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SJW and the pill.

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So there's a theory that St. John's wort stops contraceptive pills from working.

Nice theory. Fortunately, it's not all that close to reality.

If oral contraceptives were indeed to stop working when you also do SJW (Hypericum perforatum) you can be sure that we'd hear more than rumors.
The theory goes like this: SJW enhances the effects of cytochrome P450 enzymes in the liver. Oral contraceptives (and other meds) are metabolized by those liver enzymes. Ergo, those pills won't work anymore.
There's been scaremongers about ever since the story broke in early 2002. They've put forth statements like "SJW removes 80 % of the efficacy of the pill". I have no idea where they got that number from: there are no studies to back it up. None. Zero. Zilch.

In practice, they found two (count'em, 2) ladies, in Sweden in 2002, who had taken both contraceptive pills and SJW in 2000, and had gotten pregnant.

Pure propaganda, is my take. Because nobody at all thought to mention the obviously missing bit, which would put those two ladies into perspective:

  • How many ladies on the pill (or even the exact pills these two ladies used) got pregnant in Sweden in 2000 while not taking SJW?

Because I've been on the pill. It's easy to miss a day, after which your cover is very much lower than the 99.6 % or so that's stated on the side of the box your pills came in.

I did a medline search, using the search terms hypericum contraceptive. The only thing before Feb 2002 (when this headline was discussed on alt.folklore.herbs) is a letter (not a study). Letters don't have abstracts ... sorry.

And, of course, there's other signs that this particular scare is just that, a scare, designed to get people to back off SJW:

  • Why pull out the megaphone 2 years after the fact?
  • Where are all the 'mercan ladies who've gotten pregnant on oral contraceptives + SJW and who would promptly sue the makers of either SJW products or the makers of those contraceptives?
  • And where are all the headlines from those lawsuits?

You can be sure that pharmacogiants would see all those pregnant ladies as a golden opportunity for a massive anti-herbal propaganda campaign.

Yet there's no headlines, there's no lawsuits, there's no multitudes of pregnant ladies. Why not? Could it possibly be that the theory isn't all that close to actual practice?

Yes, SJW does enhance liver metabolism.
Yes, tests have shown that SJW therefore decreases the effects of the pill.
No, that effect is not big enough to make the pill stop working. (Thanks Jim!)

The whole issue is just anti-herbal propaganda. Pharmacogiant FUD. Fight it.

Related entries: The yellow herbs of summer: St. John's wort. - SJW oil - St. John's wort oil - Herbs for sorrow


Yes, SJW does enhance liver metabolism.
Yes, tests have shown that SJW therefore decreases the effects of the pill.
No, that effect is not big enough to make the pill stop working. (Thanks Jim!)

You're welcome...

Though you stole my idea to add something like this to my site after it came up on the herb list... that's OK, though... I'll just link to ya. Maybe I'll go for another herban myth... like debunking the Echinacea/Goldenseal compound... or that Goldenseal won't help you beat a drug test... or perhaps that the stuff that comes out of you after consuming obscene quantities of lemon juice and olive oil AREN'T gall stones (which wouldn't float after they're gruesomely evacuated and certainly wouldn't melt...).

but wait a minute... you've already got all that stuff on your herbal homepage, don't you? Jeez... you think you'd been at the web stuff for awhile...

As a practicing pharmacist, I wouldn't recommend taking anything known to be a CYPxyz inducer with a CYPxyz-metabolized drug unless there's a study I can point to showing no theraputic difference; that goes for herbs, drugs, and food, and I warn about anything else that can alter drug metabolism, too. I know that's a somewhat shaky justification because what about all the foods and other things I don't know about?, but I'm not sure how else to cover my professional ass.

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