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  • Title: Urinary tract infection in relation to diaphragm use and obesity.
    Author: Vessey MP, Metcalfe MA, McPherson K, Yeates D.
    Journal: Int J Epidemiol; 1987 Sep; 16(3):441-4. PubMed ID: 3667045.
    Abstract:
    We have examined factors influencing the rate of first referral to hospital for urinary tract infection among the 17,032 women taking part in the Oxford Family Planning Association contraceptive study. The risk of first referral declined with age, was higher in nulliparous women than in parous women, was higher in non-obese than in obese women and was higher in current users of the diaphragm than in current users of other methods or no method of contraception. The main increase in the risk of referral in current diaphragm users occurred during the first 24 months when overall rates were 2-3 times higher in users than in non-users or ex-users of the diaphragm. The negative association between hospital referral for urinary tract infection and obesity was unexpected. It was not explicable in terms of age, parity or diaphragm use. It may be that obese women are less likely to receive trauma to the genital area during sexual intercourse than non-obese women because adipose tissue offers them some protection. Another possibility is that increased oestrogenization in obese women, resulting from peripheral conversion of androstenedione to oestrone, has a beneficial effect on the bladder and urethra, thus reducing the liability to infection. Throughout England and Scotland from 1968-74, 17,032 white, married women whose ages ranged from 25-39 years were studied in an attempt to observe the correlation of urinary tract infection to diaphragm use and obesity. The risk of urinary tract infection was not found to be linked to social class and cigarette smoking. Infection was, however, found to be connected to age, parity, obesity and contraceptive use. The risk of urinary tract infection was shown to decrease with age. The risk of UTI (urinary tract infection) was found to be more prevalent among nulliparous than parous women. Women who were non-obese and women who currently used the diaphragm were at greater risk than women who were obese and women who used other/none methods of birth control. The current study along with other studies confirm that a connection exists between the use of a diaphragm and an increased risk of urinary tract infection.
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