Cited by 117Reproductive tract infections researchUrinary Tract Infections ManagementHIV/AIDS Research and Interventions

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Effects of recent sexual activity and use of a diaphragm on the vaginal microflora.

Hooton, T. M., Roberts, P. L., Stamm, W. E.·1994·Clinical Infectious Diseases

DOI 10.1093/clinids/19.2.274

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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.

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van der Straten, A., Napierala, S., Cheng, H., Mauck, C. K., DePiñeres, T., Dhlakama, P. M., Thompson, M. E., Chipato, T., Hammond, N., & PADIAN, N. S. (2007) · Contraception · doi:10.1016/j.contraception.2007.07.004 · Cited by 27
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“The vaginal flora is easily disrupted; several studies have indicated that frequent sexual activity [9], the use of spermicide contraceptives [10], and certain hygiene regimens [11] allow different pathogens to colonize vaginal epithelial cells (VECs) and establish a potential reservoir for future UTIs.”
Background
RISK FACTORS OF VULVOVAGINAL CANDIDIASIS IN DERMATO-VENEREOLOGY OUTPATIENTS CLINIC OF SOETOMO GENERAL HOSPITAL, SURABAYA, INDONESIA
Arfiputri, D. S., Hidayati, A. N., Handayani, S., & Ervianti, E. (2018) · African Journal of Infectious Diseases · doi:10.21010/ajid.v12i1s.13 · Cited by 26
Loss of Innate Host Defense Following Unprotected Vaginal Sex
Nakra, N. A., Madan, R. P., Buckley, N. J., Huber, A. M., Freiermuth, J. L., Espinoza, L., Walsh, J., Parikh, U. M., Penrose, K. J., Keller, M. J., et al. (2015) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiv488 · Cited by 24
“coli colonization following intercourse [19, 20], and we hypothesize that this may be secondary to the observed decline in E.”
Background
Low-dose inoculation of Escherichia coli achieves robust vaginal colonization and results in ascending infection accompanied by severe uterine inflammation in mice
O'Brien, V. P., Gilbert, N., Lebratti, T. J., Agarwal, K., Foster, L. R., Shin, H.-N., & Lewis, A. (2019) · PLoS ONE · doi:10.1371/journal.pone.0219941 · Cited by 23
Recurrent vulvo-vaginal candidiasis in Abidjan (Côte d’Ivoire): Aetiology and associated factors
Djohan, V., Angora, K. E., Vanga-Bosson, A. H., Konaté, A., Kassi, K., Kiki-Barro, P. C. M., Bedia-Tanoh, A. V., Miezan, S., Menan, E. I. H., & Yavo, W. (2019) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2019.04.002 · Cited by 21
Host Factors in Susceptibility to Urinary Tract Infections
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Seid, M., Markos, M., Aklilu, A., Manilal, A., Zakir, A., Kebede, T., Kulayta, K., & Yesera, G. E. (2023) · Infection and Drug Resistance · doi:10.2147/idr.s407092 · Cited by 23
“During coitus, bacteria in the vaginal area or the male partner’s penile are pushed up into the urethra and transmitted to the bladder, where urine in the bladder offers the perfect environment for the bacteria to multiply and cause an infection.(22) Alternatively, these observations could reflect that the introductio…”
Background
The Globoseries Glycosphingolipid Sialosyl Galactosyl Globoside is Found in Urinary Tract Tissues and is a Preferred Binding Receptor In Vitro for Uropathogenic Escherichia Coli Expressing Pap-Encoded Adhesins
Stapleton, A. E., Stroud, M. R., Hakomori, S., & Stamm, W. E. (1999) · The Journal of Urology · doi:10.1016/s0022-5347(01)61738-5 · Cited by 18
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Background
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Mikelsaar, M., Mändar, R., Sepp, E., Annuk, H., Salminen, S., & Ouwehand, A. C. (2004) · doi:10.1201/9780824752033-21 · Cited by 15
Sex and Urinary Tract Infections
Ronald, A. (1996) · New England Journal of Medicine · doi:10.1056/nejm199608153350711 · Cited by 15
Microbiota Ecosystem in Recurrent Cystitis and the Immunological Microenvironment of Urothelium
Dominoni, M., Scatigno, A. L., La Verde, M., Bogliolo, S., Melito, C., Gritti, A., Pasquali, M. F., Torella, M., & Gardella, B. (2023) · Healthcare · doi:10.3390/healthcare11040525 · Cited by 13
Vaginitis, Vulvitis, Cervicitis and Cutaneous Vulval Lesions
Sobel, J. D. (2016) · Elsevier eBooks · doi:10.1016/b978-0-7020-6285-8.00053-8 · Cited by 13
Precise and rapid assessment of Escherichia coli adherence to vaginal epithelial cells by flow cytometry
Stapleton, A. E., Fennell, C. L., Coder, D. M., Wobbe, C. L., Roberts, P. L., & Stamm, W. E. (2002) · Cytometry · doi:10.1002/cyto.10046 · Cited by 10
Contraception as a risk factor for urinary tract infection in Port Harcourt, Nigeria: A case control study
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Antimicrobial Sensitivity Patterns Of Urogenital Bacterial Isolates Among Hiv Positive Patients In The Federal Medical Centre In Gombe
(2012) · The Internet Journal of Infectious Diseases · doi:10.5580/2a7b · Cited by 7
“This finding also agreed with report by Hooton, (22) that bacteria from gastro intestinal tract (fecal flora) are the most common cause of gastro intestinal tract diseases among sexually active women.”
Result
Urinary Tract Infection
Foxman, B. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-384978-6.00036-4 · Cited by 5
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Larcombe, J. (2012) · Durham e-Theses (Durham University) · Cited by 5
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“A prior investigation of young women including university students in the USA demonstrated an increased risk of BV in women using the diaphragm for contraception, an association that had previously been thought to be due to the use of N-9 [15, 16].”
BackgroundInfluential
Contraception as a risk factor for urinary tract infection in Port Harcourt, Nigeria: A case control study
Dienye, P. O., & Gbeneol, P. K. (2011) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v4i1.207 · Cited by 4
Vulvovaginitis
Sobel, J. D., & Nyirjesy, P. (2020) · Wiley eBooks · doi:10.1002/9781119482598.ch28 · Cited by 5
Does Bacterial Vaginosis Contribute to Urinary Tract Infection?
Handa, V. L., Brotman, R. M., Ravel, J., & Tuddenham, S. (2023) · Current Infectious Disease Reports · doi:10.1007/s11908-022-00795-0 · Cited by 3
URINARY TRACT INFECTIONS IN WOMEN
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Valor do exame clinico especular e da anamnese para o diagnostico do corrimento vaginal
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Urinary Tract Infections:
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Human Lactic Acid Microflora and Its Role in the Welfare of the Host
Mändar, R., Mikelsaar, M., Sepp, E., & Annuk, H. (2004) · CRC Press eBooks · doi:10.1201/9780824752033.ch16 · Cited by 2
Interrelationship Between Virulence Properties of Uropathogenic E. coli and Blood Group Phenotype of Patients with Chronic Urinary Tract Infection
Fünfstück, R., Jacobsohn, N., & Stein, G. (2005) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-46840-9_27 · Cited by 2
Microbiota and the Urogenital Tract, Pathogenesis, and Therapies
Tungland, B. C. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-814649-1.00014-4 · Cited by 2

Authors: Hooton, T. M., Roberts, P. L., & Stamm, W. E.
Affiliations: University of Washington (US)
Corresponding author: Hooton, T. M.
ORCID: Hooton, T. M.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 1994-08-01
Volume: 19
Issue: 2
Pages: 274-278
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1093/clinids/19.2.274
OpenAlex: W2055449086
Cited by: 117
References: 15
Citations by year: 2025: 2 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 6
FWCI: 4.28
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: University of Washington
Topics: Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Urology › Urinary Tract Infections Management
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: vaginal microbiota, diaphragm, spermicides, sexual intercourse, uropathogenic bacteria, Escherichia coli, Gram-negative uropathogens, Streptococcus agalactiae, group D streptococci, candidal colonization, Lactobacillus, vaginal colonization
MeSH terms: Adult, Candida, Coitus, Contraceptive Agents, Female, Contraceptive Devices, Female, Female, Gram-Negative Bacteria, Humans, Prospective Studies, Urinary Tract Infections, Vagina

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Effects of recent sexual activity and use of a diaphragm on the vaginal microflora.

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