CBD is a non-psychoactive cannabinoid compound extracted from cannabis or hemp. Although non-psychoactive, it’s commonly taken for its anti-inflammatory, anti-anxiety, to promote healthy sleeping patterns, and relaxant effects.
And considering that anxiety is 1.5 to 2 times more prevalent in women than it is in men, it’s no wonder that many women are taking CBD to help deal with stress and anxiety.
This of course raises a question, which is the main topic of this article – does CBD interfere with birth control, and if so, in what way? We’ll give you the short answer right away, but as with anything that has to do with biochemistry, the actual answer will be somewhat complicated.
So, does CBD affect birth control?
The short answer is maybe – CBD may indeed affect how estrogen-based birth control pills work and may do so through two mechanisms – inhibition of a cytochrome system called P450, and competition with female sex hormones.
The longer answer is that it depends, and we’re not really sure how and how much CBD will modify the contraceptive effect of birth control.
There is also plenty of anecdotal evidence on the web that may convince anyone that CBD is unlikely to negate the contraceptive effect of birth control, especially if the pills you’re taking are progestin-based and not estrogen-based.
To complicate things further, there is also a biochemical pathway, through which CBD may actually increase the effects of birth control, namely, the P450 cytochrome.
HOW DOES HORMONAL BIRTH CONTROL WORK?
Let’s quickly go over the mechanisms responsible for the effectiveness of birth control pills, before we start exploring how CBD might affect them.
Birth control works by stopping ovulation – it contains a synthetic form of the hormones progesterone and/or estrogen. Increased levels of progesterone send a signal to the ovaries and prevent them from producing an egg. Without an egg, fertilization is obviously not possible.
So, birth control works by controlling the levels of progesterone and estrogen. This is where CBD may start interfering.
How CBD may interfere with estrogen
CBD may directly compete with estradiol, which is one of the forms of estrogen found in the body.
To put it simply, estradiol tries to attach itself to an estrogen receptor, but that receptor already has some cannabidiol (CBD) attached to it, preventing the estradiol from attaching itself and serving its signaling purpose.
There is a catch here, however: First, not all birth control pills are based on estrogen – some are based on progestin, and some contain both progestin and estrogen. There is no clear answer as to whether or not CBD affects progestin and the possibility that CBD will not modify the action of progestin-based birth control pills.
But also, the claim that CBD interferes with estrogen is debatable as well – it’s based on a limited number of studies, most of which from the 1980s.
How CBD may affect the metabolism of birth control, by affecting the P450 cytochrome
There are several chemical compounds, commonly found in plants, that ‘saturate’ the P450 cytochrome system in the liver and make it unable to further process chemicals that are dependent on it for their breakdown.
Grapefruit is the most common P450 affecting the plant, and it’s well known that grapefruit juice may slow down the speed with which your liver breaks down caffeine. At the end of the day, you’ll have around two times higher caffeine content in your blood if you’ve eaten a grapefruit together with your coffee.
As it turns out, CBD may affect the P450 system in the same way, although this is likely to occur only with high doses.
Birth control pills also depend on the P450 system for their breakdown and clearance. However, this will mean that the levels of the birth control hormones will actually be increased, and not decreased, as a result of the CBD intake.
This effect is highly dose-dependent and also depends on the method you use to administer CBD – edibles may affect the P450 system much more than inhalation or sublingual absorption.
What does the anecdotal evidence say
The evidence on message boards and forums is mixed – most women who have had direct experience with taking CBD and birth control together claim there is no problem, and their birth control works fine.
Others cite the scientific information given above and say that you should avoid estrogen-based contraceptives if you’re taking CBD.
Whether or not progestin birth control is less affected than estrogen-based pills is not a widely discussed topic and there is no clear answer yet.