How does genital candidiasis affect women and men?

Genital candidiasis is a common type of infection caused by the yeast, Candida. Although it is a common disease in the population, there are differences between women and men that are not so well known.

1. Candidiasis vs. balanitis

In women, Candida infection is known as vulvovaginal candidiasis while, in men, it usually leads to inflammation of the glans (head of the penis) known as balanitis. However, balanitis can be caused by other fungi, bacteria or viruses, not only Candida. Balanitis can also occur for non-infectious reasons, such as due to irritants or blows.

2. Risk factors

Genital candidiasis is an infection caused by an abnormal growth in the Candida population. Candida is a fungus that is often normally present in the genital microbiota of both healthy women and men. Normally, the immune system and other genital microbiota microorganisms keep the Candida population stable, but certain conditions can lead to its excess growth, causing candidiasis. The main risk factors for its development are when the immune system or the microbiota are damaged, such as when using antibiotics, having certain diseases, poor hygiene or eating habits. However, some conditions particular to the sexes can promote infection, such as pregnancy in women or having a foreskin in men.

3. Disease incidence

Genital candidiasis is more likely to develop in women. Approximately 75% of women will develop vulvovaginal candidiasis at least once in their lives. About 50% will have several episodes and 4-10% will have recurrent candidiasis, considered as 4 or more episodes per year.

However, although less well known, candidiasis is also common in men. It is one of the most frequent penis infections. Recurrent episodes of balanitis can be a sign of hidden diabetes. Men with recurrent episodes are advised to have a blood glucose test for diabetes and to see a urologist for evaluation.

4. Disease transmission

Vulvovaginal candidiasis and balanitis are not considered sexually transmitted infections, as the disease itself is not transferred from one person to another, only the organisms that cause it. However, practising risky sex – e.g. not using barrier contraceptives or sharing unsterilized sex toys – can increase the chances of developing the disease. This is especially so if the genital microbiota or immune system are affected.

Transmission and infection may also occur in other areas of the body. The mouth and throat are common examples. Infection of other areas by self-contagion is more likely in men than in women, due to access to the infected area.

Information documented by: Dr. Veronica Rico, doctor in the Infectious Diseases Service and Home Hospitalisation Service, and member of the IDIBAPS Nosocomial Infection Research Group.