Is Birth Control Causing Your Vaginal and Urinary Tract Infections?

Brianna Anderson
Brianna Anderson
March 5, 2024
8
min read
Medically reviewed by:
Trager Hintze, PharmD
Is Birth Control Causing Your Vaginal and Urinary Tract Infections?
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Birth control has become an integral part of women’s health care. According to a KFF survey, 72% of women use two or more types of contraception during their lifetime. Additionally, 60% of sexually active women reported using contraception during their last sexual encounter [1].

Birth control has many benefits, from preventing unwanted pregnancies to treating medical conditions [1]. However, recent studies suggest that contraceptives may cause vaginal and urinary tract infections (UTI). Understanding the potential link between birth control, UTI, and other conditions can help you make informed decisions about your reproductive health.

Understanding Contraceptives

Women can choose from a broad range of contraceptives with different mechanisms of action.

Oral contraceptives are the most popular form of birth control. These pills contain progesterone by itself or combined with estrogen. These hormones suppress ovulation by inhibiting follicular development [2].

Copper and hormonal intrauterine devices (IUD) are T-shaped devices implanted in the uterus. Copper IUDs cause an inflammatory response that inhibits the movement of sperm in the uterus. By contrast, levonorgestrel IUDs prevent sperm motility by thickening the cervical mucus [3].

Condoms are barriers that prevent semen from entering the vagina. These contraceptives also reduce the risk of sexually transmitted infections (STIs) [4].

Women can also vaginally administer spermicidal gels and suppositories to immobilize and kill sperm cells. Many spermicides use the surfactant Nonoxynol-9 (N-9), which can damage vaginal membranes and cause irritation [5].

Various contraceptive methods are available to women, each with a unique mechanism of action.

Vaginal Health and Contraceptives

The vagina has a delicate ecosystem filled with hundreds of species of bacteria and other microflora. A healthy vaginal microbiome stabilizes the pH level and decreases the risk of infection.

Can birth control cause BV (bacterial vaginosis)? Many contraceptives disrupt the vaginal microbiome and may contribute to infections. For example, N-9 spermicide destroys beneficial Lactobacillus bacteria, which help fight infection. They also have harsh chemicals that can cause allergic vaginitis [6].

Can Plan B cause yeast infections? Research suggests oral contraceptives may increase vaginal candidiasis, leading to an overgrowth of yeast [6]. A 2021 study also linked oral contraceptives to vaginal dryness, which may affect sexual lubrication [7].

Unlike spermicides and oral contraceptives, male and female condoms typically don’t alter the overall vaginal ecosystem. However, these barrier methods can cause inflammation. This response may lead to irritant vulvovaginitis and vaginal dermatitis, especially if the condom contains latex or spermicide [6].

However, several studies have found that hormonal IUDs don’t impact vaginal microflora. As a result, women concerned about their vaginal health may prefer this method [6].

Urinary Tract Health and Contraceptives

Can birth control cause a UTI? Certain contraceptives have been linked to an elevated risk of UTIs.

According to a 2023 study of reproductive-aged women, hormonal contraceptives significantly increase the risk of UTI. Methods linked to these infections include the oral contraceptive pill, IUDs, and medroxyprogesterone acetate injectable [8].

Several nonhormonal contraceptives can also cause UTIs. Spermicides and condoms may irritate the skin and vaginal tract, allowing harmful bacteria to enter the bladder. Also, diaphragms can impede urine flow and allow bacteria to flourish [9].

Choosing the Right Contraceptive

There’s no one-size-fits-all approach to birth control. It’s important to consider your individual needs and lifestyle while choosing a contraceptive.

Discuss these factors with your healthcare provider to make an informed decision [10]:

  • Accessibility
  • Cost
  • Ease of use
  • Effectiveness
  • Medical history
  • STI prevention
  • Side effects
  • Family goals
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Proactive Measures for Vaginal and Urinary Health

Along with choosing the right birth control, you can take these steps to promote a healthy vaginal microbiome and prevent UTIs [11]:

  • Stay hydrated by drinking 2 to 4 liters of water daily
  • Wear loose-fitting underwear and pants
  • Shower instead of bathing
  • Avoid feminine hygiene sprays and douches
  • Consider using sanitary napkins instead of tampons

You can also use the Vaginox vaginal pH test strips to check for pH imbalances from the privacy of your home. This simple test can help you determine if you have a medical condition that requires treatment.  

When To See a Doctor

Vaginal and urinary tract infections typically require medical treatment. Consult a doctor if you notice these symptoms of vaginitis [12]:

  • Burning and itching
  • Abnormal vaginal discharge
  • Fish-like odor
  • Soreness of the vulva

Additionally, these symptoms can be signs of a UTI [13]:

  • Burning or pain when urinating
  • Frequent urination
  • Difficulty starting urination
  • Blood in urine
  • Bladder spasms

Balancing the Benefits and Risks of Contraceptives

It’s essential to weigh the benefits and risks of contraceptives carefully. Choosing a birth control method is highly personal, so only you can decide if a method is right for you.

Researching recent studies on the link between contraceptives and infections can help you understand your options. For instance, a 2023 study in Frontiers in Microbiomes investigates the influence of different contraceptives on the vaginal microbiome [6]. This research continues to evolve as scientists conduct studies.

Take Control of Your Reproductive Health

Many women rely on contraceptives to prevent pregnancy and STIs. However, birth control may increase your risk of vaginal and urinary infections. A healthcare provider can help you understand the pros and cons of each method and pick the method that best suits your unique health needs.

References

[1] B. Frederiksen, U. Ranji, M. L. P. Apr 21, and 2021, “Women’s Sexual and Reproductive Health Services: Key Findings from the 2020 KFF Women’s Health Survey,” KFF, Apr. 21, 2021.

[2] D. B. Cooper, H. Mahdy, and P. Patel, “Oral Contraceptive Pills,” PubMed, Nov. 24, 2022.

[3] E. L. Lanzola and K. Ketvertis, “Intrauterine Device,” PubMed, 2022.

[4] H. Mahdy, A. D. Shaeffer, and D. M. McNabb, “Condoms,” PubMed, 2020.

[5] B. T. Chappell, B. L. Griffin, and B. Howard, “Mechanisms of action of currently available woman-controlled, vaginally administered, non-hormonal contraceptive products,” Therapeutic Advances in Reproductive Health, vol. 16, p. 263349412211071, Jan. 2022.

[6] C. Bakus, K. L. Budge, N. Feigenblum, M. Figueroa, and A. P. Francis, “The impact of contraceptives on the vaginal microbiome in the non-pregnant state,” Frontiers in Microbiomes, vol. 1, Jan. 2023.

[7] A. B. Handy, “An assessment of vaginal lubrication and blood flow in women taking oral contraceptive pills,” repositories.lib.utexas.edu, Aug. 2021.

[8] C. Lo et al., “Contraceptive exposure associates with urinary tract infection risk in a cohort of reproductive-age women: a case control study,” The European Journal of Contraception & Reproductive Health Care, vol. 28, no. 1, pp. 17–22, Feb. 2023, doi: 10.1080/13625187.2022.2156278.

[9] Eunice Kennedy Shriver National Institute of Child Health and Human Development, “What causes UTIs & UI?.

[10] Office of Disease Prevention and Health Promotion, "Choose the Right Birth Control".

[11] MedlinePlus, “Urinary tract infection in women - self-care," 2019.

[12] MedlinePlus, “Vaginitis,” 2019.

[13] M. J. Bono, W. C. Reygaert, and S. W. Leslie, “Uncomplicated Urinary Tract Infections,” National Library of Medicine, Nov. 13, 2023.

About the Author
Brianna Anderson
About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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