Vulvovaginal Candidiasis: Pathophysiology, the Role of Biofilms, and Emerging Therapeutics

Vulvovaginal candidiasis (VVC) is a prevalent fungal infection of the female genital tract that impacts millions of women worldwide, representing a considerable burden on health and quality of life. Despite comprehensive knowledge of the causative species (Candida albicans and non-albicans Candida), approximately 8% of women experience recurrent VVC (RVVC), characterised by more frequent, persistent infections. Fungal biofilm formation has been proposed as one possible mechanism underlying this response; however, this remains a topic of debate. In this chapter, we review the current understanding of R/VVC pathophysiology, clinical presentation and diagnostic approaches. We further discuss the evidence linking biofilms to RVVC and highlight emerging therapeutic strategies aimed at better managing this challenging condition.