Skip to main content
Log in

Vulvovaginitis in healthy women

  • Original Article
  • Published:
Comprehensive Therapy

Abstract

Vulvovaginal symptoms are extremely common and result in millions of visits to practitioners’ offices, STD clinics and emergency rooms. Vaginal infections or infectious vaginitis is responsible for only a minority of symptoms and is readily diagnosed. Epidemiology, diagnosis and therapy of vaginitis is reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Berg AO, Heidrich RD, Fihn SD, et al. Establishing the cause of symptoms in women in a family practice.JAMA. 1984;251:620–625.

    Article  PubMed  CAS  Google Scholar 

  2. Geiger AM, Foxman B, Gillespie BW. Epidemiology of vulvovaginal candidiasis among university student.Am J Pub Health. 1995;85:1146–1148.

    PubMed  CAS  Google Scholar 

  3. Geiger AM, Foxman B. Risk factors in vulvovaginal candidiasis: a case-control study among college students.Epidemiology. 1996;182–187.

  4. Hurley R, DeLouvois J. Candida vaginitis.Postgrad Med J. 1979;55:645–647.

    PubMed  CAS  Google Scholar 

  5. Odds FC. Candidiasis of the genitalia. In: Odd RC, ed. Candidaand Candidosis: A Review and Bibliography. 2nd ed. London: Balliere Tindal, 1988;124–135.

    Google Scholar 

  6. Horowitz BJ, Giaquinta D, Ito S. Evolving pathogens in vulvovaginal candidiasis: implications for patient care.J Clin Pharmacol. 1992;32:248–255.

    PubMed  CAS  Google Scholar 

  7. Foxman B. Epidemiology of vulvovaginal candidiasis: risk factors.Am J Pub Health. 1990;80:329–331.

    PubMed  CAS  Google Scholar 

  8. Ferris DG, Dekle C, Litaker MS. Women’s use of over-the-counter antifungal pharmaceutical products for gynecologic symptoms.J Fam Pract. 1996;42:595–600.

    PubMed  CAS  Google Scholar 

  9. Reef S, Levine WC, McNeil MM, et al. Treatment options for vulvovaginal candidiasis. Background paper for development of 1993 STD treatment recommendations.Clin Infect Dis. 1995;20(Suppl):580–590.

    Google Scholar 

  10. Sobel JD, Brooker D, Stein GE, et al. Single oral dose fluconazole compared with conventional topical therapy ofCandida vaginitis.Am J Obstet Gynecol. 1995;172:1263–1268.

    Article  PubMed  CAS  Google Scholar 

  11. Houang ET, Chappatte, Byrne D, Macrae PV, Thoiper JE. Fluconazole levels in plasma and vaginal secretions of patients with the 150 mg single dose and rate of eradication of infections in vaginal candidiasis.Antimicrob Ag Chem. 1990;34:909–913.

    CAS  Google Scholar 

  12. Sobel JD, Chaim W. Treatment ofCandida glabrata vaginitis: a retrospective review of boric acid therapy.Clin Infect Dis. 1997;24:649–652.

    PubMed  CAS  Google Scholar 

  13. Sobel JD. Epidemiology and pathogenesis of recurrent vulvovaginal canidiasis.Am J Obstet Gynecol. 1985;152:924–934.

    PubMed  CAS  Google Scholar 

  14. Vazquez JA, Sobel JD, Demitriou R, Vaishampayan J, Lynch M, Zervos MJ. Karyotyping ofC. albicans isolates obtained longitudinally in women with recurrent vulvovaginal candidiasis.J Infect Dis. 1994;170:1566–1569.

    PubMed  CAS  Google Scholar 

  15. Spinillo A, Carrata L, Pizzoli G. Recurrent vulvovaginal candidiasis: Results of a cohort study of sexual transmission and intestinal reservoir.J Reproduct Med. 1992;37:343–347.

    CAS  Google Scholar 

  16. Fidel PJ Jr, Sobel JD. Immunopathogenesis of recurrent vulvovaginal candidiasis.Clin Micro Rev. 1996;9:335–348.

    PubMed  Google Scholar 

  17. Chaim W, Foxman B, Sobel JD. Association of recurrent vaginal candidiasis and secretory ABO + Lewis phenotype.J Infect Dis. 1997;176:828–830.

    Article  PubMed  CAS  Google Scholar 

  18. Sobel JD, Chaim W. Vaginal microbiology of women with recurrent vulvovaginal candidiasis.J Clin Micro. 1996;34:2497–2502.

    CAS  Google Scholar 

  19. Sobel JD, Vazquez JA. Symptomatic vulvovaginitis due to resistantCandida albicans in a female who was not infected with human immunodeficiency virus.Clin Infect Dis. 1996;22:726–727.

    PubMed  CAS  Google Scholar 

  20. Lossick JC. Epidemiology of urogenital trichomoniasis. In Honigberg BM, ed.Trichomonads Parasitic in Humans. New York: Springer-Verlag; 1990;311–323.

    Google Scholar 

  21. Luga M, Manoka AT, Kivuvu AT, et al. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: result from cohort study.AIDS. 1993;7:95–102.

    Article  Google Scholar 

  22. Hammil HA.Trichomonas vaginalis.Obstet Gynecol Clin North Am. 1989;16:531–540.

    Google Scholar 

  23. Wolner-Hanssen P, Krieger JN, Stevens CD et al. Clinical manifestations of vaginal trichomoniasis.JAMA. 1989;261:571–576.

    Article  PubMed  CAS  Google Scholar 

  24. Soper DE, Bump RC, Hurt WR. Bacterial vaginosis and trichomoniasis are risk factors for cuff cellulitis after abdominal hysterectomy.Am J Obstet Gynecol. 1990;163:1016–1021.

    PubMed  CAS  Google Scholar 

  25. Krieger JN, Tam MR, Stevens CE, et al. Diagnosis of trichomoniasis: comparison of conventional wet-mount examination with cytologic studies, cultures, and monoclonal antibody staining of direct specimens.JAMA. 1988;259:1223–1227.

    Article  PubMed  CAS  Google Scholar 

  26. DeMeo LR, Draper DL, McGregor JA, et al. Evaluation of a deoxyribonucleic acid probe for the detection ofTrichomonas vaginalis in vaginal secretions.Am J Obstet Gynecol. 1996;174:1339–1342.

    Article  PubMed  CAS  Google Scholar 

  27. Nyirjesy P, Weitz MV, Gelone SP, Fekete T. Paramomycin for nitroimidazole-resistant trichomoniasis.Lancet. 1995;346:1100.

    Article  Google Scholar 

  28. Kurohara ML, Kwong FK, Lebherz TB, Klaustermeyer WB. Metronidazole hypersensitivity and oral desensitization.J Allerg Clin Immunol. 1991;88:279–280.

    Article  CAS  Google Scholar 

  29. Hillier SL, Holmes KK. Bacterial Vaginosis In:Sexually Transmitted Diseases. Holmes KK, Mardh PA, Sparling PF, et al, eds. New York: McGraw-Hill; 1990;547–560.

    Google Scholar 

  30. Eschenbach DA, Davick PR, Williams BL. Prevalence of hydrogen peroxide-producingLactobacillus species in normal women and women with bacterial vaginosis.J Clin Microbiol. 1989;27:251–256.

    PubMed  CAS  Google Scholar 

  31. Hill GB. Microbiology of bacterial vaginosis.Am J Obstet Gynecol. 1993;169:450–454.

    PubMed  CAS  Google Scholar 

  32. Gardner H, Dukes CD.Hemophilus vaginalis vaginitis: a newly defined specific infection previously classified “non-specific” vaginitis.Am J Obstet Gynecol. 1955;69:962–976.

    PubMed  CAS  Google Scholar 

  33. Amsel R, Totten PA, Speigel CA, Chen KS, Eschenbach DA, Holmes KK. Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations.Am J Med. 1983;74:14–22.

    Article  PubMed  CAS  Google Scholar 

  34. Eschenbach DA, Hillier SL, Critchlow C, Stevens C, DeRauen T, Holmes KK. Diagnosis and clinical manifestations of bacterial vaginosis.Am J Obstet Gynecol. 1988;158:819–828.

    PubMed  CAS  Google Scholar 

  35. Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation.J Clin Microbiol. 1991;29:297–301.

    PubMed  CAS  Google Scholar 

  36. Sheiness D, Dix K, Watanabe S, Hillier SL. High levels ofGardnerella vaginalis detected with an oligonucleotide probe combined with elevated pH as a diagnostic indicator of bacterial vaginosis.J Clin Micro. 1992;30:642–645.

    CAS  Google Scholar 

  37. Oleen-Burkey MA, Hillier SL. Pregnancy complications associated with bacterial vaginosis and their estimated costs.Infect Dis Obstet Gynecol. 1995;3:149–157.

    Article  PubMed  CAS  Google Scholar 

  38. Hillier SL, Martius J, Krohn M, Kiviat N, Holmes KK, Eschenbach DA. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity.N Engl J Med. 1988;319:971–978.

    Google Scholar 

  39. Eschenbach DA. Bacterial vaginosis: emphasis on upper genital tract complications.Obstet Gynecol Clin North Am. 1989;16:593–610.

    PubMed  CAS  Google Scholar 

  40. Kurk T, Sivonen A, Renkonen O, Savia F, Ylikorkala O. Bacterial vaginosis in early pregnancy and pregnancy outcomes.Obstet Gynecol. 1992;80:173–177.

    Google Scholar 

  41. Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonization of the genital tract and subsequent preterm delivery and late miscarriage.Br Med J. 1994;308:295–298.

    CAS  Google Scholar 

  42. McGregor JA, French JJ, Parker R, et al. Prevention of premature birth by screening and treatment of common genital tract infections: results of a propsective controlled evaluation.Am J Obstet Gynecol. 1995;173:157–167.

    Article  PubMed  CAS  Google Scholar 

  43. Morales WJ, Schorr S, Albritton J. Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study.Am J Obstet Gynecol. 1994;71:345–349.

    Google Scholar 

  44. Hauth JC, Goldenberg RL, Andrews WW, DuBard MB, Copper RD. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis.N Engl J Med. 1995;333:1732–1736.

    Article  PubMed  CAS  Google Scholar 

  45. MacDermott RIJ. Bacterial vaginosis.Brit J Obstet Gynecol. 1995;102:92–94.

    CAS  Google Scholar 

  46. Korn AP, Bolan G, Padian N, et al. Plasma cell endometritis in women with symptomatic bacterial vaginosis.Obstet Gynecol. 1995;85:387–390.

    Article  PubMed  CAS  Google Scholar 

  47. Platz-Christensen JJ, Sundstrom E, Larsson PG. Bacterial vaginosis and cervical intraepithelial neoplasia.Acta Obstet Gynecol Scand. 1994;73:586–588.

    Article  PubMed  CAS  Google Scholar 

  48. Peters N, Van Leeuwen AM, Pieters WJLM, Holleman H, Quint WGV, Burger MPM. Bacterial vaginosis is not important in the etiology of cervical neoplasia: a survey of women with dyskariotic smears.Sex Trans Dis. 1995;22:296–302.

    Article  CAS  Google Scholar 

  49. Joesoef MR, Schmid GP. Bacterial vaginosis: review of treatment options and potential clinical indications for therapy.Clin Infect Dis. 1995;20(Suppl 1):572–579.

    Google Scholar 

  50. Ferris DG, Litaker MS, Woodward L, Marhis D, Hendrich J. Treatment of bacterial vaginosis: a comparison of oral metronidazole: metronidazole vaginal gel and clindamycin vaginal cream.J Fam Pract. 1995;41:443–449.

    PubMed  CAS  Google Scholar 

  51. Ahmed-Jushuf, IH Shahmanesh M, Arya OP. The treatment of bacterial vaginosis with a 3 day course of 2% clindamycin cream: results of a multicenter, double blind, placebo controlled trial.Genitourin Med. 1995;71:254–256.

    PubMed  CAS  Google Scholar 

  52. Fleury FJ. Adult vaginitis.Clin Obstet Gynecol. 1981;24:407–438.

    Article  PubMed  CAS  Google Scholar 

  53. Sobel JD. Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy.Am J Obstet Gynecol. 1994;171:1215–1220.

    PubMed  CAS  Google Scholar 

  54. Gardner HL. Desquamative inflammatory vaginitis: a newly defined entity.Am J Obstet Gyn. 1968;102:1102–1105.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Sobel, J.D. Vulvovaginitis in healthy women. Compr Ther 25, 335–346 (1999). https://doi.org/10.1007/BF02944280

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02944280

Keywords

Navigation