The specific features of the course of acute vulvovaginal candidiasis and its therapy with fenticonazole in reproductive-aged women with different phenotypes of polycystic ovary syndrome

DOI

https://dx.doi.org/10.18565/aig.2019.11.201-208

Abashova E.I., Yarmolinskaya M.I., Misharina E.V.
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, Saint Petersburg, Russia

Objective. To establish the specific features of the course acute vulvovaginal candidiasis (VVC) and therapy with fenticonazole in reproductive-aged women with different phenotypes of polycystic ovary syndrome (PCOS). Subjects and methods. The investigation enrolled 65 women of reproductive age (mean age, 27.4±3.6 years) with severe acute VVC. A study group included 35 women with PCOS (Group 1); a comparison group consisted of 30 women without PCOS (Group 2). To treat acute VVC, all the women received an intravaginal 600-mg fenticonazole capsule once overnight on days 1 and 4 of treatment. In both groups, the efficiency of treatment for acute VVC was evaluated at 10-14 days, 1 and 3 months after therapy. Results. At 10-14 days and 1 month after fenticonazole treatment, its efficiency was high in both groups and amounted to 94.3 and 96.7% (at 10-14 days after treatment) and 91.4% and 93.3% (at 1 month after treatment), respectively. At 3 months after treatment, its efficiency remained high in the comparison (non-PCOS) group and amounted to 90%, whereas that in the study (PCOS) group significantly decreased to 71.4% (p <0.05). In the women with PCOS, the recurrence rate of VVC depended directly proportionally (r = 0.60; p <0.001) on the presence of carbohydrate metabolic disturbances as glucose intolerance and insulin resistance (r = 0.50; p <0.01) and overweight or obesity (r = 0.77 p <0.001). Almost all women with an exacerbation of VVC were diagnosed with glucose intolerance or insulin resistance (Homeostasis model assessment of insulin resistance (HOMA-IR) was more than 2.5 scores). In women with hyperandrogenism (phenotypes A, B, C), an exacerbation of VVC occurred significantly more frequently (r = 0.40 p <0.01), Conclusion. Recurrent VVC in women with PCOS may be prevented by correcting main metabolic changes, overcoming insulin resistance, and restoring the ovulatory cycle. In case of an exacerbation of VVC in this patient group, it is recommended to use fenticonazole at a dose of 600 mg twice with an interval of 3 days. Thus, fenticonazole may be recommended as the first-choice drug in treating acute VVC in reproductive-aged women.

acute vulvovaginal candidiasis

fenticonazole

phenotypes (A

D) of polycystic ovary syndrome

glucose intolerance

insulin resistance

HOMA-IR index

obesity

Full text (in Russian)

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Received 30.09.2019

Accepted 04.10.2019

Elena I. Abashova, PhD, Senior Researcher, Department of Endocrinology of Reproduction, Federal State Budgetary Institution «Scientific Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott» Tel .: +7(812)328-9820; +7 (921) 9459090. Email: abashova@yandex.ru. https://orcid.org/0000-0003-2399-3108.
SPIN Code: 2133-0310
199034, St. Petersburg, Mendeleev Line, 3.
Maria I. Yarmolinskaya, MD, professor, Russian Academy of Sciences, professor, head of the department of endocrinology of reproduction, head of the Center for diagnosis and treatment of endometriosis, Federal State Budgetary Scientific Institution «Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Otta» Phone: + 7 (812) 328-9820. E-mail: m.yarmolinskaya@gmai.com; https://orcid.org/0000-0002-6551-4147; SPIN: 3686-3605
199034, St. Petersburg, Mendeleev Line, 3;
Elena V. Misharina, PhD, Senior Researcher, Department of Reproductive Endocrinology, Federal State Budgetary Institution «Scientific Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Otta», Tel. 8 (812) 3289820. Email: mishellena@gmail.com; https://orcid.org/0000-0002-0276-7112; SPIN: 7350-5674
199034, St. Petersburg, Mendeleev Line, 3.

For citations: Abashova E.I., Yarmolinskaya M.I., Misharina E.V. The specific features of the course of acute vulvovaginal candidiasis and its therapy with fenticonazole in reproductive-aged women with different phenotypes of polycystic ovary syndrome.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 11: 201-8.(In Russian).
https://dx.doi.org/10.18565/aig.2019.11.201-208

The specific features of the course of acute vulvovaginal candidiasis and its therapy with fenticonazole in reproductive-aged women with different phenotypes of polycystic ovary syndrome

Abashova E.I., Yarmolinskaya M.I., Misharina E.V.

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