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Aunt Vadge,
I’ve been on the NuvaRing since last March (almost a year). It worked perfectly until about a month and a half ago. Now I’m getting both anal and vaginal fissures that are extremely painful and itchy. My labia get severely irritated and swollen, and I also get a dry white discharge that resembles moist bits of toilet paper.
When I apply hydrocortisone cream I get relief for a day or two and the cuts eventually heal – only to rip again a week or so later. I’ve read your article on the NuvaRing and its drying side-effects, but I’m wondering whether this side-effect could develop randomly, almost a year after I started? Please help!
Itchy and Torn
Dear Itchy and Torn,
That sounds thoroughly miserable, and I think there’s a thread to pull on here. The itching, the swelling, the white cottage-cheesey discharge and the recurring little splits are the classic signature of a yeast infection rather than the ring drying you out. And to answer your actual question: yes, a side-effect can absolutely appear after a year – bodies change, and so do the bacteria and yeast living in there.
Now, about that hydrocortisone. A steroid cream calms the itch for a day or two, which is why it feels like it helps, but it doesn’t touch yeast – and worse, steroids can actually feed it, so the relief is followed by another flare and another split. If yeast is the culprit, the cream is quietly keeping the cycle going. So the first move is to stop the hydrocortisone and get properly tested for yeast, rather than treating the symptom.
Pausing the NuvaRing for a few weeks is still a sensible experiment, since it’s an easy suspect to remove and hormones do shift the vaginal environment. Just sort out backup contraception first – a condom or other barrier – before you do (and given how sore everything is, your poor vag may want a break from sex anyway). If stopping the ring clears these NuvaRing fissures, you have your answer; if it doesn’t, you’ve ruled it out.
While you’re at it, run an eye over anything else that touches the area – lubes, condoms, soaps, washes, wipes, creams and lotions, even laundry detergent – because contact irritants cause exactly this picture too, and it can be a combination of things. Strip it back to plain warm water and nothing else for a bit.
Because it keeps coming back, this is worth getting on top of properly. A swab confirms whether it’s yeast, and if it’s stubborn, our pieces on treatment-resistant yeast and a comprehensive vaginal microbiome test will help you see exactly what’s going on. In our clinical experience, recurring fissures with a white discharge can point to under-treated yeast – but a hormonal ring can also thin the delicate tissue at the vaginal entrance by lowering local oestrogen, a recognised cause of fissuring, so both are worth chasing down. If the splits keep recurring even once yeast is ruled out, ask a doctor to check the skin itself, since recurrent fissures occasionally point to a skin condition that needs its own treatment.
If you’d like a hand working out the root cause and a plan, you’re welcome to book an appointment with us. And do see a doctor sooner if the pain becomes severe, the fissures bleed a lot, or you develop a fever.
You’ll get there – it’s a fixable one once you’re treating the right thing.
Warmest regards,
Aunt Vadge
This is general information, not a substitute for personalised medical advice.
