Can a Change in Birth Control Cause Cold Sores?

  • Medically reviewed by Emina Ribic (MD) on October 25, 2018. Written by Linda White (MD).

Changes in birth control pills can trigger a cold sore outbreak. Creating drastic hormonal swings, contraception causes the body to become overwhelmed.

Because birth control has many of the same side effects as pregnancy, the female body enters a state of flux. As it relates to the herpes simplex virus, the mouth is a known point of concern for women who are either pregnant or taking birth control tablets.

Due to a rapid increase in hormones, birth control (and pregnancy) can lead to irritation of the gums and inner linings of the mouth.[1] This can lead to a host of bacterial and viral infections, including HSV-1. Each of these oral health problems will need to be managed.

While the importance of contraceptive pills should never be understated, many women will face a crossroads. This is especially true if contraceptives are accompanied by a series of health issues. We will address many of your concerns while offering ways to cope better with any problems.

How Can Birth Control Pills Trigger Cold Sores?

Birth control pills can cause dramatic hormonal swings. These highs and lows within the body can cause cold sores. In fact, birth control can often lead to the same hormonal shifts that occur during pregnancy.

When the body is unstable, whether that instability is mental or physical, HSV-1 can be triggered. In truth, birth control can lead to numerous cold sore triggers at once. While most women will experience a unique reaction to oral contraceptives, fever blisters are more likely to arise.

If you are concerned that the pill is causing an issue, you should contact your physician. While cold sores will naturally heal on their own, continued use of the same contraceptive can lead to further outbreaks. Your doctor will be able to determine if your birth control pill is the problem and recommend an alternative.

To summarize:

  • Birth control pills can trigger cold sores due to the hormonal swings they induce. Oral contraceptives can cause similar hormonal swings that are often seen in pregnancy.
  • Instability within the body (hormonally) can act as a trigger. When the body is not settled, either mentally or physically, HSV-1 can be activated. It is not as much as the hormonal swing but rather what the swing causes.
  • Everyone is different, and each woman will react differently to birth control. However, if you believe your fever blisters are a direct result of your pills, then you should contact your doctor. Changing birth prevention meds could prevent a cold sore outbreak.

Why Do Hormonal Swings Cause Cold Sores?

Hormonal swings, generally speaking, can be a potential nightmare for HSV-1 carriers. This is especially true if you know that specific moods, stresses, etc. can cause an outbreak.

When hormones are racing, the mind becomes a maze of emotions.[2] When you are naturally emotional, the body lacks stability. Similar to the way that stress and fatigue are known causes, hormonal shifts can also lead to problems.

Potential personality and mood effects from birth control include, but are not limited to the following factors:

  • Euphoria
  • Sadness
  • Fear
  • Anger
  • Stress
  • Fatigue
  • Isolation

Any of the above emotions/moods can potentially cause a recurrent HSV-1 infection. However, when these events come in somewhat of a rapid-fire rotation, cold sores can form with ease. Unfortunately for some women, the pill can cause all of these adverse reactions.

It is also worth noting that all of these hormonal reactions can be made worse if you are sick. If you are currently dealing with the common cold, for example, you’re more likely to be affected. General fatigue, on its own, is a stand-alone trigger.

To recap:

  • Birth control pills can cause distinct hormonal swings. These can present themselves in various moods of intensity.
  • Each mood (or side effect) can be considered a trigger on its own. However, the problem is exacerbated when the swings come in cycles.
  • If you are sick or nauseous due to an unrelated issue, it can make the entire situation worse.

Can Cold Sore Medications Reduce the Effectiveness of Birth Control?

While nothing seems 100% medically conclusive, there is a school of thought that seems to indicate the possibility.[3] Of course mixing and matching birth control pills and OTC cold sore meds would be the only way to prove this theory.

Given that birth control has the existing potential to active HSV-1, the natural course of action is to treat the forming sores. However, various cold sore medications might also have the potential to render birth control ineffective. Valtrex, an antiviral cold sore remedy, is a notable example of marginal complaint.[4]

If birth control causes cold sores and cold sore treatment cancels out birth control, what do you do?

While the number of women affected is likely small, the real problem is quite obvious. Do I simply ignore my cold sores for the sake of pregnancy prevention? Or, do I clear up my blisters and run the risk of becoming pregnant?

The notion of having to sacrifice one for the other is not something that has to (or should) occur. Finding the right balance is key. Trial and error of both contraceptives and cold sore remedies could be in order.

Although this question probably does not apply to most women, it could apply to you. If you are concerned that you are taking a potentially risky cold sore OTC, make it a priority to a professional opinion.

To summarize:

  • While the odds are inconclusive, some cold sore OTC remedies could negatively interact with the birth control. The result could disrupt the effectiveness of the contraceptive.
  • If you are concerned that treating your cold sore has come with a pregnancy prevention consequence, consult your physician.

Contraception pills and fever blisters

Can Birth Control Pills Cause Gingivitis?

HSV-1 is just one of many issues that can occur. Blisters, ulcers, and general irritation can be a problem.

It is important to note that mouth issues are often a side effect of pregnancy. As it relates to gingivitis, an estimated of 60-75% of all pregnant women deal with this particular issue.

Due to the hormonal changes that occur during pregnancy the tissue and inner lining of the gums can become aggravated. The hormonal response to existing bacterial plaque increases and irritation becomes commonplace. Swelling and gum structure changes are also common.

Because birth control can mimic the hormonal changes in pregnancy, these exact gum issues can occur.[5] Women on birth control can have gingivitis, swelling, general irritation, etc.

Noted below are a few ways to combat these oral health issues:

  • Brush your teeth (once or twice per day) with a soft toothbrush
  • Floss daily
  • Gargle with a salt water rinse at least one time per day
  • Practice good nutrition (Do not eat a lot of junk food, candy, etc.)
  • Schedule routine dental visits for a basic checkup and cleaning

How Can You Control Cold Sores While on Birth Control?

The best way to manage existing cold sores caused by birth control is to avoid known triggers. While hormonal swings will act as a trigger, you can still be proactive. Being mindful of your environment and your diet can go a long way.

Additionally, managing your sores with a proven and non-conflicting OTC is priceless. Cold sore remedies only become an issue if they cancel out the needed effects of birth control. However, blister remedies that work without issue can heal cold sores fast.

Although contraceptives can potentially create more blister outbreaks than normal, a strong OTC can clear them within days. This is likely a worthy trade for most women if it means cold sore healing and effective birth control.

Birth control and cold sores

To recap:

  • Avoiding known triggers is a proactive way to manage cold sores while on birth control. You can potentially reduce your hormonal swings with quality nutrition and general wellness.
  • Cold sore treatments can work in the face of birth control. As long as the medication does not limit the effects of your contraceptive, everything will be fine.

Conclusion

Oral contraceptives can trigger cold sores in a multitude of different ways. Because birth control can cause mood swings, irritability, tiredness, sickness, sleeplessness, and tension, cold sores are more likely to form among HSV-1 carriers (recurrent cold sores)

If you have dealt with an outbreak before using birth control you likely know the symptoms. There is also a good chance that you are familiar with the underlying causes. Several of these involve various emotional and physical states. Fatigue, stress, general illness, etc. For this core reason, changes in contraception can be an issue for some women.

Consult with your physician before starting birth control (or new birth control) if you have HSV-1. Because oral health issues are often a problem, telling your physician of your HSV-1 history is critical. This will likely enable your doctor to change your birth control to something that works better for you. Finding a contraceptive that will be effective while not triggering the herpes simplex virus is the goal.

References

  1. Lee R, Nair M. Diagnosis and treatment of herpes simplex 1 virus infection in pregnancy. Obstetric Medicine. 2017;10(2):58-60. doi:10.1177/1753495X16689434.
  2. Lundin C, Danielsson KG, Bixo M, et al. : Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle-A double-blind, placebo-controlled randomized trial. Psychoneuroendocrinology. 2017;76:135–43. 10.1016/j.psyneuen.2016.11.033
  3. https://www.nhs.uk/conditions/contraception/contraceptive-pill-interact-medicines/
  4. https://www.rxresource.org/consumer-information/valtrex.html
  5. Preshaw P. M. Oral contraceptives and the periodontium. Periodontology 2000. 2013;61(1):125–159. doi: 10.1111/j.1600-0757.2011.00399.x.

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