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].
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
