How IUDs Can Influence the Vaginal Microbiome

Intrauterine devices—or IUDs—are one of the most effective forms of birth control¹. In fact, these small, T-shaped contraceptives are over 99% effective in preventing pregnancy. And since they are inserted directly into the uterus, they are incredibly easy to use (no need to remember to take a daily birth control pill!).

However, like many other birth control methods, IUDs can come with side effects². Dr. Barry Peskin, a doctor of gynecology and obstetrics with over 20 years of experience, advises his patients to expect side effects like irregular bleeding and cramping after IUD insertion.

Some women also report experiencing changes in their vaginal health while using an IUD³. If you’re one of these women and are wondering if your only course of action is to remove the IUD, there may be other options. By learning more about how IUDs may influence the vaginal microbiome, there are steps you can take and lifestyle adjustments that may support vaginal wellness, even while using an IUD.

This post is for informational purposes only and does not constitute medical advice. See full disclaimer below.

How IUDs May Affect the Vaginal Microbiome

An IUD’s effect on the vaginal microbiome (also called vaginal flora or vaginal microbiota) may depend on the type of IUD used⁴. There are two kinds of IUDs: hormonal IUDs (like Mirena) and copper IUDs (like ParaGard). While many people prefer copper IUDs because they are non-hormonal, some research suggests that copper IUDs may be associated with shifts in the vaginal microbiome (aka the community of bacteria that help maintain vaginal health). Specifically, some studies have observed that copper IUDs may be associated with lower levels of Lactobacillus in the vagina.

Lactobacillus is a critical bacteria for vaginal wellness⁵. It helps produce lactic acid, which contributes to a slightly acidic vaginal pH. This environment supports the growth of beneficial bacteria.

When Lactobacillus levels are lower, vaginal pH may become less acidic⁶. Some research has explored whether this change may be linked to a greater likelihood of experiencing microbial imbalance, or an increase in bad bacteria.

Of course, IUDs are not the only factors that may influence the vaginal environment. Other factors include:

• The use of douches and scented soaps or washes
• Unprotected sex or having multiple sexual partners
• A diet high in processed foods and/or sugar
• Hormonal changes associated with pregnancy or menstruation
• Not changing tampons frequently during your period
• The use of antibiotics

By understanding how the body maintains balance and what can affect it, you may be able to support your vaginal wellness through certain habits and daily choices.

IUDs and Vaginal Microbial Imbalance

The two most commonly reported issues associated with vaginal imbalance are yeast overgrowth and bacterial vaginosis (BV)⁷.

IUDs and BV

Statistically, BV is the most common type of vaginal imbalance⁸. Most people with BV don’t experience noticeable symptoms. When symptoms do occur, they may include:

• Vaginal discharge with an unusual odor, often described as a fishy smell
• Itching around the vaginal opening or vulva
• A burning sensation while peeing
• Thin vaginal discharge that’s a grayish color

Healthy Lactobacillus levels and balanced pH are considered supportive of vaginal wellness⁹. Since copper IUDs have been studied in relation to shifts in Lactobacillus levels, researchers have examined whether IUD use may be associated with a higher incidence of BV compared to other contraceptives. One study found a higher prevalence of BV in people using IUDs compared to those using oral contraceptives. Another article published in Evidence-Based Practice reviewed data that reported a range of 7–47 percent of IUD users had BV, while among oral contraceptive users the range was only 2–35 percent.

IUDs and Yeast Overgrowth

Similarly, some research has looked at the relationship between IUDs and changes in yeast levels¹⁰. For example, a 2014 study found higher levels of vaginal candida 12 months after IUD insertion compared to baseline. Another study observed increased levels within three months of insertion.

If you’ve noticed changes in your vaginal health after getting an IUD, you’re not alone. There are simple strategies and lifestyle considerations that may help you feel more balanced while continuing to use your preferred birth control.

Supporting Vaginal Health While Using an IUD

Dr. Peskin recommends discussing any vaginal health concerns with your gynecologist or healthcare provider¹¹. If you’d like to keep your IUD for its convenience and effectiveness, your provider can help you explore options to support your microbiome.

Dr. Peskin often recommends the following strategies to his patients:

• Practice good hygiene, such as wiping from front to back and using warm water and mild, unscented soap¹².
• Avoid scented soaps, shampoos, or washes in the vaginal area.
• Eat a balanced diet with fiber, vegetables, fruits, and foods rich in probiotics. Some individuals also consider adding a probiotic supplement to their daily routine.
• Use protection during sex to help reduce exposure to semen and potential shifts in pH.
• Choose breathable cotton underwear and avoid synthetic fabrics.

If these adjustments don’t support the level of comfort you're looking for, you can talk with your provider about other contraceptive options, including those that may be less likely to influence the vaginal microbiome. And remember, most forms of birth control—including IUDs—do not protect against sexually transmitted infections (STIs), so it’s important to use barrier methods and get tested regularly if you are sexually active.

Safeguard Your Vaginal Wellness With Support From Happy V

Lactobacillus isn’t just a naturally occurring bacteria—it’s also considered a probiotic. Our Prebiotic + Probiotic features clinically studied strains of Lactobacillus at scientifically supported dosages. When taken daily, it can help support a balanced vaginal microbiome and maintain healthy pH levels.*

When paired with healthy habits like safe sex, a nutritious diet, and good hygiene, Happy V’s probiotic formula can be part of a wellness routine designed to support a healthy vaginal environment.*

Disclaimer: This blog is for informational and educational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. Statements about dietary supplements have not been evaluated by the Food and Drug Administration (FDA). Always consult your healthcare provider before starting any new supplement.