Could the pill be to blame for frequent UTIs?

Could hormonal contraceptives have an influence when it comes to urinary tract infections?



Qualified Nutritionist (BSc, MSc, RNutr)
@EmmaThornton
Ask Emma


17 September 2018

Common causes of cystitis

When it comes to urinary tract infections (UTIs), the main cause is bad bacteria getting into the wrong places. As bacteria infects your urinary tract, it can easily lead into an infection of the bladder, which we call cystitis. But how does this happen? In most cases this happens as a result of the simple transfer of bacteria. This is more common in girls (we have anatomy to thank for that) and it may crop up more often after sex or as a result of different clothing choices or hygiene practices. However, what else could be having an influence? Is it possible that everyday medications could be having an effect too? 

How do you know if the pill is having an influence?

When it comes to the pill and UTIs or cystitis, firstly it’s important to consider what the pill is actually doing. 

The pill, much like many other forms of hormonal contraceptives including the implant, the injection and the Mirena coil act as contraceptives by providing a specific dose of synthetic sex hormones, namely oestrogen and progesterone.  In this way, they help to prevent pregnancy and may help with the symptoms PMS, for example. However, if our natural balance of hormones can contribute to symptoms of PMS, isn’t it possible that the synthetic hormones provided by the pill or other forms of contraceptives could be having an influence on our symptoms too?

Although it isn’t common knowledge and we don’t know exactly why, early research shows that being on the pill puts us greater risk of infections and changes in the structure of the urinary tract1

One theory for this is that significant drops in oestrogen could be having a part to play. Especially when it comes to oestrogenic forms of the pill, i.e. the combined pill, the drop off in oestrogen that we experience at the end of the month could be making our tissues more prone to infections. Almost like a mini menopause, low oestrogen can affect the structure of the delicate mucous membranes, or muscles, that line many parts of our body, including our urinary tract, making infections more likely to set in. Worryingly, it also looks likely that the longer a lady had been on hormonal contraceptives, the more likely she was to suffer from recurrent infections1

Another possibility is the effects being on hormonal contraceptives can have on our nutrient stores. These meds are thought to contribute to draining our stores of vital minerals including vitamin C, B vitamins and zinc, to name a few, both of which have an important role in supporting our immune system and therefore our ability to keep on top of infections. 

Finally, women on hormonal contraceptives are perhaps more likely to be sexually active than those who don’t have a need for it. It’s not that sex directly causes UTIs, but we may just have to take more steps to protect ourselves from the transfer of bacteria; one top tip is to ensure you go to the loo straight after sex to help keep any lingering bacteria flushing through.

Then as well as the hormonal methods, how do barrier methods of contraception come into all of this? Is there still a risk there too? Condoms, depending on how they’re used could make the transfer or bacteria more likely and other options such as diaphragms or spermicides risk changing the internal environment of the vagina. The pH of the vagina is well equipped for fending off bacteria, so if this is deliberately changed it could make infections more likely, so this is also something to be aware of.

What can be done to help?

If you suffer from recurrent urinary tract infections and suspect being on the pill, or another type of hormonal contraceptive, could be contributing, some advice from me for tackling this is as follows:

Listen to your symptoms

It sounds simple enough, but do many of us listen and I mean really listen, to our symptoms? Much like issues such as thrush, if your symptoms of cystitis crop up at the same time each month, it’s likely that hormones are having something to do with – it’s time we started to understand more of what’s going on with our bodies, and especially if you’re on hormonal contraceptives.

This applies to specific symptoms too, once you’ve started to identify the underlying cause, you can hopefully begin to have a better go at preventing those recurrent episodes which get so many of them down. However, if they do crop up on the odd time, by understanding the causes more carefully, you’ll hopefully be in a better position to decide if you can treat the symptoms from home, or if a trip to your doctor or pharmacist is necessary. 

Chat to your doctor

Hand in hand with paying more attention to your symptoms, when it comes to cystitis, it may be helpful to chat things over with your doctor. Firstly, discussing your pill may be the best place to start. As above, research suggests that certain pills could be contributing to some of the symptoms of cystitis, so it’s best to consider your current situation and perhaps a chat with your doctor will open up the possibility of some different options for you. If one type of pill isn’t agreeing with you, it might be time to try switching to another or exploring methods of contraception you hadn’t yet considered.

Then, when it comes to treating the infection itself, although antibiotics come top of mind for many of us, there is a time and place for antibiotics when it comes to UTIs (read my blog on this topic for more detail). The threat of antibiotic resistance is fast upon us, not to mention the adverse effects antibiotics can have on our balance of beneficial bacteria, so this is all something to be aware of and perhaps think twice about going forward. My advice if antibiotics are considered necessary is to take a course of good quality probiotics alongside them.

Take other steps to manage your symptoms

Whether it’s with or without some intervention from your doctor first (in terms of discussing the pill or the need for antibiotics), sometimes when it comes to managing the symptoms of UTIs, it may be appropriate to take things into your own hands. 

Factors such as diet can have a big influence when it comes to UTIs and cystitis, and surprisingly, there are also a number of other things you can do at home to help keep things under control – something as simple as managing your liquid intake can have a huge difference (more water, more good quality cranberry juice and less caffeine, for example), can be a simple step in the right direction. 

However, there are also herbs that can lend a helping hand. Uva-ursi is a licensed herbal remedy for the symptomatic relief of UTIs and cystitis. You can take this up to 5 times daily at the height of an infection to help get troublesome symptoms under control.

 

1. https://www.ncbi.nlm.nih.gov/pubmed/793141

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Here’s what I recommend

Emma our women's health advisor recommends Uva-ursi complex to help ease symptoms of cystitis and cranberry to maintain bladder health.

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Did you know?

Cystitis is sometimes known as ‘honeymoon cystitis’. Why? Well, during sex, bacteria can spread from the perineum to the urethral opening. The risk of developing cystitis is therefore increased depending on the frequency you have intercourse (sorry honeymooners!).

7 reasons you keep getting cystitis

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