J Gen Intern Med. 2008 Feb 12 [Epub ahead of print]

Sexual Intercourse and Risk of Symptomatic Urinary Tract Infection in Post-Menopausal Women.
Moore EE, Hawes SE, Scholes D, Boyko EJ, Hughes JP, Fihn SD.

Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA, elya. Moore@mcri.edu. Au.

Background:

Sexual intercourse increases the risk of symptomatic urinary tract infections (UTI) in young women, but its role among post-menopausal women is unclear.

Objectives:

To determine whether recent sexual intercourse, as documented by daily diaries, is associated with an increased risk of symptomatic UTI in post-menopausal women.

Design:

A 2-year prospective cohort study conducted from 1998 to 2002. PARTICIPANTS: One thousand and seventeen randomly selected post-menopausal women enrolled at Group Health Cooperative (GHC), a Washington State HMO. MEASUREMENTS AND

Main Results:

Women were asked to enter daily diary information on vaginal intercourse, medication use, and genito-urinary symptoms. The outcome of interest, symptomatic UTI, was defined as a positive urine culture >/=10(5) CFU/mL of a uropathogen and the presence of >/=2 acute urinary symptoms. Nine hundred thirteen women returned diaries and were included in this study. Seventy-eight women experienced 108 symptomatic UTIs, and 361 (40%) reported sexual intercourse in their diaries. There was an increased hazard for UTI 2 calendar days after the reporting of sexual intercourse in the diaries (adjusted hazard ratio [HR], 3.42, 95% CI 1.49-7.80), while there was no evidence for an increased hazard associated with intercourse at other times. When the UTI criterion was relaxed from >/=10(5) CFU/mL to >/=10(4) CFU/mL, adding 9 UTI events to the analysis, the HR for UTI 2 days after intercourse changed slightly to 3.26 (95% CI 1.43-7.43).

Conclusions:

Our data suggest that, as with younger women, recent sexual intercourse is strongly associated with incident UTI in generally healthy post-menopausal women.




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