title: Comparison of two long-term gestagen regimens in the management of recurrent vulvovaginal candidiasis: A pilot study.
abstract: Vulvovaginal candidiasis (VVC) is a hormonal-dependent infection but in contrast to sporadic VVC, therapy of recurrent vulvovaginal candidiasis (RVVC) is still unsolved. Long-term administration of medroxyprogesterone acetate was evaluated for the management of RVVC. Overall, 20 patients were treated with Depo-Provera; 14 patients were treated with Provera. Gestagen therapy was evaluated based on visual analogue scale (VAS), the frequency of attacks, the side effects of gestagens and the consumption of antifungals. There was a reduced symptomatology in both of the groups and substantial reduction in antifungal drug consumption during the second year of gestagen use. Twenty-four patients (70.6%) evaluated their condition regarding the vulvovaginal area as improvement (VAS decrease of 3-5 points). Five patients (14.7%) mentioned minimal or no improvement. Further, a number of antifungal drug-treated episodes dropped dramatically during the study period. Both regimes provided similar results, but five patients from the Depo-Provera group had to withdraw from gestagen therapy. Gestagen supplementation ameliorated the quality of life for the majority of patients with RVVC and suggested a potential role in the management of this syndrome, even if beneficial effect was evident after longer application, and some patients met with side effects that led to an interruption of therapy.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Špaček
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Kestřánek
authors.affiliation: Department of Biological and Medical Sciences, Faculty of Pharmacy, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Jílek
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Leško
authors.affiliation: Department of Clinical Microbiology, University Hospital, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Silvie
authors.initials: S
authors.lastname: Plucnarová
authors.affiliation: Department of Biological and Medical Sciences, Faculty of Pharmacy, Charles University, Hradec Kralove, Czech Republic.|Department of Clinical Microbiology, University Hospital, Charles University, Hradec Kralove, Czech Republic.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Buchta
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000302:isolation & purification / Q000648:ultrastructure; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy* / Q000382:microbiology; D019468:Disease Management; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011372:Progestins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D013995:Time; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D011372:Progestins; D017258:Medroxyprogesterone Acetate
keywords: gestagens; hormonal imbalance; quality of life; recurrent vulvovaginal candidiasis; vulvovaginal discomfort