Is my IUD giving me BV?

Kate graduated with a B.A. in Journalism from San Diego State University. She is the Content Manager at Uqora and is responsible for Uqora's social media, newsletters and contributing to the UTI Learning Center.

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Search for “BV IUD” on Reddit and you’ll find thousands of stories from women who’ve struggled with bacterial vaginosis after getting their IUD inserted. Their stories ring with the same frustration: “I would treat it and it would go away only to come back.”

For most, it was totally unexpected. They’d never been warned that the IUD could cause a bacterial disruption resulting in chronic, unpleasant symptoms, like fishy-smelling odor, burning urination, and intense vaginal itching (1). When they complained about the symptoms, some women said their Ob/Gyns minimized the connection to the IUD, despite the clear onset after insertion.

These women weren’t just making assumptions. Plenty of evidence points to the connection between the IUDs and bacterial vaginosis — and in particular, the copper IUD (AKA Paragard). A 2017 study found that the rate of BV in women with the copper IUD increased from 27% at baseline to 44% six months after insertion (2).

It’s not just the copper IUD that causes issues though. Another study followed women for six months after they began different forms of birth control to track the differences in BV rates (3). In women using oral contraceptives, rings, and patches, the rate of BV was just over 19% — but among all IUD users, it was 37%. So what is BV, and why does the IUD cause it?

BV is an inflammatory condition resulting from the overgrowth of “bad” bacteria in the vagina. Beyond the unpleasant symptoms we mentioned above, this microbial imbalance can lead to an array of more serious issues. BV is linked to:

• Premature deliveries in pregnant women.
• Higher susceptibility to sexually transmitted infections like HIV, herpes simplex virus, chlamydia, and gonorrhea. (Plus, if you’re HIV-positive, BV increases your odds of passing it to your partner.)
• Higher risk of infection after gynecological surgeries.
• Pelvic inflammatory disease (PID), which can lead to infertility in serious cases.

So while the fishy odor is more than enough to be unhappy, BV is not just about discomfort. It can be dangerous and life-altering, especially if it goes untreated.

For IUD users, that complicates things. The copper IUD often causes irregular, heavy periods, and the increased blood flow is thought to disrupt the vagina’s microbial imbalance. On top of that, it’s been shown that bacteria like E. coli can feed off of copper, which may encourage overgrowth (4). So beyond removing the IUD, the only treatment options are to take antibiotics continually or address the imbalance in other ways, like through diet, supplementation, and lifestyle changes.

With hormonal IUDs, it’s a little fuzzier. As opposed to heavy periods, women on the Mirena IUD often have no periods at all. In their case, BV is thought to be caused by the IUD strings, which can irritate the vaginal walls, causing inflammation that can then manifest as a microbial imbalance. Again, removing your IUD is the only surefire way to overcome repeat infections, though many women take other steps to address the issue.

First off, talk to your Ob/Gyn. Although you may experience a bit of pushback, most practitioners are now aware of the connection between the two. You can discuss the next best options for contraception or figure out a game plan to reduce your risk of BV, if you want to stick with the IUD.

If you decide to keep it and want to explore other preventive options, consider some of the basics for keeping your vaginal flora in balance:

• Wear breathable cotton underwear.
• Avoid scented soaps, douches, and other synthetic products, which can kill off healthy bacteria.
• Stick to pads and unscented tampons if possible.
• Avoid synthetic lubricants.
• Add a vaginal probiotic to your regimen.
• Cut down on sugar, alcohol, and caffeine as much as possible.
• Here’s to a happy, healthy vagina

We all deserve to feel in control of our health. While the IUD is an incredible form of birth control that has changed many women’s lives, like any contraception, it comes with its drawbacks. Just remember that you don’t have to live with abnormal symptoms, and talking to your doctor about what works for YOU is the best way to pave the way to a happy, healthy hooha.

1. Bacterial Vaginosis. Patient Health & Info. Mayo Clinic. Accessed Sept, 2020.

2. Achilles SL, Austin MN, Meyn LA, Mhlanga F, Chirenje ZM, Hillier SL. Impact of contraceptive initiation on vaginal microbiota. Am J Obstet Gynecol. 2018 Jun; 218(6).

3. Madden T, Grentzer JM, Secura GM, Allsworth JE, Peipert JF. Risk of bacterial vaginosis in users of the intrauterine device: a longitudinal study. Sex Transm Dis. 2012; 39(3).

4. Strait J. Aggressive UTI bacteria hijack copper, feed off it. Washington University School of Medicine. July, 2017.