Vulvovaginal Candidiasis in Postmenopausal Women

Purpose of Review Vulvovaginal candidiasis (VVC) is one of the most common vaginal infections worldwide, but limited evidence-based data is available on postmenopausal women who develop this infection. As women transition through menopause, the effects of decreasing endogenous estrogen production on the vaginal environment have a significant impact on VVC infections in these women. In this review, we discuss the protective mechanism of menopause against VVC and risk factors for postmenopausal women in developing VVC, as well as the presentation and treatment of the infection in postmenopausal patients. Recent Findings The odds of developing VVC have found to decrease by 7% with each year of age after 57, as predicted by the low glycogen levels occurring in postmenopausal women. However, certain medications and comorbidities such as tamoxifen, antibiotics, sodium-glucose cotransporter-2 (SLGT-2) inhibitors, diabetes mellitus, hormone replacement therapy (HRT), and immunosuppressants have been found to increase the prevalence of VVC in the postmenopausal population. Summary Unfortunately, there is still a paucity of literature on the prevalence, risk factors, clinical presentation, treatment, and recurrence of vulvovaginal candidiasis in postmenopausal women. Due to the fact that the vaginal environment, comorbidities, and Candida species are different in this population, the disease is often missed. Future research on VVC should include analysis of postmenopausal women such that providers can confidently educate and treat this specific population.