Asociación entre el uso de etinilestradiol y el riesgo de candidiasis vulvovaginal en mujeres en edad reproductiva: revisión sistemática

Abstract

Association between ethinylestradiol use and the risk of vulvovaginal candidiasis in women of reproductive age: a systematic review Introduction: Vulvovaginal candidiasis (VVC) is a common infection of the lower genital tract in women of reproductive age. Factors such as vaginal microbiome imbalance and the use of hormonal contraceptives, especially ethinylestradiol, can promote Candida albicans. Objectives: To analyze the association between ethinylestradiol use and the risk of vulvovaginal candidiasis in women of reproductive age. Methodology: Eligibility criteria: Original studies in English, Spanish, Portuguese, and French, published between 2019 and 2024, were included. Reviews, studies with incomplete data, and animal studies were excluded. Information Sources: PubMed, Scopus, Taylor & Francis, Cochrane, ProQuest. Risk of bias: Assessed using the GRADEpro tool. Synthesis of results: Contingency tables were grouped according to specific objectives. Results: Eleven studies (cross-sectional, cohort, and experimental) were included, involving approximately 5086 women. Most showed a positive association between ethinylestradiol use and the risk of VVC, especially with combined oral contraceptives. Only one study demonstrated a possible protective effect. Discussion: Studies with very low certainty, methodological limitations, and bias predominated, which reduces the strength of the conclusions. However, a possible relationship between ethinylestradiol and VVC is evident. Conclusions: There is a possible association between ethinylestradiol use and an increased risk of VVC. It is recommended to consider individual factors, select appropriate contraceptive methods, and perform antifungal tests in recurrent cases.