Can the contraceptive pill cause cystitis?

What is cystitis?
What causes Cystitis/UTIs?
How does the pill affect hormones and UTIs?
What types of birth control are linked to UTIs?
When should you see a doctor for cystitis?
How can you prevent cystitis and UTIs?

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.

What is cystitis?

“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

What causes Cystitis/UTIs?

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.

How does the pill affect hormones and UTIs?

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.

What types of birth control are linked to UTIs?

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.

When should you see a doctor for cystitis?

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.

How can you prevent cystitis and 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.