Does Melatonin Cancel Out Birth Control?
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After you've counted dozens of sheep, listened to Regé-Jean Page read you a bedtime story on the Calm app, and skimmed through supposedly snooze-inducing books all in hopes of scoring some shut-eye, you might gulp down a melatonin supplement to finally get the rest you so desperately need.
However, if you've ever heard about other medications or supplements potentially interfering with your birth control pill (hi, antibiotics), you may have wondered whether your trusty melatonin poses the same risk: Is there any way melatonin cancels out birth control? Here, ob-gyns break down everything you need to know about melatonin and birth control, including what to do if you're concerned about your contraceptive's efficacy.
What Is Melatonin?
First things first, a quick bio lesson. Melatonin is a hormone that plays a key role in regulating your body's sleep-wake cycle, according to the U.S. Food and Drug Administration. Your brain's pineal gland produces the hormone in response to darkness and releases it into your blood, as well as the fluid surrounding your brain and spinal cord. Then, the melatonin works to inhibit the stimulation of your suprachiasmatic nucleus, a tiny region in the brain that acts as a "master circadian clock" and tells your body to wake up or chill out, according to research published in the Journal of Clinical Sleep Medicine. At that point, you'll start to feel drowsy and ready for some shut-eye.
The melatonin found in sleep supplements, however, is often made synthetically, and these aids have been used to ease jet lag, help restore normal sleep schedules in folks with delayed sleep-wake phase disorder, and reduce anxiety before surgery, according to the National Center for Complementary and Integrative Health. Though short-term use of melatonin supplements seems to be safe for most people, the long-term risks aren't well studied, per the NCCIH. More importantly, the FDA considers melatonin sleep aids to be dietary supplements, meaning they're not regulated as strictly as prescription or over-the-counter drugs. As a result, the supplements may not contain the same amount of melatonin or the same ingredients as what's listed on the label, according to the NCCIH.
Does Melatonin Affect Birth Control?
Currently, research looking into the question "does melatonin cancel out birth control" is sparse, but it would be unlikely, says Sophia Yen, M.D., M.P.H., the co-founder and CEO of Pandia Health, a birth control delivery company. Amy Roskin, J.D., M.D., the chief medical officer of Seven Starling, agrees: "Melatonin doesn't impact hormonal birth control's efficacy at all," she says.
Oral melatonin supplements (e.g. pills, gummies, and drops) are first metabolized by the liver — the same organ that processes oral contraceptives — so there is a possibility that they may interact with birth control there, but again, it's improbable, says Dr. Yen.
And other forms of birth control definitely won't be affected by the sleep aid. "Because the patch, the ring, the IUD, the implant, and the shot don't go through the liver, there should be no effect on those," explains Dr. Yen.
In fact, the opposite may be true: Hormonal birth control pills appear to raise the amount of melatonin the body naturally produces, according to the National Library of Medicine. And taking an oral contraceptive along with a melatonin supplement may strengthen its sedative effect and raise your risk of experiencing side effects, such as headaches, dizziness, nausea, and drowsiness, per the Mayo Clinic. Simply put, "taking melatonin and other sleep aids on top of birth control can have a larger-than-desired impact on melatonin production, as birth control naturally increases melatonin production in the body," explains Dr. Roskin. (More here: How Dietary Supplements Can Interact with Your Prescription Drugs)
At the moment, the long-term effects of combining oral contraceptives with melatonin supplements aren't well-studied, and research on the safety of regularly taking melatonin supplements is lacking, according to the NCCIH. That said, experts generally recommend seeing a sleep pro if you're consistently taking melatonin to catch some zzz's, as you could be putting a Band-Aid on a problem that requires more heavy-duty treatment. So if you've noticed yourself popping a sleep supplement regularly — whether you're taking birth control pills or not — chat with an expert to find a proper treatment. (Wait, is it bad to take melatonin every night?)
What to Do If You're Taking Melatonin While On Birth Control
Though there currently isn't any evidence to suggest that melatonin supplements affect the efficacy of birth control, both Dr. Yen and Dr. Roskin recommend telling your healthcare provider about any and all supplements you're taking. By doing so, your doctor will be able to better pinpoint the cause if you do start experiencing unpleasant side effects and, if the sleep aid is to blame, recommend more suitable treatments for your sleeping troubles. (One option: Cognitive behavioral therapy.)
If you're still worried about a potential — yet unlikely — blow to your contraceptive's efficacy, Dr. Yen suggests taking your birth control pill at a different time than your melatonin supplement to reduce the risk of the two interacting. You may also want to look out for signs that your contraceptive isn't functioning properly and, if you notice any, book an appointment with your doctor ASAP. "If you're vomiting, your boobs hurt, or you missed a period, then those are signs that your birth control may not be working," she says. "If you didn't have breakthrough bleeding before and now you do, that's always a sign to go get your birth control checked." In the meantime, use a backup method, such as condoms, to reduce your chances of pregnancy, she suggests.
All in all, melatonin isn't likely to "cancel out" your birth control pills, and you're in the clear if you use another method of contraception, as they're not metabolized in the liver. But if the lack of research on the topic makes you uneasy, don't be afraid to bring up your concerns with your doctor, as they'll be able to help you find a form of birth control and/or treatment for restless nights that's best for you and your body.