Vaginal discharge, itching, burning, and urinary pain can be easy to blame on lupus, especially when symptoms show up during a flare or after a change in medication. But lupus and gynecological problems can overlap in several ways, and new symptoms aren’t always caused by lupus itself.

Symptoms around the vagina or vulva can come from bacterial vaginosis (BV), a yeast infection, a urinary tract infection (UTI), irritation, or another condition. This article will explain what researchers know about these connections, the difference between common causes, and when testing can help.

Does Lupus Raise the Risk of Gynecological Infections?

Systemic lupus erythematosus (SLE), the most common form of lupus, is linked to a higher overall risk of infection.

A systematic review found that adults with SLE were about three times more likely to develop severe infection compared with people without SLE. However, that doesn’t mean lupus has been shown to raise the risk of every type of vaginal infection.

The increased risk of infection is partly because lupus can disrupt normal immune defenses. Normal antibodies help recognize and fight infections. In lupus, autoantibodies mistakenly target the body’s own healthy tissues. Lupus treatments can also suppress the immune system, which normally protects against bacteria, viruses, and fungi.

There’s much discussion about vaginal infections in the MyLupusTeam community. One member said, “I have started to have more yeast infections and bacterial vaginosis since taking new lupus medication.”

Another member reported, “I have bacterial vaginosis and I’ve noticed it occurs frequently since starting my medicine. I’m learning some struggle with yeast infections, some struggle with BV, and others struggle with UTIs. It’s a vicious cycle and it makes it hard to be intimate because it appears out of the blue.”

Lupus and Yeast Infections

A weakened immune system can make Candida, the fungus that causes yeast infections, harder to keep under control. However, the evidence connecting lupus and yeast infections is stronger for oral candidiasis, also called thrush, than for vaginal yeast infections.

There are also other risk factors for people with SLE, such as dry mouth, immunosuppressive treatment and corticosteroid treatment.

Vaginal yeast infections can occur in people with lupus, but research hasn’t established whether lupus itself affects someone’s risk. Antibiotic use, pregnancy, diabetes, and conditions that weaken the immune system can all increase the risk of vaginal yeast infections.

Corticosteroids (like prednisone), which are commonly used to treat lupus, may also play a role. Research in people with SLE has linked higher corticosteroid doses with higher rates of yeast infections, especially of oral candidiasis.

Lupus and Bacterial Vaginosis

There isn’t enough research to say that having lupus increases the chance of developing BV. BV happens when the usual balance of bacteria in the vagina shifts.

Because the bacteria don’t cause problems at normal levels, BV isn’t considered a true infection in the same way as a UTI or yeast infection.

A small 2023 study compared the vaginal bacterial environments of 30 premenopausal people with SLE and 30 without SLE. The SLE group had a different mix of vaginal bacteria, including lower levels of Lactobacillus, a type of bacteria often linked to a healthy vaginal environment.

This connection is worth noting, but it doesn’t prove that SLE raises BV risk on its own. The study specifically excluded participants who had vaginitis, a UTI, or other active infections. The researchers also noted that they couldn’t determine whether the microbiome differences led to vaginal infections in people with SLE.

Lupus and UTIs

UTIs are among the more common infections in people with lupus, and having lupus may increase the chances of getting a UTI.

In one study of 81 people with lupus, UTIs occurred in 36 percent during the one-year study period, compared with 9 percent of people without lupus.

UTIs can cause burning when you urinate, a frequent or urgent need to urinate, and pelvic discomfort. However, lupus can also cause symptoms similar to a UTI.

Lupus cystitis is the inflammation of the bladder connected to lupus. People with lupus cystitis or UTIs both need to pee more often than usual. This is called urinary frequency.

Other Causes of Vaginal Symptoms

The vulva is the external genital area, and its skin can become irritated for many reasons unrelated to lupus or infections.

Common noninfectious causes of vulvar itching include skin irritation (contact dermatitis) from soaps, fragrances, detergents, pads, or other products. Skin conditions such as lichen planus or lichen sclerosus can also cause itching, burning, soreness, or changes in the skin. People with SLE can also present vaginal dryness that can cause itching.

How Can You Tell a Yeast Infection, BV, and a UTI Apart?

Symptoms of BV, vaginal yeast infections, and UTIs can overlap. The location of the symptoms, the type of discharge, and testing can help identify the cause.

What if Infections or Symptoms Keep Coming Back?

You should talk to your healthcare provider if your symptoms keep coming back. You may need a different treatment plan, such as a longer course of antifungal treatments for a yeast infection or antibiotics for a UTI. Keep in mind that using antibiotics can increase the risk of having a yeast infection. It’s best to talk to your doctor to receive the proper treatment to prevent it.

BV also commonly returns after treatment. In this case, healthcare providers may look at other factors contributing to BV risk. In 2025, the American College of Obstetricians and Gynecologists updated its guidance to recommend considering treating sexual partners to help address recurrent BV.

Tell your doctor about all lupus medicines, over-the-counter drugs, and supplements you take. Antibiotics can interact with other medications, and people taking immunosuppressive treatment for lupus may need careful monitoring for new infections.

Don’t stop or change a lupus medication on your own because you think it’s causing an infection. Your rheumatologist or other healthcare professional can help decide whether any changes are needed.

When Should You Contact a Doctor?

New vaginal or urinary symptoms usually aren’t an emergency, but some signs deserve quicker medical attention:

• Fever over 100 degrees Fahrenheit while taking immunosuppressive treatment
• Back or side pain with fever, chills, nausea, or vomiting, which can occur with a kidney infection
• New or worsening pelvic pain, genital sores, or significant swelling
• Symptoms that keep returning after treatment
• Vaginal or urinary symptoms during pregnancy

You should also reach out to your healthcare providers if your symptoms feel different from previous infections or you aren’t sure what’s causing them. Getting the right diagnosis can help you avoid unnecessary treatments and find an option that is safe with your lupus care.