Side Effects of Birth Control Pills

>> Thursday, May 7, 2015

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Here is a concern I often hear: "Since I started birth control pills, I noticed my vaginal discharge has changed. Most of the time I have an increase in vaginal dryness and I've noticed that I have a lot more yeast and bacterial infections."

These are common side effects because of how the pill works. The pill stops the natural fluctuations of estrogen and progesterone (and a spike called the LH surge - which causes ovulation and an increase in sexual libido.) The pill is made up of estrogen and progesterone and, when taken daily, flattens and overrides the natural fluctuations. This prevents ovulation, reduces vaginal discharge and can suppress our libido.

We've talked many times about how important pH balance is to vaginal health. Any change in hormonal balance can affect vaginal pH - like starting birth control pills, hormone replacement, menopause and the first few months post-partum (i.e. post-partum depression) - making us more susceptible to bacterial and yeast infections.

Bacterial vaginosis can also be triggered by douching and the use of chemicals, vinegar, lemon, or soap to cleanse the vagina. It doesn't matter if it is mixed in water and put inside with a douche bottle, or by using your soap covered fingers to clean up inside the vagina, or if a tampon is soaked in watered down lemon juice, tea tree oil, vinegar etc..

But women can get desperate to get rid of vaginal odor. It is embarrassing, worrisome, makes us want to avoid sex and feels uncomfortable, causing us to have less confidence. So we douche anyway or soap up inside and cover up with lotion. But it only works for a short time before the odor returns and keeps getting worse.

Untreated, BV can lead to significant health problems, including premature births, postpartum infections, pelvic inflammatory disease, and increased vulnerability to HIV infection. It's estimated that up to one-third of women in the United States will have BV at any given time, even during pregnancy.

How can it make us more susceptible to HIV? Because constant irritation causes little openings in the vagina. Think of when you fall and get a "road rash". It's not really a cut, but rather many little scratches. These can lead to a break in the skin or vaginal mucosa, making a way of entry for the HIV. Anal sex can do the same, because the stretching of the anus can cause micro-tearing, making an entry way for bacteria and viruses like HIV.

Bacterial infections can cause PID (pelvic inflammatory disease) because sex or douching can push that bacteria from the vagina up into the uterus and Fallopian tubes. PID is extremely painful and can damage your Fallopian tubes, so you could be unable to get pregnant naturally. It also puts women at risk for ectopic (tubal) pregnancies. This happens because fertilization happens in the Fallopian tube, but because of scarring, the embryo get stuck there. This is a life threatening condition and you can bleed internally and even die.

So don't ignore odor that doesn't go away or an increase of discharge that itches or has an abnormal "fishy" sourish odor. See your doctor if you think you have a bacterial or yeast infection, as you may need antibiotics or anti-fungal medication to clear it. And you may have to repeat it back to back if it's been going on a long time. That's because sex, your period, or taking allergy medications like a steroid injection can bring it right back. It's not that we are not clean enough, in fact most of us fail at clearing these infections by trying to be too clean. It's best to let the vagina heal internally on its own. Washing externally with soap is just fine. Just don't let any soap, or feminine wash, get inside the vagina.

Now wouldn't you love to have a safe way to cleanse your vagina internally? Wouldn't it be wonderful to wash out old period blood, excess discharge, or semen after sex?

Well there is an FDA cleared device called WaterWorks that we can use every day for feminine hygiene purposes and to keep odor away. Many of my patients use it every day to feel clean or after sex to rinse out semen and at the end of their period to rinse the old blood out.

WaterWorks is reusable and uses only plain water. It appears to be a reusable douching system but is nothing like that. The water sprinkles downward out of the stainless steel tip. The reaction that happens between the stainless steel, water and vaginal mucous works similar to the stainless steel bars that chefs use to get onion and garlic odors off their hands.

My patients who struggled with odor for years have not had vaginal odor for years now and rarely have a yeast or bacterial infection as the pH balance is under control.

I'm pleased and amazed myself at how well WaterWorks performs and how well made this device is.
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