What is Ashwaganda?
Found in parts of India, Africa, and the Middle East, this evergreen shrub called ashwagandha is a herbal remedy used by people to reduce stress and anxiety. It contains bioactive compounds, specifically a group of substances called withanolides. These withanolides have shown to have anti-inflammatory and antioxidant properties. It has been used for thousands of years, especially in traditional Ayurvedic medicine1.
Is Ashwagandha safe?
The National Centre for Complementary and Integrative Health has found that ashwagandha can be taken safely for a short period of time (3 months), however, the long-term safety health effects are still unknown. For some, ashwagandha can cause sleepiness, diarrhoea and vomiting. In some rare cases, ashwagandha was found to cause liver injury1.
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Ashwagandha is definitely not recommended for use while pregnant or breastfeeding. There has been evidence found that ashwagandha can interact with some medications for diabetes, high blood pressure, epilepsy and thyroid and immunosuppressants.
Ashwagandha has also been shown to increase testosterone levels so should be avoided for use in people with testosterone-sensitive cancers (like prostate cancer)1. And if you have PCOS, which already increases your testosterone levels, this might make you think twice before trying it, or if you do, to monitor your symptoms closely to check they don’t get worse.
How is birth control metabolised by the body?
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Oral birth control can come in the form of the combined oral contraceptive pill (COCP) and the progesterone-only pill (POP). They both contain a synthetic version of progesterone called progestogen, and the COCP also contains synthetic oestrogen. Progestogen works by preventing ovulation and thickening the cervical mucus2. Both these methods prevent pregnancy.
When you take your birth control pill, it is dissolved by the digestive system and broken down (metabolised) by the liver enzymes. Enzymes are proteins in our body which help processes like digestion to happen. The main liver enzyme in charge of metabolising your contraception is called CYP3A43 – catchy title we know….
Some medications or supplements can speed up the work of enzyme CYP3A4 which means the hormones are broken down more quickly and reduce the effectiveness of the contraception. There have been concerns about the new weight loss medications Ozempic, Monjuro and Wegovy affecting birth control too.
Does ashwagandha affect birth control?
There are some products that are clearly known to reduce the effectiveness of birth control like St John’s Wort4 or antibiotics like rifampicin.
Unfortunately, the interaction between ashwagandha and birth control has not been researched thoroughly. There has been a big buzz on TikTok talking about “ashwaganda and birth control”. In this video, a user mentions that she was told by her doctor that ashwagandha can affect your hormones and thus hormonal contraception. Do we know this to be true?
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Well, a study published in the Frontiers journal wrote “ashwagandha seems to be safe to co-administer with the substrates of CYP3A4, CYP2C8, and CYP2D6. 5”. Which is complete medical jargon and means: ashwagandha is safe to use with medications that are usually broken down by those 3 enzymes. As CYP3A4 is the main liver enzyme in charge of breaking down contraception, this suggests that it’s safe to use birth control pills and ashwagandha together.
However, as there haven’t been specific studies, we cannot officially recommend that taking ashwagandha with oral birth control is safe.
If you are using ashwagandha with hormonal birth control pills, and are worried, you could use another form of contraception at the same time like a barrier method, at the same time or switch to a completely different method.
Until we have more specific research on the topic of does ashwagandha interfere with birth control, we apologise that we can’t give you a straight forward answer. Sorry! But if you are worried, the contraceptives that aren’t affected by medications or supplements include:
- Hormonal coil
- Copper coil / IUD
- Injection
- Condoms
- Cap / diaphragm
- Fertility awareness methods
And you can check out our contraception quiz to see which option might suit you best.
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