Which of the following is NOT a risk factor for vaginal candidiasis?

• A. Diabetes mellitus
• B. Hypertension
• C. Increased estrogen
• D. Systemic antibiotics

Answer: (B)

Vaginal candidiasis occurs when Candida overgrows because factors disrupt the normal vaginal flora or immune defenses that keep yeast in check. Diabetes mellitus provides more glucose in secretions and can impair immune function, creating a nutrient-rich and less robust environment for Candida. Increased estrogen—such as from pregnancy or estrogen-containing therapies—raises vaginal glycogen stores, which Candida can ferment to fuel its growth. Systemic antibiotics reduce the protective lactobacilli that normally suppress yeast, removing a key check on Candida expansion. Hypertension, by itself, does not alter vaginal flora or immune defense in a way that promotes Candida overgrowth, so it is not a risk factor.