Cystitis is a common type of urinary tract infection (UTI) that affects the bladder. It can cause symptoms such as pain or burning when urinating, frequent or urgent need to pee, blood in the urine, and lower abdominal pain. Cystitis is fairly common in women (more than half of women will get at least one UTI at some point in their lives) and it’s less common in (although can still affect) men.

You may be wondering if hormonal oral contraceptive pills can cause cystitis. We want to share accurate, medically backed information around sex and contraception so you can understand your body better, so we’ve spoken to some medical experts to let you know what’s up.

“Cystitis is a bladder infection, usually caused by a strain of bacteria (often E. Coli),” says  Dr. Michael Green*, Co-Founder & CMO of Winona. “Some of the symptoms of cystitis are a mild fever, frequent urge to pee, burning or pain during urination, cloudy or strong-smelling urine, or lower abdominal pain or discomfort. If you’re experiencing any of these symptoms, a medical professional can diagnose whether or not you have contracted cystitis.”

Typical symptoms of cystitis/UTIs include:

• Pain or a burning sensation when you pee.
• A frequent need to pee.
• Feeling like you need to pee even when you don’t.
• Bloody or cloudy looking urine.
• Abdominal pain or pressure.
• Fever

UTIs are often caused by bacteria which gets into the bladder. Women and people with vulvas are more likely to get UTIs than men because the urethra is shorter, so it’s easier for bacteria to travel through it, and it’s also closer to both the vagina and anus, both of which may contain bacteria that could cause a UTI.

Some people, particularly those with vulvas, are more likely to get UTIs than others. Whilst some people just seem to be more sensitive to UTIs, there are risk factors which may make cystitis more likely. These are:

• Sexual activity. Having vaginal sex can help move bacteria from the vagina to the urethra and may make the transference of bacteria from your sexual partner more likely.
• Some forms of contraception (more on this in a moment).
• Pregnancy. Pregnancy hormones can change the bacteria in the urinary tract, which makes UTIs more likely.
• Difficulty emptying your bladder.
• Diabetes.
• A weakened immune system.
• Scented feminine hygiene products.
• Wiping back to front after going to the toilet.
• Not peeing after sex. Peeing soon after sex can help flush bacteria out of the urethra.
• Holding your pee for too long, as it can encourage bacteria to grow.
• Menopause. A lower level of oestrogen can cause vaginal tissue to become thin and dry, which may make UTIs more likely.
• Kidney stones.
• Having a catheter placed in your bladder.

The pill contains synthetic versions of the naturally occurring female sex hormones oestrogen and progesterone. Combined contraceptive pills contain the synthetic hormones estrogen and progestogen, whilst progestogen-only pills contain (you guessed it!) only progestogen.  

Current research does not show a link between taking contraceptive pills and getting UTIs. Whilst some people who use hormonal birth control may experience more UTIs than some people who don’t, everyone is different and some people are unfortunately more sensitive to and likely to get UTIs than others. 

Whilst contraceptive pills are unlikely to cause UTIs in themselves, having sex without a condom may make UTIs more likely as it increases the chance of bacteria moving around and getting into the urethra.

According to a 2019 topic briefing by the Agency for Healthcare Research and Quality (AHRQ), oral contraceptive pills are not commonly cited as a risk factor for recurrent UTIs. However, other forms of hormonal birth control that involve devices inserted into the vagina or uterus may have a stronger association with UTIs. These include:

• Diaphragms. These are reusable silicone cups that fit over the cervix and block sperm from entering the uterus. Diaphragms can put pressure on the urethra and make it harder to empty the bladder completely. This may increase the chance of bacteria growth and infection. Diaphragms are often used with spermicide, which can also affect the vaginal flora and pH.
• Cervical caps. These are similar to diaphragms but smaller and tighter. They also cover the cervix and prevent sperm from reaching the uterus. Cervical caps can also cause pressure on the urethra and disrupt the vaginal balance when used with spermicide.
• Spermicide. This is a substance that kills sperm and blocks the cervix. It can be used alone or with other methods such as diaphragms, cervical caps, or condoms. Spermicide can destroy the good bacteria in the vagina and make it easier for harmful bacteria to cause infections.
• Spermicide condoms. These are condoms that are coated with spermicide for extra protection. However, they may also have similar effects as spermicide alone on the vaginal flora and pH.

If you have symptoms of cystitis or a UTI, you should see your doctor as soon as possible. Left untreated, a UTI can spread to the kidneys and cause serious complications. Your doctor can diagnose a UTI by testing your urine sample and then prescribe antibiotics to treat the infection.

You should also see your doctor if you have recurrent UTIs, which means you have more than two UTIs in six months or more than three in a year. Recurrent UTIs may indicate an underlying problem that needs further investigation and treatment. Your doctor may also suggest changing your birth control method if it is contributing to your UTIs.

There are some steps you can take to prevent cystitis and UTIs. “The primary way to reduce cystitis risk is to take good care of yourself,” says Dr Michael Green. “Hydrate, pee often, wipe from front to back, and take care of your vaginal pH. Douches and scented cleaning products tend to disrupt the natural pH balance of the vagina, so avoid them for good measure.”

• Drink plenty of water to flush out bacteria from your urinary tract.
• Urinate frequently and completely, especially after sex.
• Wipe from front to back after using the toilet to avoid spreading bacteria from the anus to the urethra.
• Avoid products that can irritate the urinary tract, such as douches, scented soaps, or feminine sprays.
• Wear cotton underwear and loose-fitting clothes to keep the genital area dry and ventilated.
• Take cranberry supplements or drink cranberry juice, which may have some benefits for preventing UTIs.
• Take probiotics or eat yoghurts with live cultures, which may help restore the vaginal flora and prevent infections.

If you have symptoms of cystitis or a UTI, you should see your doctor for diagnosis and treatment. You should also talk to your doctor about your birth control options and whether you need to switch to a different method that suits your needs and preferences. By taking care of your urinary tract health, you can avoid infections and enjoy a better quality of life.

*Dr. Michael Green does not endorse any products or brands

Hana® 75µg film-coated tablets contains desogestrel and is an oral contraception for women of child bearing age to prevent pregnancy. Always read the instructions on the package leaflet carefully.

https://effectivehealthcare.ahrq.gov/system/files/docs/topic-brief-hormonal-birth-control-utis.pdf  

https://www.avogel.co.uk/health/cystitis/could-the-pill-be-to-blame-for-frequent-utis 

https://www.healthline.com/health/can-birth-control-cause-uti

https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-tract-infection-uti 

https://www.womenshealth.gov/a-z-topics/urinary-tract-infection

Around 1 in 10 women are affected by a condition called polycystic ovary syndrome (PCOS). Whilst PCOS is fairly common, it can be very difficult to live with and many people suffer for the entirety of their childbearing years.

PCOS is caused by an imbalance of hormones. People with PCOS experience higher-than-usual levels of the ‘male’ hormone androgen, which affects the ovaries. In those with PCOS, fluid filled sacs grow inside the ovaries, so the egg might not develop or be released properly. This is the reason for the altered hormone levels.

The cause of PCOS is still relatively unknown. Studies have shown that PCOS can be genetic, or it can be down to naturally high levels of androgens or insulin. High levels of insulin, or insulin resistance, can be the cause of PCOS because it can impair ovulation and cause the ovaries to produce excess testosterone.

PCOS can affect women and people with uteruses – basically anyone with the ability to get pregnant – during the time that they can conceive, i.e. the time between their first period and menopause.

PCOS can have a physical effect on the body, and often has a negative impact on the patient’s mental health too. We spoke to Jane (she/her), who is 28, lives in Manchester and was diagnosed with PCOS when she was 24.

“When I was first diagnosed, it was a bit of a relief,” says Jane. “I finally had an answer to the months of painful, irregular periods and massive weight gain. But then I started to really suffer with some of the symptoms like acne and excess hair growth and found my self esteem plummeting. It’s a weird one, really – the GP initially told me I needed to have kids sooner rather than later, but I was 24 and absolutely not ready for that, so there was quite a bit of emotional turmoil there.”

The side effects and symptoms of PCOS will vary from person to person – some might experience none or only one of these symptoms, and others might suffer with more. Some women and people with uteruses might experience one or more of these side effects mildly, and some more extremely. It’s always important to remember that everyone is unique, and will experience things differently.

Common symptoms of PCOS include irregular periods or loss of periods, difficulty getting pregnant, hair growth (hirsutism) – usually on the face, chest or back – weight gain or a change in weight, hair loss from head, skin problems or acne.

PCOS can potentially have an effect on your overall health, too, and can be linked to conditions such as type 2 diabetes (due to insulin resistance), depression, high blood pressure and cholesterol.

In short, yes. PCOS can have an effect on your fertility. PCOS is actually one of the most common causes of infertility in women. But that’s not necessarily a reason to panic! Lots of women who do suffer with PCOS are able to conceive with various treatment options. If you have PCOS and get pregnant, you might be at a higher risk of being diagnosed with conditions like high blood pressure, preeclampsia (another high-blood pressure condition) or gestational diabetes, but this will be monitored by your doctor.  

Although it can’t be cured, there are quite a few treatment options when it comes to PCOS, depending on which symptoms you are looking to treat. If you are looking for help with fertility, you might be offered a medication called clomifene, which helps stimulate ovulation. Metformin (a commonly-used diabetes drug) can also be prescribed to help with insulin and blood sugar levels and encourage monthly periods. Various forms of hormonal contraception are often favoured to help with symptoms like acne and general hormonal imbalance, while there are an abundance of natural remedies and changes to diet and lifestyle that are said to have a positive effect on PCOS symptoms. 

We asked Jane how she manages her symptoms: “I’ve had some laser treatment for the hair growth on my face, but it really needs to be more of a regular occurrence to work properly, and I don’t have the time or budget to accommodate that right now! Otherwise, I try and really look after my body, eating foods that nourish it and trying to avoid anything that might contribute to a spike in my insulin and doing gentle exercise as often as I can. There are loads of great support and information pages on Instagram that I’ve found really helpful, too!”

Although it cannot be cured, there are many ways of potentially easing some of the side effects of PCOS, and hopefully letting those who suffer with PCOS live a much happier, more normal life. Again, it’s important to note here that everybody is different, and what works for one person might not work for another. 

If you have concerns about your PCOS symptoms, are worried about whether or not you might have PCOS or are looking into treatment options, we recommend speaking to a medical professional. 

References

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20is,and%20treatable%20cause%20of%20infertility

https://helloclue.com/articles/cycle-a-z/the-link-between-pcos-and-insulin-resistance#:~:text=The%20relationship%20between%20insulin%20resistance,4%2C5%2C6

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776334/

https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/

Hormones are chemicals in your body that are responsible for most aspects of daily life: sleep, digestion, metabolism, stress and energy levels. These “chemical messengers” carry signals from the brain and through the blood to your organs, skin, muscles and other tissues, which instruct your body what to do and when to do it. 

As we get older, hormone production naturally starts to change and shift. But there are also factors that affect our hormone balances such as too much stress, poor diet and nutrition, or use of hormonal medication. Hana® is here to tell you everything you need to know about how your hormones change as you age.

From about our mid-to-late twenties, estrogen and progesterone levels are at their peak for people with uteruses. These two hormones are important for female reproductive and sexual development, including regulating the menstrual cycle and playing an essential role in pregnancy.

As you reach your thirties, the levels of these hormones start to naturally decline, which is most commonly marked by changes to your menstrual cycle. From mid-to-late forties, people with ovaries may experience “perimenopause”, which is when levels of estrogen and progesterone fluctuate and can be unpredictable. From around 50-years-old, oestrogen declines by around 50% and significantly decreases after menopause. 

For women and people with uteruses, hormone balances naturally change during puberty, menstruation, pregnancy, when breastfeeding, and during menopause. 

A hormonal imbalance occurs when you have too much or too little or one or more hormones. Common side effects of hormonal imbalances are acne, decline in libido, changes in weight, pain during sex, night sweats, excessive or unwanted hair growth, fatigue, insomnia, darkening of the skin, vaginal dryness, and changes in the menstrual cycle. 

There are two types of contraceptive pill: the combined pill, which contains a synthetic form of the hormone progesterone (called a progestogen) and a synthetic form of oestrogen; then we have the progestogen-only pill (also called the “mini pill”), which just contains progestogen as the active ingredient. To find out more about the different contraceptive pills, head over to our other article here.

Hana® is a progestogen-only pill containing the active ingredient desogestrel. When taken correctly, it helps prevent pregnancy by working to consistently inhibit ovulation and alter your cervical mucus. Side effects of the “mini-pill” vary from person to person. To read more about the potential side effects of taking Hana®, check out our article here.

Weight gain is listed as a common side effect of the hormonal contraceptive pill, so around one in ten may experience this. Click here if you want to read more about whether the mini-pill can cause weight gain. If you experience any side effects, or you’re worried about gaining weight from the pill, talk to your doctor or pharmacist. 

Hormones play an important role in our emotions. So, changes in our hormones when taking the oral contraceptive pill, might affect a person’s mood. A 2016 study of more than one million females in Denmark found that there was a link between hormonal contraception and increased risk for first use of antidepressants and first diagnosis of depression. 

If you’re concerned that your birth control pill is affecting your mood, speak to your healthcare provider who will be able to help you. Hana® also has an article dedicated to how the contraceptive might impact your mood, documenting one woman’s journey with different contraceptive methods. 

Due to the changes in hormone levels caused by contraceptive pills, some people may experience a change in vaginal discharge or vaginal dryness. Unless there’s a change in odour or colour, which might point to an infection, these changes are usually not harmful. If you’re experiencing vaginal dryness and want to engage in sexual activity, try using a lubricant, which will help to make this more comfortable. 

Acne occurs when hair follicles in the skin become clogged with oil and dead skin cells – also called “sebum”. A build up in sebum is often caused by changing hormone levels. Changes in hormone levels can cause flare-ups in acne, which is why some women experience a break-out before their period or during the first three months of pregnancy. 

However, there are many different treatments for acne that your GP can advise you on.

The decline of oestrogen and progesterone levels in women and people with uteruses leads to menopause, which is when the ovaries stop producing as much estrogen and cease to release an egg every month. It’s a natural part of ageing and usually occurs between 45-55 years of age. After this time, a woman will no longer have periods nor be able to get pregnant naturally. In the UK, the average age for a woman to reach menopause is 51-years-old. 

Commons symptoms of menopause are: hot flushes, night sweats, vaginal dryness, difficuty sleeping, low mood or anxiety, reduced sex drive, problems with memory of concentrations. 

If you experience any of these symptoms before the age of 45, you should go see a medical professional. A blood test may be taken if you’re under the age of 45 to confirm whether you’re menopausal or not. 

Some severe symptoms of menopause can be treated such as vaginal dryness, for which a moisturiser, lubricant or estrogen cream may be given. There is also hormone replacement therapy (HRT) in the form of tablets, skin patches, gels and implants that can relieve symptoms by replacing oestrogen levels.

Hormone imbalances can affect several bodily processes that lead to weight gain. Thyroid hormones act to regulate the body’s metabolism (the rate at which it burns energy). If you have too few of these hormones, then the metabolism can slow, leading to weight gain. 

“Hypothyroidism” is the term for an underactive thyroid – one that produces too few hormones – and “hyperthyroidism” describes an overactive thyroid, one that produces too many hormones.

As we age, the prevalence of thyroid disorders increases. But hypothyroidism and hyperthyroidism are generally straightforward to diagnose via a blood test to measure the amount of thyroid hormones in the body.

If you think you may have a problem with your thyroid, speak to your GP who will be able to advise on treatments.

Certain hormones, like estrogen, testosterone, or thyroid hormone, can be examined via a blood test. 

But testing for hormones rests largely on what your healthcare provider thinks may be causing the issue. For example, ultrasound, X-ray, or magnetic resonance imaging (MRI) tests can be used to identify cysts or tumours that might be causing the body to produce excess amounts of hormones. Or, urine testing can be carried out to test for hormones related to the menstrual cycle.