Recurrent Candida Vulvovaginitis is a common disorder which results in discomfort, temporary disability, loss of time at work, and significant expense (medical care, laboratory testing, and medications) as will as loss of productivity at the time of evaluation. Estimated national costs range from $700 million to $1.2 billion per year. While several potential risk factors for Candida vulvovaginitis are known,no reason is found for the treatment failure or recurrence in most cases of this disorder. The role of the male sexual partner in recurrences of Candida albicans of the female is not clear, but data suggest sexual transmission may be involved. Evidence suggests Candida may be harbored in the male gastrointestinal tract, semen, oral cavity and urine, and male colonization is associated with female vaginal colonization often with the same strain. The role of numerous factors related to male-female communicability need to be assessed, such as sexual frequency and practices, male symptoms or signs, and relationship of timing of recolonization to symptomatic recurrences, in order to better evaluate this factor and the rationale for treating both partners. This prospective cohort study will evaluate the role of sexual transmission of Candida albicans between sexual partners on recurrence of Candida vulvovaginitis. The individual and collective associations of other potential risk factors, clothing habits and diet patterns, and gastrointestinal Candida carriage, with outcome of recurrence of microscopic and clinical Candida vulvovaginitis will also be addressed in order to control for multiple risk factors occurring concomitantly. Consenting patients with Candida vulvovaginitis and their sexual partners will be studied via self-administered questionnaire, physical examinations, and laboratory testing over a 1 year period to evaluate the association between sexual transmission and other risk factors to microbiological and clinical recurrence.
