for more than one year (long-term users) were compared with forty 2nd trimester pregnant cases with respect to vaginal candidiasis. The basis of comparison was the presence of amenorrhea and high hormonal levels in both groups. However, pregnant subjects showed a 60% prevalence while none of the DMPA cases had a positive culture or smear. Another group of 25 cases was similarly studied once before DMPA injection and again three months following drug administration (short-term use). The pre-therapy samples demonstrated a 32% incidence which was reduced to 8% after three months of use. It therefore appears that progestogen only contraceptives have the advantage of some protective influence against monilial vaginitis. Moreover, the use of these drugs may carry the beneficial potential of use in resistant cases of monilial vaginitis, either as a single approach or better as a supplementary procedure to known antifungal agents.