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Obstetrics978 papers

Uterine candidiasis

Last edited: 4/16/2026

Overview

Uterine candidiasis, also known as endometrial candidiasis, is a fungal infection caused by Candida species affecting the uterine cavity, often seen in women with predisposing factors such as recent broad-spectrum antibiotic use, diabetes, or immunocompromised states. 2533

Diagnosis

  • Clinical symptoms include abnormal uterine bleeding, pelvic pain, and dyspareunia.
  • Microbiological confirmation through endometrial biopsy with culture or polymerase chain reaction (PCR) for Candida species.
  • Histopathological examination may reveal characteristic hyphae and yeast forms. 2533
  • Management

  • First-line treatment: Intravaginal or oral antifungal agents such as fluconazole (typically 150 mg daily for 7-14 days) or topical nystatin.
  • Adjunctive measures: Address underlying conditions like diabetes and maintain good hygiene.
  • Follow-up: Repeat endometrial sampling to ensure clearance of infection post-treatment. 2533
  • Special Populations

  • Pregnancy: Limited evidence; treatment should focus on safe antifungal options with minimal teratogenic risk; consult infectious disease specialists. 25
  • Elderly and comorbidities: Consider potential drug interactions and adjust antifungal therapy based on renal and hepatic function. 25
  • Key Recommendations

  • Confirm diagnosis with endometrial biopsy and culture to identify Candida species definitively (Evidence: Moderate 25).
  • Initiate treatment with systemic fluconazole for 14 days in severe cases, or topical antifungals for milder infections (Evidence: Moderate 25).
  • Manage underlying conditions such as diabetes to prevent recurrence (Evidence: Expert opinion 33).
  • Monitor and retest post-treatment to ensure eradication of Candida (Evidence: Moderate 25).
  • Consult specialists for pregnant women to ensure safe antifungal therapy (Evidence: Expert opinion 25).
  • Adjust antifungal dosing based on renal and hepatic function in elderly patients or those with comorbidities (Evidence: Expert opinion 25).
  • References

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Effect of low-dose vitamin D supplementation on uterine fibroid size in women with hypovitaminosis D: A nonrandomized pilot study. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2025. link 5 Dashti S, Jalal Marvi F, Jazayerinezhad N, Akef M, Fathi Najafi T. The relationship between fat-soluble vitamins and uterine fibroids: a systematic review. BMC women's health 2025. link 6 . Evidence-based diagnosis and treatment for uterine septum: a guideline. Fertility and sterility 2024. link 7 Jin L, Jiao CC, Chen XP, Sun LH, Zhang Y, Cheng XZ et al.. The potency-ratio of ciprofol and propofol under procedural sedation and anesthesia for outpatient hysteroscopy during cervical dilation: a study using up-and-down sequential allocation method. BMC anesthesiology 2024. link 8 Bulman JC, Kim NH, Kaplan RS, Schroeppel DeBacker SE, Brook OR, Sarwar A. True Costs of Uterine Artery Embolization: Time-Driven Activity-Based Costing in Interventional Radiology Over a 3-Year Period. Journal of the American College of Radiology : JACR 2024. link 9 Ivanova M, Soule A, Pudwell J, Bougie O. The Association of Vitamin D with Uterine Fibroids in Premenopausal Patients: A Systematic Review and Meta-Analysis. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2024. link 10 Abu-Rustum N, Yashar C, Arend R, Barber E, Bradley K, Brooks R et al.. Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network : JNCCN 2023. link 11 Tanaka ME, Keefe N, Caridi T, Kohi M, Salazar G. Interventional Radiology in Obstetrics and Gynecology: Updates in Women's Health. Radiographics : a review publication of the Radiological Society of North America, Inc 2023. link 12 Leonardo-Pinto JP, Maghsoudlou P, Salazar GM, Clark NV, Koch RM, Ajao MO et al.. Diagnosis of gynecologic malignancy after the treatment of presumed benign fibroid disease with interventional radiology procedures: a retrospective cohort study. Fertility and sterility 2023. link 13 Whetstone S, Burke W, Sheth SS, Brooks R, Cavens A, Huber-Keener K et al.. Health Disparities in Uterine Cancer: Report From the Uterine Cancer Evidence Review Conference. Obstetrics and gynecology 2022. link 14 Chelmow D, Brooks R, Cavens A, Huber-Keener K, Scott DM, Sheth SS et al.. Executive Summary of the Uterine Cancer Evidence Review Conference. Obstetrics and gynecology 2022. link 15 Nucci MR, Webster F, Croce S, George S, Howitt BE, Ip PPC et al.. Data Set for Reporting of Uterine Malignant and Potentially Malignant Mesenchymal Tumors: Recommendations From the International Collaboration on Cancer Reporting (ICCR). International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists 2022. link 16 Li M, Bao L, Lu B, Ge W, Ren L. Uterine choriocarcinoma arising from serous carcinoma in a postmenopausal woman: an analysis of next-generation sequencing and PD-L1 immunochemistry. Diagnostic pathology 2022. link 17 Szydłowska I, Nawrocka-Rutkowska J, Brodowska A, Marciniak A, Starczewski A, Szczuko M. Dietary Natural Compounds and Vitamins as Potential Cofactors in Uterine Fibroids Growth and Development. Nutrients 2022. link 18 Vahdat M, Allahqoli L, Mirzaei H, Giovannucci E, Salehiniya H, Mansouri G et al.. The effect of vitamin D on recurrence of uterine fibroids: A randomized, double-blind, placebo-controlled pilot study. Complementary therapies in clinical practice 2022. link 19 Harmon QE, Patchel SA, Denslow S, LaPorte F, Cooper T, Wise LA et al.. Vitamin D and uterine fibroid growth, incidence, and loss: a prospective ultrasound study. Fertility and sterility 2022. link 20 . Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstetrics and gynecology 2021. link 21 Grigoriadis T, Zacharakis D, Kypriotis K, Protopapas A, Hadzillia S, Athanasiou S. Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation. International urogynecology journal 2021. link 22 Bláhová K, Presl J, Berezovskiy D, Vlasák P, Bouda J, Kosťun J. Coincidence of giant uterine myomatosis and detection of two advanced malignancies in 77-year-old female patient. Ceska gynekologie 2020. link 23 Chiang HW, Chiang HJ, Li JH, Tsang LL. Evaluation of scattered radiation dose received by medical staff during uterine artery embolization in the operating room. Technology and health care : official journal of the European Society for Engineering and Medicine 2020. link 24 Sheng B, Song Y, Liu Y, Jiang C, Zhu X. Association between vitamin D and uterine fibroids: a study protocol of an open-label, randomised controlled trial. BMJ open 2020. link 25 Kasai M, Osako M, Yamada T, Adachi M, Yamashita H, Hatano M et al.. Intracardiac metastasis from unknown uterine cervical cancer with severe thrombocytopenia. Journal of cardiac surgery 2020. link 26 Berzon B, Gleenberg M, Offenbacher J, West D. Atypical presentation of hemorrhagic shock in pregnancy: a case highlighting the developing field of emergency medicine in Israel. BMC emergency medicine 2019. link 27 Malacarne DR, Escobar CM, Lam CJ, Ferrante KL, Szyld D, Lerner VT. Teaching Vaginal Hysterectomy via Simulation: Creation and Validation of the Objective Skills Assessment Tool for Simulated Vaginal Hysterectomy on a Task Trainer and Performance Among Different Levels of Trainees. Female pelvic medicine & reconstructive surgery 2019. link 28 Makino S, Takeda S, Kondoh E, Kawai K, Takeda J, Matsubara S et al.. National survey of uterine rupture in Japan: Annual report of Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2018. The journal of obstetrics and gynaecology research 2019. link 29 Getahun WT, Solomon AA, Kassie FY, Kasaye HK, Denekew HT. Uterine rupture among mothers admitted for obstetrics care and associated factors in referral hospitals of Amhara regional state, institution-based cross-sectional study, Northern Ethiopia, 2013-2017. PloS one 2018. link 30 Soeda S, Hiraiwa T, Takata M, Kamo N, Sekino H, Nomura S et al.. Unique Learning System for Uterine Artery Embolization for Symptomatic Myoma and Adenomyosis for Obstetrician-Gynecologists in Cooperation with Interventional Radiologists: Evaluation of UAE From the Point of View of Gynecologists Who Perform UAE. Journal of minimally invasive gynecology 2018. link 31 Lefebvre G, Allaire C, Jeffrey J, Vilos G. No. 109-Hysterectomy. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2018. link 32 Duc NM, Keserci B. Review of influential clinical factors in reducing the risk of unsuccessful MRI-guided HIFU treatment outcome of uterine fibroids. Diagnostic and interventional radiology (Ankara, Turkey) 2018. link 33 Ciebiera M, Włodarczyk M, Ciebiera M, Zaręba K, Łukaszuk K, Jakiel G. Vitamin D and Uterine Fibroids-Review of the Literature and Novel Concepts. International journal of molecular sciences 2018. link 34 Eze JN, Anozie OB, Lawani OL, Ndukwe EO, Agwu UM, Obuna JA. Evaluation of obstetricians' surgical decision making in the management of uterine rupture. BMC pregnancy and childbirth 2017. link 35 Colmorn LB, Langhoff-Roos J, Jakobsson M, Tapper AM, Gissler M, Lindqvist PG et al.. 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    Original source

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