Original Article

Journal of General Internal Medicine

, Volume 23, Issue 5, pp 595-599

Sexual Intercourse and Risk of Symptomatic Urinary Tract Infection in Post-Menopausal Women

  • Elya E. MooreAffiliated withDepartment of Epidemiology, University of Washington School of Public Health and Community MedicineHealth Services Research & Development Center of Excellence, VA Puget Sound Health Care SystemMurdoch Childrens Research Institute, Royal Children’s Hospital Email author 
  • , Stephen E. HawesAffiliated withDepartment of Epidemiology, University of Washington School of Public Health and Community Medicine
  • , Delia ScholesAffiliated withDepartment of Epidemiology, University of Washington School of Public Health and Community MedicineCenter for Health Studies, Group Health Cooperative
  • , Edward J. BoykoAffiliated withDepartment of Epidemiology, University of Washington School of Public Health and Community MedicineDepartment of Medicine, University of WashingtonSeattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System
  • , James P. HughesAffiliated withDepartment of Biostatistics, University of Washington School of Public Health and Community Medicine
  • , Stephan D. FihnAffiliated withHealth Services Research & Development Center of Excellence, VA Puget Sound Health Care SystemDepartment of Medicine, University of Washington

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

ABSTRACT

Background

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

Objective

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 ≥105 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 ≥105 CFU/mL to ≥104 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.

KEY WORDS

coitus diaries postmenopause urinary tract infections