الفهرس 
PHYSIIOLOGY AND MIICROBIIOLOGY OF THE VAGIINAOnly 14 pages are availabe for public view
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Abstract
Vulvovaginal candidiasis (VVC) is an epithelial infection caused by Candida species. Candida albicans, a dimorphic commensal organism of the genital and gastrointestinal tracts, is the causative agent of VVC in approximately 85 to 90% of patients with positive vaginal fungal cultures, the remainder of the cases are due to non-C.albicans Candida species, the most common of which are C.glabrata and C.tropicalis.
Vaginal colonization of Candida species requires adherence to the vaginal epithelial cells, with both estrogens and progesterone promoting the adherence of C.albicans to the genital mucosa. On the other hand, it is believed that progesterone has an antiproliferative and exfoliative effect on the epithelial cells, mainly between the 23rd and 28th day of the cycle, coinciding with the blood progestin peak.
Progesterone is excreted as a pregnanediol glucuronide in urine. They are used for the demonstration of ovulatory (biphasic) cycles, the monitoring of infertility treatment, and for the determination of ovulation. The production of progesterone may be assessed by direct midluteal-phase sampling from the serum or by repeated determination of urine pregnanediol glucuronide during the luteal phase.
The aim of the study is to evaluate if there is a relation between mid luteal serum progesterone level and recurrent vulvo-vaginal candidiasis in order to investigate a possible role of the altered hormonal status in case of luteal phase defect in the pathogenesis of recurrent vulvo-vaginal candidiasis.
This study is a cross sectional case control study that was carried out at Shark El Madina Hospital, on a total number of 50 women (justified by Lehr’s formula x90%). The women in our study were divided into 2 groups: Group1 (study Group): enrolled 25 patients in childbearing period complaining of lower genital tract discomfort with history of recurrent vulvo-vaginal candidiasis defined as three or more episodes documented by three positive cultures in the previous year or during the period of conducting the study. Group 2 (control Group): enrolled another 25 healthy women in childbearing period with no history of recurrent vulvovaginal candidiasis and with documented negative culture during progesterone determination at mid luteal phase.
Women with irregular cycles, combined oral contraceptive pills (COC), patients with history of diabetes mellitus, immuno-suppressed patients, and pregnant women were excluded from our study.
After enrollment in the study, full history taking, pelvic examination, vaginal swap culture for diagnosis of candidiasis and serum progesterone determination using ELISA technique. Data were collected and analyzed using STATA statistical program. Chi-sqaure test and paired student’s t-test were done to find out the presence of significant difference between two groups with p<0.05 was considered significant.
There was no significant difference between the two groups regarding their age, marital status, parity, prevalence of abortion, the frequency of the use of contraceptives (p>0.05).
Our results showed that the serum progesterone level was significantly higher among group 2 (control group) than that of group 1 (study group) as it was 23.77 ± 6.09 for group 2 versus 6.03 ± 1.82 for group 1 (p<0.001).
Results of the current study showed that there was no significant relationship between parity, frequency of abortion and method of contraception and progesterone level in group 1 (p>0.05).