Outcomes of spa therapy in early postmenopausal women with recurrent vulvovaginal candidiasis

BACKGROUND: Early postmenopausal women are particularly vulnerable to treatment variability due to age-related and physiological changes, which influence the active adhesion of Candida spp. and the subsequent development of recurrent vulvovaginal candidiasis. Spa therapy is a promising approach for managing this condition, offering significant health-promoting and adaptogenic effects. AIM: To assess the effectiveness of spa therapy in early postmenopausal women with a history of recurrent vulvovaginal candidiasis. MATERIALS AND METHODS: A total of 108 early postmenopausal women with recurrent vulvovaginal candidiasis were enrolled and randomly assigned to three groups: control group (n=36, group 3) received standard spa therapy protocols for gynecological conditions; comparison group (n=36, group 2) received pelotherapy in addition to standard spa therapy; main group (n=36, group 1) underwent endomassage and magnetic field therapy in combination with pelotherapy and standard spa therapy. The effectiveness of spa therapy was evaluated based on: vaginal microbiota analysis, degree of vaginal atrophy, medical and psychological assessments. RESULTS: By the end of treatment and at the 6-month follow-up, an absolute normocenosis was observed in nearly half of the women in group 1, whereas at 12 months, microbiota shifted to an intermediate type, comparable to that of healthy early postmenopausal women. In group 2, a conditional normocenosis was identified after 18 days and persisted for 6 months, but with an intermediate smear type. Group 3 retained a dysbiotic profile throughout the follow-ups. At 6 months, both groups 1 and 2 showed positive shifts in vaginal atrophy; however, only group 1 exhibited minimal abnormalities. Quality of life indicators (well-being, activity, and mood) significantly improved in group 1, reaching normative values by the end of spa therapy. The well-being score in group 2 was interpreted as favorable but was statistically different from that in group 1. A statistically significant difference was observed between groups 1 and 3. CONCLUSION: The newly developed spa therapy protocol for early postmenopausal women with recurrent vulvovaginal candidiasis sequelae promotes the restoration of vaginal microbiota, reduces vaginal atrophy, and significantly improves quality of life.