The relationship of bacterial vaginosis, candida and trichomonas infection to symptomatic vaginitis in postmenopausal women attending a vaginitis clinic

• Published in: Maturitas 1997-07, Vol.27 (3), p.253-260
• Main Authors: Spinillo, Arsenio, Bernuzzi, Anna Maria, Cevini, Claudia, Gulminetti, Roberto, Luzi, Stefania, Santolo, Antonella De
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bacterial vaginosis; Biological and medical sciences; Candida albicans; Candidiasis, Vulvovaginal - diagnosis; Candidiasis, Vulvovaginal - epidemiology; Confidence Intervals; Cross-Sectional Studies; Diagnosis, Differential; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Italy - epidemiology; Medical sciences; Middle Aged; Non tumoral diseases; Odds Ratio; Postmenopause; Trichomonas vaginalis; Trichomonas Vaginitis - diagnosis; Trichomonas Vaginitis - epidemiology; Vaginitis; Vaginosis, Bacterial - diagnosis; Vaginosis, Bacterial - epidemiology
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/S0378-5122(97)00038-8

Objective: To estimate the prevalence of bacterial vaginosis, Candida albicans, and Trichomonas vaginalis infections in a population of postmenopausal women with symptoms of vaginitis seen at a vaginitis clinic either as self-referred or clinician referred patients. Methods: A cross-sectional study of 148 postmenopausal women (cases) and 1564 controls of reproductive age attending a vaginitis clinic. C. albicans and T. vaginalis infections were diagnosed by culture techniques. Bacterial vaginosis was diagnosed on the basis of clinical findings. Results: Fifty-six (37.8%) postmenopausal women and 834 (53.3%) controls were diagnosed with T. vaginalis or C. albicans infection, or bacterial vaginosis, or mixed infection (odds ratio (OR) 0.53, 95% confidence interval (CI) 0.37–0.75). C. albicans and T. vaginalis infection were diagnosed in 34.1% ( 534 1564 ) and 1.92% ( 30 1564 ) of women of childbearing age and in 3.5% ( 20 148 ) and 10.8% of postmenopausal women, respectively. ( P < 0.05 for both comparisons). The prevalence of bacterial vaginosis was similar between the two groups ( 14 148 in postmenopausal patients and 210 1564 in controls of reproductive age; P = 0.22). Conclusions: Among postmenopausal women attending a vaginitis clinic, a defined diagnosis of bacterial vaginosis, C. albicans or T. vaginalis infection can be made in about one third of such patients. Concerning the two thirds of symptomatic women lacking such a microbiologic diagnosis, alternative causes (e.g., estrogen deficiency, nonanaerobic bacterial infections, local irritants or allergenes, and dermatologic conditions) need to be considered.