785 croadenomas on careful follow-up. Infarction during or after pregnancy of a previously undiagnosed microadenoma would therefore provide a more plausible explanation for the reversal
ofhyperprolactinsmia. Westminster
Hospital,
London SW1P 2AP
A. J. ISAACS
RECURRENT VAGINITIS AND ORAL SEX
SIR,-I have read Dr White and Dr Spencer-Phillips’s letter (March 17, p. 621) and would like to confirm their views. I see many patients with recurrent vaginal thrush; a very high pro-
portion of these couples practise orogenital sex. Several couples have specifically adopted the practice to prevent vaginal thrush which they have noticed to be associated with genital sexual intercourse. People with healthy mouths may "carry" Candida albicans, so it is not surprising that oral sex lead to reinfection. A woman with recurrent vaginal thrush infections should be asked about orogenital sex and the possibility of reinfection by this route should be explained to her and her husband. Such advice may well resolve a common and troublesome clinical problem.
INDOMETHACIN-INDUCED HYPORENINÆMIC HYPOALDOSTERONISM SIR,-Norby et al.1 have described a patient with a 30-year history of raised blood-pressure and with a syndrome of hyporeninxmic hypoaldosteronism. They suggested a central role for a defect in renal prostaglandin synthesis in the pathophy-
siology of hyporeninxmic hypoaldosteronism. In thirty patients with chronic glomerulonephritis during indomethacin treatment (150-200 mg/day) we regularly found a fall in plasma-renin-activity (P.R.A.) and in serum and urine aldosterone, measured by radioimmunoassay. P.R.A. (ng/ml/h) fell from 3-59±0-62 before treatment to 2.16+0.3 (P
ofhyperprolactinsmia. Westminster
Hospital,
London SW1P 2AP
A. J. ISAACS
RECURRENT VAGINITIS AND ORAL SEX
SIR,-I have read Dr White and Dr Spencer-Phillips’s letter (March 17, p. 621) and would like to confirm their views. I see many patients with recurrent vaginal thrush; a very high pro-
portion of these couples practise orogenital sex. Several couples have specifically adopted the practice to prevent vaginal thrush which they have noticed to be associated with genital sexual intercourse. People with healthy mouths may "carry" Candida albicans, so it is not surprising that oral sex lead to reinfection. A woman with recurrent vaginal thrush infections should be asked about orogenital sex and the possibility of reinfection by this route should be explained to her and her husband. Such advice may well resolve a common and troublesome clinical problem.
INDOMETHACIN-INDUCED HYPORENINÆMIC HYPOALDOSTERONISM SIR,-Norby et al.1 have described a patient with a 30-year history of raised blood-pressure and with a syndrome of hyporeninxmic hypoaldosteronism. They suggested a central role for a defect in renal prostaglandin synthesis in the pathophy-
siology of hyporeninxmic hypoaldosteronism. In thirty patients with chronic glomerulonephritis during indomethacin treatment (150-200 mg/day) we regularly found a fall in plasma-renin-activity (P.R.A.) and in serum and urine aldosterone, measured by radioimmunoassay. P.R.A. (ng/ml/h) fell from 3-59±0-62 before treatment to 2.16+0.3 (P
