Premenstrual vaginal colonization of Candida and symptoms of vaginitis

Cathy J. Watson, Danilla Grando, Suzanne M. Garland, Stephen Myers, Christopher K. Fairley, Marie Pirotta

¹General Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton 3053, Australia

²Microbiology Dept, Building 223 Level 1, RMIT University Bundoora Campus, School of Applied Sciences, RMIT University, PO Box 71, Bundoora 3083, Australia

³Dept Microbiology Infectious Diseases, Royal Women's Hospital, Department of Obstetrics and Gynaecology, University of Melbourne, Carlton 3053, Australia

⁴NatMed-Research, The Natural and Complementary Medicine Research Unit School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia

⁵School of Population Health, University of Melbourne, Melbourne, Australia; and Melbourne Sexual Health Centre, Alfred Health, Carlton 3053, Australia

Correspondence
Cathy Watson cathyw{at}unimelb.edu.au

Journal of Medical Microbiology 2012; 61(Pt 11):1580–1583 · https://doi.org/10.1099/jmm.0.044578-0

Abstract

Although premenstrual exacerbation of vulvovaginal symptoms attributed to Candida spp. is well documented, the causation of these symptoms is not well understood. This study describes the daily vaginal colonization of Candida in three women. A single pilot study was designed to test the methodology of the proposed randomized controlled trial, Garlic and Candida. This study reports the colonization of Candida spp. in three women. Ten women aged 18–50 who reported at least one episode of vulvovaginal candidiasis were recruited by the University of Melbourne. Each participant took daily vaginal swabs for 2 weeks during the luteal phase of their menstrual cycle, which were analysed for quantitative colony counts of Candida spp. Of these, three women were colonized with Candida spp. For the first time, to our knowledge, daily colonization of Candida during the luteal phase of the menstrual cycle is described in three women, demonstrating an increase in the colony count preceding symptom development. This small study demonstrated the colonization of Candida spp. during the luteal phase of the menstrual cycle in three women. Candida colonization is poorly understood, yet investigating the relevance of the link between symptom exacerbation and the menstrual cycle in those women who experience recurrent episodes of vulvovaginal candidiasis may influence the management of this condition.