Sexual Health Behaviors by Age 17 and Lower Urinary Tract Symptoms at Age 19: PLUS Research Consortium Analysis of ALSPAC Data

Deepa R. Camenga, Zhenxun Wang, Haitao Chu, Sarah Lindberg, Siobhan Sutcliffe, Sonya S. Brady, Tamera Coyne-Beasley, Colleen M. Fitzgerald, Sheila Gahagan, Lisa Kane Low, D. Yvette LaCoursiere, Missy Lavender, Ariana L. Smith, Ann Stapleton, Bernard L. Harlow

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1 Scopus citations


Purpose: We examined how antecedent sexual health factors affect lower urinary tract symptoms (LUTS) in adolescent women. Methods: We analyzed 1,941 adolescent women from the Avon Longitudinal Study of Parents and Children at age 19. At ages 15 and 17, participants reported use of oral contraceptives (OCs), history of sexual intercourse, number of sexual partners, and condom use. At age 19, The Bristol Female Lower Urinary Tract Symptoms questionnaire quantified the frequency over the past month: stress incontinence, any incontinence, urgency, sensation of incomplete emptying, bladder pain, and urinary tract infection. Multivariable regression models examined associations between sexual health behaviors reported at ages 15 and 17 and six LUTS reported at age 19, after controlling for covariates. Results: Commonly reported LUTS at age 19 were past-month stress incontinence (26.8%), bladder pain (26.3%), any urine leakage (22.1%), and urinary tract infection (15.4%). OC use by age 17 was associated with urgency (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.19–2.20), incomplete emptying (OR = 1.62, 95% CI = 1.17–2.26), bladder pain (OR = 1.45, 95% CI = 1.15–1.83), and urinary tract infections (OR = 1.68, 95% CI = 1.28–2.21) at age 19 after adjustment for covariates. However, associations were attenuated after adjustment for condom use and number of sexual partners. Sexual intercourse by age 17 was associated with 1.53–2.65 increased odds of LUTs categories except incontinence, with lower confidence interval boundaries > 1.0. Associations were stronger among women with ≥ 3 sexual partners (vs. 0) by age 17. Discussion: We found longitudinally assessed associations between OC use, sexual intercourse, and number of sexual partners during adolescence and LUTS at age 19.

Original languageEnglish (US)
Pages (from-to)737-745
Number of pages9
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 2023

Bibliographical note

Funding Information:
The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium is supported by the National Institutes of Health (NIH) through cooperative agreements (grants U01DK106786 , U01DK106853 , U01DK106858 , U01DK106898 , U01DK106893 , U01DK106827 , U01DK106908 , U01DK106892 ). Additional support is provided by the National Institute on Aging , NIH Office of Research on Women's Health , and NIH Office of Behavioral and Social Sciences Research . The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of NIH. The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors who will serve as guarantors for the contents of this article. A comprehensive list of grants funding is available on the ALSPAC website ( ); These data collected for this research were specifically funded by the Wellcome Trust and MRC (Core) 76467/Z/05/Z & 86676/Z/08/Z, MRC G0701503/85179, and the International Urogynecological Association. Please note that the ALPSAC study website contains details of all the data that are available through a fully searchable data dictionary and variable search tool: .

Publisher Copyright:
© 2023 Society for Adolescent Health and Medicine


  • Adolescent women
  • Epidemiology
  • Lower urinary tract symptoms
  • Sexual history

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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