Will St. John’s Wort Affect Birth Control?

st-johns-wortHerbal remedies are very popular around the world. Many people prefer them to pharmaceuticals because they believe herbs can elicit positive results without serious side effects. However, plants produce a wide variety of chemicals at varying concentrations, and might have a number of effects on your body, both good and bad. Furthermore, since herbal supplements are not evaluated by the FDA for safety or effectiveness, consumers often don’t have ready access to evidence about herbal products. We can’t even be sure that they contain the ingredients that are listed on the label!


St. John’s wort might decrease the effectiveness of birth control pills, and might be unsafe during pregnancy.


One popular herb is St. John’s wort, or Hypericum perforatum. While the scientific evidence is mixed at best, many people believe that St. John’s wort can be used as an antidepressant. However, people often treat themselves with herbal supplements without guidance from a medical doctor or pharmacist — and without knowing whether or not these herbs are safe to use with any medications they might be taking.

Over the millennia, plants have evolved all sorts of powerful chemicals, such as toxins, to defend themselves against insects and other predators. For this reason, we can’t assume that plants only contain inert chemicals that won’t affect us or interact with the chemicals in other drugs and supplements we use. St. John’s wort, in fact, contains chemicals that interfere with other medications. It has been banned in France, and other countries require or are considering warning labels on St. John’s wort products so consumers can be aware of possible drug interactions. Continue reading

Let’s Talk Contraception: Can I Use Birth Control to Skip a Period?

In 2003, the FDA approved Seasonale, an extended-cycle birth control pill. This pill, a combination of estrogen and progestin, is taken daily for 84 days followed by one week of inactive (placebo) pills, allowing a woman to have her period once every three months — four times per year.

Since that time, several other extended-cycle birth control pills have been marketed, including Lybrel, released in 2007, which offers women continuous contraception coverage with only one period per year.


Using birth control to skip periods doesn’t result in side effects quite this exaggerated.

Prior to Seasonale’s debut, certain types of birth control pills could be taken back to back, allowing users to have period-free weddings and honeymoons, or to treat certain conditions, such as endometriosis. But there was no consensus about how to use birth control pills this way, and no actual product marketed specifically for this type of use. Early studies on extended-cycle pills reported that users were highly satisfied using pills to have fewer periods — and wanted to continue using these pills to reduce periods after the study was completed.

Can skipping periods be beneficial or harmful? Is this a lifestyle choice that’s not “natural”? How many “normal” periods do you need in a lifetime? Continue reading

Let’s Talk Contraception: What’s the Difference Between Generic and Brand-Name Birth Control?

Oral contraceptives (birth control pills) have been around for decades, and many are now available as generics. In general, generics cost less than brand-name medications. Despite saving money, some users question whether generic birth control pills are as “good” as brand-name pills. To confuse the situation, new brand-name birth control pills have been developed that specifically claim other benefits in addition to protection from pregnancy, such as treatment of acne. The cost of these brand-name pills is much higher. To understand the generic vs. brand-name debate, it is first important to understand how drugs are developed.


Clinical evidence doesn’t support the idea that generic birth control pills have different failure rates or side effects than their name-brand counterparts.


When a drug is first discovered and developed it goes through a drug review process. This involves many steps: chemistry experiments to discover the active chemical structure of the drug, manufacturing and testing the chemical drug product, inspections of the manufacturing process, and many other developmental studies. Then there are animal studies to check safety and efficacy — and if the drug works without major side effects. Finally, clinical studies are conducted in people; these studies test to assure bioavailability (the amount of time it takes for the body to absorb the drug). These last tests, in animals and people, show bioequivalence. Bioequivalence means the drug must enter the body, be absorbed in the same time frame, and work in the body the same way consistently.

When a new drug is finally approved by the FDA, it has met strict standards regarding its strength, purity, quality, potency, safety, and clinical effectiveness. New drugs are awarded patents for 20 years, but by the time they come to market, much of that time has run out due to all of the testing requirements. Generics are usually less expensive — manufacturers do not need to repeat discovering the drug, nor must they redo animal and human studies to assure the drug is safe and works as intended. The generic companies also do not need to spend as much money on advertising, marketing, and promotion. Continue reading