title: Effects of recent sexual activity and use of a diaphragm on the vaginal microflora.
abstract: We prospectively studied 40 women over a median period of 28 weeks to ascertain the effects on vaginal microflora of sexual intercourse alone compared with sexual intercourse associated with use of a diaphragm with a spermicide (diaphragm/spermicide). Compared with no sexual intercourse, sexual intercourse with use of a diaphragm/spermicide in the preceding 3 days was strongly associated with increases in rates of vaginal colonization with uropathogenic flora, including Escherichia coli (P < .0001), other gram-negative uropathogens (P = .0045), group D streptococci (P = .014), and group B streptococci (P = .0015). Except for E. coli colonization, no such increases in rates of vaginal colonization were seen at visits preceded by sexual intercourse without use of a diaphragm/spermicide. Compared with no sexual intercourse, sexual intercourse with use of a diaphragm/spermicide in the preceding 3 days also was associated with a marked increase in rates of candidal colonization (P < .0001) and with a decrease in rates of lactobacillus colonization (P < .0001). We conclude that bacterial and fungal microflora in the vagina are strongly influenced by recent use of a diaphragm/spermicide and minimally affected by sexual intercourse alone.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle 98122.
authors.forename: T M
authors.initials: TM
authors.lastname: Hooton
authors.forename: P L
authors.initials: PL
authors.lastname: Roberts
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000328:Adult; D002175:Candida / Q000254:growth & development* / Q000302:isolation & purification; D003075:Coitus; D003271:Contraceptive Agents, Female; D003274:Contraceptive Devices, Female; D005260:Female; D006090:Gram-Negative Bacteria / Q000254:growth & development* / Q000302:isolation & purification; D006801:Humans; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000382:microbiology; D014621:Vagina / Q000382:microbiology*
chemical_list: D003271:Contraceptive Agents, Female