Overview of Vulvovaginal Candidiasis Diagnosis and Treatment

Vaginal yeast infections, also called yeast vaginitis or vulvovaginal candidiasis (VVC), are the second most common cause of vaginitis and account for more than ten million medical visits annually. These infections are known to be caused by a variety of risk factors such as new sexual partners, recent antibiotic use, uncontrolled diabetes, or a weak immune system; however, most cases do not have an identifiable trigger. According to the United States Centers for Disease Control and Prevention (CDC), approximately 75% of women will have at least one episode of vulvovaginal candidiasis in their lifetime and 40 to 45% of women will experience two or more episodes. Approximately 138 million women worldwide are affected by recurrent vulvovaginal candidiasis (RVVC). Four culture-positive candidiasis episodes within twelve months constitute having RVVC. The Lactobacillus species are essential in healthy vaginal microbiota. They create a barrier against pathogen invasion. Studies have focused on the vagina’s microenvironment and its innate role in disease prevention. Of specific interest are Lactobacilli that inhibit C. albicans growth. L. crispatus and L. fermentum are two Lactobacilli that have been studied and demonstrated antagonist effects against Candida albicans in healthy women. While these advancements are promising, more research is needed to understand the mechanism in which lactobacilli inhibit yeast growth and hyphal transition. Currently, no evidence supports using probiotics for treating vulvovaginal candidiasis. These recent studies could support the use of L. crispatus and L. fermentum as probiotics in the treatment and suppression of vulvovaginal candidiasis in the future