The Birth Control–Yeast Infection Connection

A vaginal yeast infection, also known as candidiasis, is a common infection, and most women will have one at some point in their lives. A yeast infection occurs when there is an overgrowth of the Candida fungus in the vagina. Symptoms include burning, itching, and a thick, white discharge that affect the vagina and vulva. 

Using certain types of birth control can put a person at higher risk for developing a vaginal yeast infection due to their effect on the vagina's balance of bacteria and yeast. Fortunately, many yeast infections can be easily treated at home, and some can even be prevented. 

Ways Birth Control Increases Yeast Infection Risk

There are several factors that can affect your risk of developing a yeast infection. Pregnancy, hormone therapy, uncontrolled diabetes, immunosuppression, and antibiotic use can all contribute to a yeast infection. In addition, birth control like oral contraceptives, intrauterine devices, spermicide, and condoms can increase your chances of getting one as well. 

Hormonal Birth Control

Hormonal birth control does not cause yeast infections, but it can increase the risk of getting them. This type of birth control contains estrogen, which stops ovulation and prevents the woman’s egg from being fertilized by the sperm. 

It can come in the form of a daily oral pill, vaginal ring (replaced monthly), skin patches (replaced monthly), injections (given every three months), or an intrauterine device (changed every three to 10 years depending on the brand). Not all types of hormonal contraception can increase the risk of yeast infections.

A 2017 study found that women who use either oral contraceptives or the levonorgestrel-releasing intrauterine system are at increased risk for developing yeast infections, bacterial vaginosis (vaginal inflammation caused by the overgrowth of bacteria in the vagina), and trichomoniasis (a sexually transmitted disease, or STD, caused by a parasite). The increased risk is highest within the first month of starting the birth control method and decreases over time.

Studies have shown that women who use the levonorgestrel intrauterine system are at higher risk of vaginal infections than women who use other types of birth control. Because hormonal birth control can increase your risk for other types of vaginal infections as well, it's important to talk with your healthcare provider if you suspect you have developed an infection. Your practititioner will be able to diagnose your infection and prescribe the appropriate treatment.

Spermicide 

Other methods of birth control include spermicides, condoms, diaphragms, and sponges. While spermicidal products do not raise a woman’s estrogen level, they can still affect the vagina’s balance of bacteria and yeast. The vagina contains healthy bacteria known as lactobacilli. When these bacteria are killed by antibiotics or spermicidal jellies and creams, the bacteria can no longer keep the Candida yeast under control and the yeast starts to overgrow.

It’s important to note that medications for vaginal yeast infections can make spermicides less effective. Talk with your gynecologist about other birth control options when you are taking an antifungal medication. 

Prevention

Even if your birth control places you at higher risk of a yeast infection, there are steps you can take to protect yourself. Prevention methods involve keeping your vagina’s balance of bacteria and yeast at a healthy level.

To prevent a yeast infection, it’s important to:

• Choose underwear that is made from breathable cotton and is not too tight.
• Keep your vagina clean and dry, making sure to change out of wet clothes or a bathing suit right away.
• Avoid douching and using any vaginal products with perfumes or dyes.
• Change your pads and tampons frequently.
• Always wipe from front to back when using the bathroom.
• Avoid sitting in a hot tub or very hot bath for too long.
• If you have diabetes, take precautions to keep your blood sugar level under control.
• Eat foods rich in probiotics like yogurt or other fermented foods.

Home Treatments

A vaginal yeast infection will not resolve on its own and needs to be treated with an antifungal medication. There are many options available over the counter, and they may come in the form of creams, ointments, or vaginal suppositories. There are also natural supplements that claim to treat yeast infections, but they have not been proven effective.

The treatment course may require one dose or take up to seven days depending on the brand and method. Over-the-counter options include:

• Gynazole, Femstat 3 (butoconazole)
• Terazol (terconazole)
• Vagistat-1 (tioconazole)
• Monistat (miconazole)
• Gyne-Lotrimin (clotrimazole)

Your healthcare provider may also recommend a onetime oral dose of prescription antifungal medication, such as Diflucan (fluconazole). 

When to Call a Healthcare Provider

If you’re unsure whether you have a yeast infection, see your healthcare provider before treating it. Using antifungal treatments when you do not need them can upset the balance of normal flora in the vagina, which could lead to other symptoms. 

Most cases of yeast infection can be safely treated at home. However, if over-the-counter products do not provide relief, talk with your practitioner. There are other infections that have the same symptoms as yeast infections, so your healthcare provider may need to see you to provide the right diagnosis and treatment. It’s estimated that up to two-thirds of women who buy over-the-counter yeast infection treatments do not have a yeast infection.

If you find that you are experiencing recurring yeast infections, talk with your healthcare provider. Your practitioner will test to confirm if your symptoms are due to a yeast infection and can prescribe medications to reduce your likelihood of getting recurrent infections. It’s also possible that you may be experiencing recurrent vulvovaginal candidiasis (RVVC), which affects about 5% of women and requires prescription antifungal medication.