Spermicide Use May Contribute to Women's Urinary Tract Infections

From the WebMD Archives

Nov. 21, 1999 (Philadelphia) -- The use of spermicides during intercourse may increase women's risk of developing a urinary tract infection, according to research presented here this week at the 37th annual meeting of the Infectious Diseases Society of America. In previous studies, these infections have been linked with use of a diaphragm with spermicide. However, this is the first study to compare how different spermicide formulations used alone -- including suppositories, creams, jellies, sponges, foams, and films -- affect risk of infections.

"This study suggests that there may be variations in the relationship between [urinary tract infections] and spermicide use, depending on the type of spermicide that you use, in the absence of using a diaphragm," lead author Margaret A. Handley, MPH, tells WebMD. Although Handley cautions that it's too early to say why this is so, she says "there's a lot of biological data supporting a relationship between spermicide use [and infection]."

Low-concentration spermicides seem to be a problem because the 'good' bacteria that exist in the vagina are more susceptible to being killed off by these spermicides. The bacteria that cause infection are then left to establish colonies, which creates infection, says Handley, who is currently completing her PhD in epidemiology at the University of California, Berkeley. She adds that higher-concentration spermicides seem to have a different effect on naturally occurring bacteria.

Jellies and creams are considered low-concentration spermicides because they contain less than 5% of the active ingredient.

For this study, 519 healthy, sexually active young women in the San Francisco Bay area reported on their use of contraceptives and history of urinary tract infections. The researchers' analysis focused on the 455 who indicated they had never used a diaphragm or cervical cap but had used spermicides in the form of suppositories, creams, jellies, sponges, foams, or films.

The researchers took into account all the women's ages, race/ethnicity, and lifetime number of sexual partners, lifetime history of spermicide use, as well as each woman's history of urinary tract infections.

Handley cautions against concluding that lower-concentration spermicides are more of a problem than the higher-concentration ones because this is a preliminary study and it relies on information women have reported about past usage. In an upcoming study, her research team will track women and their spermicide use to more fully examine the impact these products have on their reproductive health.

"I'm interested in looking at more of the properties of existing spermicidal and antibacterial methods of birth control," says Handley. "There really has not been enough understood about their properties." This study raises the issue that more research looking into not only the products' contraceptive properties but also their long-term effects may be important, she adds.