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The Silent Enemy of Your Birth Control Pill

On the pamphlet of the low-dose estrogen and antiandrogen Diane-35 birth control pill (note: not available in Canada), it indicates that certain herbs like St. John’s Wort must be avoided because it may jeopardize the effectiveness of the pill. To those who ask, pharmacists and doctors will tell their customers and patients not to take certain herbs like black cohosh while using birth control pills. Many people do not realize that herbs, and the quantity in which you take them, may have the capacity to cause you to ovulate, menstruate, and your uterus to contract while taking your birth control pill. Your ingested herbal body cleanse or deworming cleanse may cause you to become pregnant or experience a period even if you are on the pill. Some of the herbs that will do this contain emmenagogues. According to the article “Emmenagogue Essential Oils” on the Sallamander Concepts company website, emmenagogues are oils that stimulate blood flow in a woman’s pelvic region and uterus. Often, it stimulates menstruation. Herbs that are known for promoting fertility, or herbs specifically with emmenagogues should be handled with care not only when in the early stages of pregnancy, but also when on a low-hormone birth control pill, and possibly even on a high-dose pill for safety reasons. If you are on a cleanse that contains certain such herbs, or use too much of these herbs, you may find them working against your pill’s ability to prevent pregnancy. As there are a limited amount of recorded tests and accounts of birth control pill interactions with emmenagogue-containing herbs available, this writer’s experience with a strong emmenagogue herb and the birth control pill Diane-35 will be mentioned towards the end of this article.

Doctors who recommend deworming for children and adults will sometimes suggest that they deworm at least once every six months to eliminate parasites and worms. People use cleanses when they are beginning a diet and want to flush out their colon. Many people use mild, herbal cleansing teas daily that are offered by brands like Triple Leaf Tea. But if you take birth control, doing any strong cleanse containing herbs with high emmenagogue-levels, or generally consuming herbs daily that are known for encouraging fertility, you  may ultimately fight against your pill. Emmenagogues that are found in many cleansing and deworming herbal ingredients are black cohosh and wormwood. Both are common to commercial and traditional natural products, especially wormwood in deworming medicines because of wormwood’s reported effectiveness at killing worms and their eggs. In a long list of emmenagogue-containing herbs on the Plants For a Future organization website, it lists herbs like pot marigold and black cohosh as being rather strong in their medicinal capabilities. The strength of herbs should not be discounted. H.T. Brown M.D., in an 1855 edition of the American Journal for Medical Sciences, cites the strong emmenagogue properties in chamomile, which he used to treat an eighteen-year-old girl who had never once experienced a period prior to his treatments of making a tincture from the flower and administering it (268-269).

These herbs certainly have the ability to cause a great difference in fertility and menstrual flow. Although it is difficult to find research on emmenagogue-interaction with birth control pills, naturopathic doctors and your own personal practitioner will likely suggest the avoidance of certain herbs when taking birth control pills. Beth Burch N.D., a licensed Naturopathic Physician is one of them. She suggests on her website that certain herbs should be avoided when on the pill, saying that “Vitex (Chasteberry) affects the levels of FSH and LH in the body and has been shown to help promote ovulation and increase fertility.” She advises one person on her questions and answers section that “since BCP's work by preventing ovulation,” you should “avoid Vitex while on the pill”. The specific power of Vitex for fertility is expanded upon in the Women’s Encyclopaedia of Natural Medicine by Naturopathic physician Tori Hudson. Hudson’s information is summarized nicely in an article entitled “Vitex (Chasteberry), Fertility and PCOS” by the Natural Health Solutions for PCOS.

Chaste tree berry acts on the hypothalamus and pituitary glands by increasing luteinizing hormone (LH) production and mildly inhibiting the release of follicle stimulating hormone (FSH). The result is a shift in the ratio of estrogen to progesterone, in favor of progesterone. The ability of chaste tree berry to raise progesterone levels in the body is an indirect effect, so the herb itself is not a hormone. Lack of menstruation (amenorrhea) that is caused by a lack of ovulation, and therefore a lack of progesterone production, should result in menses when progesterone is taken. Progesterone-induced menses indicates an intact reproductive system that just isn't going through its cycle. It suggests that the body is producing enough FSH to stimulate the ovaries, and that the ovaries can develop follicles. It also indicates that follicular production of estrogen is sufficient to cause the lining of the uterus (endometrium) to grow and that the sloughed endometrium is able to pass through the cervical opening and the vagina. Therefore it's possible that the problem is a dysfunction in the hypothalamus or pituitary glands. The ability of chaste tree to modulate the hypothalamus or pituitary then makes this herb a good candidate for treating amenorrhea (infertility).”

Another herb to be avoided when on birth control pills is St. John’s Wort, as mentioned earlier. On Beth Burch’s website in the same question and answers section, she answers a question about the usage of this herb when on birth control.  She references studies by saying, “St. John's Wort may interfere with the contraceptive action of birth control pills. It appears that St. John's Wort promotes the breakdown of hormones in the liver[,] decreasing blood levels of the oral contraceptive [and] possibly lowering the contraceptive effectiveness.”

Since it is generally accepted by the scientific, medical community and the naturopathic community that certain herbs may interact negatively with birth control pills because of an interference with its contraceptive properties, any herb that is well-known for strongly promoting fertility or menstruation should be avoided or administered under the care of a licensed physician when on the pill. In an article titled “Herbs that Promote Ovulation” on the Pregnancy Wizard site that tries to provide women with reliable pregnancy and fertility related information, are some common herbs that are known for promoting ovulation. They include “Red Clover Flower, False Unicorn Root, Kelp, Nettle Leaves, Red Raspberry Leaves, Black Cohosh, Don Quai Root, Wild Yams, Pumpkin Seeds, Saw Palmetto Berry and Sarsaparilla Root.” Many of these ingredients are found in your internal body cleanse products. Unfortunately, the lack of tests done on these herbal interactions with birth control pills, and also the interaction of phytoestrogens, estrogen hormone-resembling chemicals found in plants, especially in soy, have left people who take birth control pills with limited information at their exposal. Even with the limited amount of sources out there, care should still be taken when mixing herbs with birth control pills. Having one stimulating menstruation while another is trying to prevent it may have negative consequences for those wishing to avoid pregnancy.

Perhaps one herb that goes ignored in the talk of strong emmenagogue-carrying herbs is wormwood. While credited greatly for getting rid of worms and helping other ailments, it is also good for menstrual problems. Doctors prescribe wormwood for different menstruation issues like low flows or lack of periods, and it may be so strong, or your reaction to it so strong, that you may experience vaginal bleeding while on a birth control pill.

It has been the experience of the author of this article, twenty-three, that while using wormwood for an intended four-week cleanse and Diane-35 simultaneously, menstrual contractions and eventually bleeding was experienced before finishing the twenty-one tablet pack. While on a low dosage of wormwood combination during Diane-35 usage, taking one to sometimes two tightly packed, size “5” capsules (typically able to retain 60-130 mg depending on powder density) three times a day of wormwood powder combination containing wormwood, black walnut hulls, and cloves, no uncomfortable menstrual contractions were felt, and no visible bleeding occurred within approximately nineteen days of soft-gel pill consumption. When the herb level was increased to the consumption of sometimes one to two size “00” capsules with each three meals, approximately 600 -700 mg of the wormwood combination blend, vaginal bleeding was experienced a few days afterwards. The herb was discontinued, and the light bleeding stopped within the next one to two days. Any menstrual bleeding while on Diane-35 and coming toward the seventh to last pill on their no-dummy pill system has never occurred within the author’s four years of taking the pill. The writer has no noted experience of receiving periods under any other circumstances than body regulated menstrual time.

Certainly, any usage of wormwood for those who may be sensitive to it, or any overdosing of the herb will produce an interference with low-hormone birth control pills and possibly any other higher hormonal birth control pill. On the Plants For a Future website, out of a long chart of herbs that have emmenagogue qualities to them, wormwood scored a three out of a possible five in medicinal capability. Yellow chamomile, of the family H.T. Brown used, scored a 1 for its medicinal rating.

In future, more studies and tests should be done to determine the interactions between herbs and birth control pills. According to the American Pregnancy Association, a 2003 updated list of birth control’s failure rate has only been 5% as compared to other methods like abstinence which had a 0% failure rate. There are few known studies or statistics, if any, that determine how many women use herbs that contain these emmenagogues and phytoestrogens while also using birth control pills, but hopefully in the future these studies will be carried out, and a greater emphasis placed on the problem of using herbs simultaneously with birth control pills.

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Health Disclaimer. Copyright ©2009. Published with permission. Syn Lee Jm is a freelance writer and is not affiliated with Aviva.ca.


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