THE RELATIONSHIP OF BACTERIAL VAGINOSIS, CANDIDA AND TRICHOMONAS INFECTION TO SYMPTOMATIC VAGINITIS IN POSTMENOPAUSAL WOMEN ATTENDING A VAGINITIS CLINIC

Objective: To estimate the prevalence of bacterial vaginosis, Candida albicans, and Trichomonas vaginalis infections in a population of post menopausal women with symptoms of vaginitis seen at a vaginitis clinic either as self-referred or clinician referred patients. Methods: A cr oss-sectional study of 148 postmenopausal women (cases) and 1564 contr ols of reproductive age attending a vaginitis clinic. C. albicans and T. vaginalis infections were diagnosed by culture techniques. Bacteria l vaginosis was diagnosed on the basis of clinical findings. Results: Fifty-six (37.8%) postmenopausal women and 834 (53.3%) controls were d iagnosed with T. vaginalis or C. albicans infection, or bacterial vagi nosis, or mixed infection (odds ratio (OR) 0.53, 95% confidence interv al (CI) 0.37-0.75). C. albicans and T. vaginalis infection were diagno sed in 34.1% (534/1564) and 1.92% (30/1564) of women of childbearing a ge and in 13.5% (20/148) and 10.8% of postmenopausal women, respective ly. (P < 0.05 for both comparisons). The prevalence of bacterial vagin osis was similar between the two groups (14/148 in postmenopausal pati ents and 210/1564 in controls of reproductive age; P = 0.22). Conclusi ons: Among postmenopausal women attending a vaginitis clinic, a define d diagnosis of bacterial vaginosis, C. albicans or T. vaginalis infect ion can be made in about one third of such patients. Concerning the tw o thirds of symptomatic women lacking such a microbiologic diagnosis, alternative causes (e.g., estrogen deficiency, nonanaerobic bacterial infections, local irritants or allergenes, and dermatologic conditions ) need to be considered. (C) 1997 Elsevier Science Ireland Ltd.