Influence of gestogenic contraceptive pills on vaginal candidosis.

The use of antiovulatory contraceptive pills has increased rapidly in recent years and the World Health Organisation estimates that they are being taken by more than 20 million women throughout the world. In Britain, the Committee on the Safety of Drugs has stated that contraceptive pills are employed by over a million and a half women at the present time. The increasing use of these preparations has been followed by a corresponding increase in the number of side-effects attributed to them; some have been serious and a number of deaths have been reported. This paper presents further information about the relationship between gestogenic contraceptive pills and vaginal candidosis. Although this is usually a benign complication, it may lead to distressing symptoms, and on rare occasions to serious systemic manifestations. The condition can be passed to men at sexual intercourse, when it usually results in balanoposthitis. Candida albicans is a facultative pathogen. Its pathogenicity depends not only on the size of the colonies, but also on the tolerance of the host tissues to it. There is evidence that the mucosa of the mouth, intestines, and vagina can show a marked tolerance to the fungus, whereas it is probable that it usually causes symptoms when found on the skin or elsewhere (Kozinn and Taschdjian, 1966). A change in the tissues or the metabolism of the host may disturb the equilibrium and lead to the development of symptoms. There is general agreement that the incidence of vaginal candidosis is increasing in many countries and the condition is being diagnosed more frequently (Pumpianski and Sheskin, 1965). Candida albicans has now replaced Trichomonas vaginalis as the commonest cause of genital symptoms in women and it is probably the pathogen found most frequently in those complaining of vaginal discharge. For example, at James Pringle House of the Middlesex Hospital in 1965, the ratio of cases of