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


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Abstract

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 of600 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.

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About the authors

E. I Abashova

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: abashova@yandex.ru

M. I Yarmolinskaya

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: m.yarmolinskaya@gmai.com

E. V Misharina

D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology

Email: mishellena@gmail.com

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