title: The impact of contraceptive methods on the onset of symptomatic vulvovaginal candidiasis within the menstrual cycle.
abstract: OBJECTIVE
  Vulvovaginal candidiasis is the second most common cause of vaginal discharge. Low-dose oral contraceptives are no longer thought to increase the absolute risk of episodic vulvovaginal candidiasis. This study investigates the possible impact that hormonal contraception may have on the timing of onset of symptoms within the menstrual cycle.
  
  
  METHODS
  In a retrospective chart review of reproductive-aged women seen at the Women's Health Care Clinic at Harbor-University of California, Los Angeles, Medical Center, data from the records of 448 symptomatic women who had 507 episodes of vulvovaginal candidiasis were extracted and analyzed for timing of onset of symptoms within the menstrual cycle. Diagnosis was based on symptoms, physical findings, and microscopy. Onset was divided into five physiologic ranges within an idealized 28-day menstrual cycle. Comparisons among groups were made with use of chi 2 and p < 0.05 thresholds for statistical significance.
  
  
  RESULTS
  No differences were found in the onset of symptoms within the idealized menstrual cycle ranges between women using hormonal birth control methods and those using nonhormonal ones. The distribution was remarkably uniform throughout the cycle with the exception of the first few days (during menses).
  
  
  CONCLUSIONS
  The timing of onset of symptoms of vulvovaginal candidiasis within a woman's menstrual cycle is not affected by her method of birth control.
authors.affiliation: Department of Obstetrics and Gynecology, Harbor-University of California, Los Angeles, Medical Center, Torrance 90509, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Nelson
mesh_terms: D002181:Candidiasis, Vulvovaginal / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D003267:Contraception / Q000009:adverse effects / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008597:Menstrual Cycle / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal