The relationship of bacterial vaginosis, Candida and Trichomonas infection to symptomatic vaginitis in postmenopausal women attending a vaginitis clinic

Maturitas. 1997 Jul;27(3):253-60. doi: 10.1016/s0378-5122(97)00038-8.


Objective: To estimate the prevalence of bacterial vaginosis, Candida albicans, and Trichomonas vaginalis infections in a population of postmenopausal women with symptoms of vaginitis seen at a vaginitis clinic either as self-referred or clinician referred patients.

Methods: A cross-sectional study of 148 postmenopausal women (cases) and 1564 controls of reproductive age attending a vaginitis clinic. C. albicans and T. vaginalis infections were diagnosed by culture techniques. Bacterial vaginosis was diagnosed on the basis of clinical findings.

Results: Fifty-six (37.8%) postmenopausal women and 834 (53.3%) controls were diagnosed with T. vaginalis or C. albicans infection, or bacterial vaginosis, or mixed infection (odds ratio (OR) 0.53, 95% confidence interval (CI) 0.37-0.75). C. albicans and T. vaginalis infection were diagnosed in 34.1% (534/1564) and 1.92% (30/1564) of women of childbearing age and in 13.5% (20/148) and 10.8% of postmenopausal women, respectively. (P < 0.05 for both comparisons). The prevalence of bacterial vaginosis was similar between the two groups (14/148 in postmenopausal patients and 210/1564 in controls of reproductive age; P = 0.22).

Conclusions: Among postmenopausal women attending a vaginitis clinic, a defined diagnosis of bacterial vaginosis, C. albicans or T. vaginalis infection can be made in about one third of such patients. Concerning the two 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.

MeSH terms

  • Adult
  • Aged
  • Candidiasis, Vulvovaginal / diagnosis
  • Candidiasis, Vulvovaginal / epidemiology*
  • Confidence Intervals
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Italy / epidemiology
  • Middle Aged
  • Odds Ratio
  • Postmenopause*
  • Trichomonas Vaginitis / diagnosis
  • Trichomonas Vaginitis / epidemiology*
  • Vaginosis, Bacterial / diagnosis
  • Vaginosis, Bacterial / epidemiology*