Hormonal control of ovulation has been available to women since the early 1960s with the introduction of “the pill.” Initially, dosages of estrogen and progesterone were available only in pill form, but in 2011 they are offered as injections, patches and implants. All hormonal methods prevent ovulation by maintaining sex hormones at high levels throughout a woman’s cycle. Some supplements may interfere with the actions of hormonal birth control, which can lead to unplanned pregnancies.
St. John's Wort
St. John's wort, or Hypericum perforatum, is usually prepared as an herbal tincture and used to treat mild depression and anxiety. It exerts its anti-anxiety and antidepressant effects by inhibiting the re-uptake of the neurotransmitters serotonin, dopamine and noradrenalin, which are brain chemicals responsible for mood. However, St. John’s wort also stimulates certain enzymes to break down the estrogen in estrogen-based oral contraceptives faster than normal, which reduces the amount of the hormone in the blood and the effectiveness of birth control, as cited in “Medical Herbalism: The Science Principles and Practices of Herbal Medicine.” In essence, taking St. John’s wort may be similar to taking a low-dose estrogen pill 1. Further, St. John's wort has been reported to cause:
- bleeding in women taking oral contraceptives
- which is a sign of diminished pill effect
- possible contraceptive failure
- as cited in “The Essential Book of Herbal Medicine.” Additional birth control
- such as a condom
- is recommended if taking St
John’s wort along with birth control pills 2.
- St. John's wort, or Hypericum perforatum, is usually prepared as an herbal tincture and used to treat mild depression and anxiety.
- However, St. John’s wort also stimulates certain enzymes to break down the estrogen in estrogen-based oral contraceptives faster than normal, which reduces the amount of the hormone in the blood and the effectiveness of birth control, as cited in “Medical Herbalism: The Science Principles and Practices of Herbal Medicine.”
Supplements to Take With Birth Control
According to the University of Maryland Medical Center, mega-dosing vitamin C can cause a rise in estrogen levels when taken with oral contraceptives and hormone replacement drugs, particularly if the user is deficient in vitamin C to begin with 5. Oral estrogen-based birth control pills decrease the effects of vitamin C in the body, although it is unknown if large doses of vitamin C increase or decrease the effectiveness of the birth control. Absorption of estrogen may be increased.
Vitamin C & Estrogen Level
Melatonin, a hormone secreted by the pineal gland within the brain in response to changing levels of light, promotes deep sleeps. As such, melatonin is important for the circadian rhythm, or internal body clock. Melatonin is also considered a “master control” hormone that regulates other hormones. Birth control pills seem to increase how much melatonin is secreted by the pineal gland, although supplementing with melatonin may have a negative impact on the effects of oral contraception. No human studies have been conducted to examine the effects, but consulting with a health professional before combining any supplement regimen with birth control pills is always recommended.
- Melatonin, a hormone secreted by the pineal gland within the brain in response to changing levels of light, promotes deep sleeps.
- Birth control pills seem to increase how much melatonin is secreted by the pineal gland, although supplementing with melatonin may have a negative impact on the effects of oral contraception.
Supplements to Take With Birth Control
Vitamin C & Estrogen Level
Vitamins for the Menstrual Cycle
Causes of Not Having Menstrual Period in 6 Months
Vitamins to Stop Menstrual Bleeding
Does Vitamin B12 Make You Lose Weight?
Can Vitamin C Affect Synthroid?
Ocella & Weight Loss
Vitamins to Improve Sperm Motility
Does Vitamin B-12 Affect Estrogen Levels?
- “Medical Herbalism: The Science Principles and Practices of Herbal Medicine”; David Hoffmann; 2003
- “The Essential Book of Herbal Medicine”; Simon Mills; 1994
- “Nutrition and Public Health”; Sari Edelstein; 2006
- “Biochemical, Physiological and Molecular Aspects of Human Nutrition”; Martha Stipanuk; 2006
- University of Maryland Medical Center: Vitamin C
- Office on Women's Health. Birth control methods. Updated April 24, 2017.
- The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 110: noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010;115(1):206-18. doi: 10.1097/AOG.0b013e3181cb50b5
- National Cancer Institute. Oral contraceptives and cancer risk. Updated February 22, 2018.
- Westhoff CL, Heartwell S, Edwards S, et al. Oral contraceptive discontinuation: do side effects matter?. Am J Obstet Gynecol. 2007;196(4):412.e1-6 doi:10.1016/j.ajog.2006.12.015
- Committee on Gynecolic Practice. ACOG Committee Opinion Number 540: Risk of venous thromboembolism among users of drospirenone-containing oral contraceptive pills. Obstet Gynecol. 2012;120(5):1239-42. doi:10.1097/aog.0b013e318277c93b
- Cherala G, Edelman A. How can we improve oral contraceptive success in obese women?. Expert Rev Clin Pharmacol. 2015;8(1):1–3. doi:10.1586/17512433.2015.974558
- Lee CR. Drug interactions and hormonal contraception. Trends in Urology, Gynaecology & Sexual Health. 2009;14(3):23-26. doi:10.1002/tre.107
- The American College of Obstetricians and Gynecologists. Practice bulletin No. 110: Noncontraceptive Uses of Hormonal Contraceptives."Obstetrics & Gynecology. Jan 2010; 115(1):206-218. .
- Westhoff CL, Heartwell S, Edwards S, Zieman M, Stuart G, Cwiak C, Davis A, Robilotto T, Cushman L, & Kalmuss D. "Oral Contraceptive Discontinuation: Do Side Effects Matter?" American Journal of Obstetrics and Gynecology. April 2007; 196(4):412.e1–412.e7.
- Apaydin EA, Maher AR, Shanman R, et al. A systematic review of St. John’s wort for major depressive disorder. Syst Rev 5, 148 (2016) doi:10.1186/s13643-016-0325-2
- Linde K, Berner MM, Kriston L. St John's wort for major depression. Cochrane Database Syst Rev. 2008 Oct 8 (4):CD000448. doi:10.1002/14651858.CD000448.pub3
- Linde K, Kriston L, Rücker G, et al. Efficacy and acceptability of pharmacological treatments for depressive disorders in primary care: Systematic review and network meta-analysis. Ann Fam Med. 2015 Jan-Feb;13(1):69-79. doi:10.1370/afm.1687
- St. John's Wort. Natural Medicines Database. Professional Monograph. 2/22/2019
- Wong A, Townley SA. Herbal medicines and anesthesia. Continuing Education in Anaesthesia Critical Care & Pain. 2011;11(1):14-17. doi:10.1093/bjaceaccp/mkq046
- Blumenthal M, Brinckmann J, Wollschlaeger B. St. John's Wort: Clinical Overview. In: The ABC Clinical Guide to Herbs. Austin, TX: American Botanical Council; 2003:303-316.
- National Center for Complementary and Integrative Health. Questions and Answers: A Trial of St. John's Wort (Hypericum perforatum) for the Treatment of Major Depression. NIH website. Updated October 25, 2018.
Owen Bond began writing professionally in 1997. Bond wrote and published a monthly nutritional newsletter for six years while working in Brisbane, Australia as an accredited nutritionalist. Some of his articles were published in the "Brisbane Courier-Mail" newspaper. He received a Master of Science in nutrition from the University of Saskatchewan.