title: Sexual intercourse and risk of symptomatic urinary tract infection in post-menopausal women.
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.
  
  
  METHODS
  A 2-year prospective cohort study conducted from 1998 to 2002.
  
  
  METHODS
  One thousand and seventeen randomly selected post-menopausal women enrolled at Group Health Cooperative (GHC), a Washington State HMO.
  
  
  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.
authors.affiliation: Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA. elya.moore@mcri.edu.au
authors.forename: Elya E
authors.initials: EE
authors.lastname: Moore
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Hawes
authors.forename: Delia
authors.initials: D
authors.lastname: Scholes
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
mesh_terms: D000368:Aged; D003075:Coitus; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*