The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
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.
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“N-9 use also has been associated with an increased risk for bacterial urinary tract infections among women (53,54).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [53]
Citations
Cites
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Escherichia coli Bacteriuria and Contraceptive Method
Hooton, T. M. (1991) · JAMA · doi:10.1001/jama.1991.03460010064032 · Cited by 168
Association Between Diaphragm Use and Urinary Tract Infection
Fihn, S. D. (1985) · JAMA · doi:10.1001/jama.1985.03360020072027 · Cited by 161
The Association of Urinary Tract Infection with Sexual Intercourse
Nicolle, L. E., Harding, G. K. M., Preiksaitis, J. K., & Ronald, A. (1982) · The Journal of Infectious Diseases · doi:10.1093/infdis/146.5.579 · Cited by 152
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RISK FACTORS FOR URINARY TRACT INFECTION
Remis, R. S., Gurwith, M., Gurwith, D., HARGRETT-BEAN, N. T., & Layde, P. M. (1987) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114708 · Cited by 100
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“A number of studies have demonstrated effects of device use, N-9 use, intercourse or a combination thereof on vaginal flora [10–20].”
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Foxman, B. (2000) · Elsevier eBooks · doi:10.1016/b978-0-443-45863-7.00043-3
Escherichia coli: Enteric and Extraintestinal Infections
Lorenz, B. D., & Donnenberg, M. S. (2014) · ASM Press eBooks · doi:10.1128/9781555815486.ch5
Craig, J. M., & Talbot, M. D. (1996) · Sexually Transmitted Infections · doi:10.1136/sti.72.1.75
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STUDY OF VAGINAL MICROBIAL FLORA IN CONTRACEPTIVE USERS
Barde, P. S., & Tankhiwale, N. S. (2017) · Journal of Evidence Based Medicine and Healthcare · doi:10.18410/jebmh/2017/892
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Hirekatur, R. S. (2009) · Elsevier eBooks · doi:10.1016/b978-84-458-1911-1.50025-7
Hirekatur, R. S. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1793-8.00021-2
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Bacterial and Viral Sexually Transmitted Infections
Hammo, A. H., Thamer, R. A., Alhafidh, N. M., Abdulrahman, T. S., & Saadi, A. M. (2025) · Pharaonic Journal of Science · doi:10.71428/pjs.2025.0211
“N-9 may also play a role in increased risk for infection of the urinary tract by bacteria among females [ 69,70 ].”
Metadata
- 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
- 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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