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. 2014 Nov;69 Suppl 2(Suppl 2):S205-14.
doi: 10.1093/geronb/gbu105.

Prevalence of bacterial vaginosis and Candida among postmenopausal women in the United States

Joscelyn N Hoffmann  1 , Hannah M You  2 , E C Hedberg  3 , Jeanne A Jordan  4 , Martha K McClintock  5
Affiliations

Prevalence of bacterial vaginosis and Candida among postmenopausal women in the United States

Joscelyn N Hoffmann et al. J Gerontol B Psychol Sci Soc Sci. 2014 Nov.

Abstract

Objectives: To describe the prevalence of bacterial vaginosis (BV) and Candida among community-dwelling postmenopausal women in the United States and determine their change with age, using estimates based on Waves 1 and 2 of the National Social Life, Health and Aging Project (NSHAP).

Method: Self-administered vaginal swabs were collected in-home from women aged 57-85 (n = 1,016) in Wave 1 and again 5 years later in Wave 2 (n = 883). Gram-stained specimens were evaluated for BV using the Nugent score as well as presence of Candida.

Results: BV was prevalent in 23% and 38% of postmenopausal women in Waves 1 and 2 and increased with age. Women initially categorized with BV in Wave 1 were more than 10 times as likely to be categorized with BV in Wave 2, relative risk ratio (RRR) = 10.5; 95% confidence interval (CI) (4.45-24.7); p < .001, whereas women initially categorized as intermediate in Wave 1 were five times more likely to have a BV categorization, RRR = 5.0; 95% CI (2.56-9.75); p < .001. Although the presence of Candida was similar in both waves (6% and 5%), its relationship with age only became evident in Wave 2, with odds of detecting Candida decreasing by 7% with each year of age, OR = 0.93, 95% CI (0.88, 0.98); p = .010.

Discussion: In Wave 2, the prevalence of BV was higher and increased with age while the prevalence of Candida was low and declined with age. A 5-year age increase contributed to the prevalence change across waves. Methods refinements in Wave 2 improved the detection of BV and Candida and clarified their relationship with age.

Keywords: Bacterial vaginosis; Candida; Population; Postmenopause; Self-collection; Vaginal swab..

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Figures

Figure 1.
Figure 1.
Effect of chronological age on the predicted Nugent score (95% CIs) in Waves 1 (ages 57–85) and 2 (ages 62–90).
Figure 2.
Figure 2.
Wave 2 differences between age groups in proportions of three diagnostic categories based on Nugent score: normal (0–3), intermediate (4–6), bacterial vaginosis (7–10).
Figure 3.
Figure 3.
Wave differences in the effect of age on predicted probability (95% CIs) of diagnostic categories based on Nugent score (normal, intermediate, and bacterial vaginosis) in Waves 1 (ages 57–85) and 2 (ages 62–90).
Figure 4.
Figure 4.
Effect of age on predicted prevalence (95% CIs) of Candida in Waves 1 and 2.
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