After writing a review on the hair, skin and nails supplement Halo Beauty, I received feedback from people on a topic I was not aware of. Many women started alerting me that one of the ingredients – saw palmetto – was linked to unplanned pregnancy by way of interfering with birth control pills. In over 20 years of investigating supplements, this was a new one. Sure enough, those women quickly pointed me to evidence. That is what I want to discuss here. Is saw palmetto really linked to getting pregnant? Does it interfere with birth control pills? Let's find out. Read the Halo Beauty review too.
What Is Saw Palmetto?
Saw palmetto (serenoa repens) is a type of small palm tree common to Florida and Georgia that ranges from 2 feet to 10 feet tall. The tree produces berries that are used in dietary supplements. As a supplement, the herb is sometimes used to help prostate problems, specially begin prostatic hyperplasia (BPH), a where the prostate grows in size as a man ages. This can cause problems during urination.
At least one study has shown saw palmetto helped BPH symptoms as well as a prescription drug called finasteride which is used to treat BPH and hair loss.
How Does Saw Palmetto Work?
The berries in from the tree contain compounds like beta-sitosterol and others that seem to inhibit an enzyme called 5-alpha-reductase which converts testosterone into dihydrotestosterone (DHT). By blocking DHT formation, this is thought to stop the prostate gland from growing.
DHT also seems to be bad for hair too and some research has noted saw palmetto helps hair grow by blocking DHT. While there are not many studies, this blocking of DHT may be why saw palmetto is in hair supplements such as Halo Beauty.
Saw Palmetto And Birth Control Pills
Some women are concerned that supplements containing saw palmetto might interfere with birth control pills and put them at an increased risk of pregnancy. After I did some digging, I noticed other credible websites like WebMd and Drugs.com mentioning this also.
I got more interested and decided to do a deep dive into the research.
I first searched the National Library of Medicine for these phrases:
- Saw Palmetto Birth Control
- Saw Palmetto Pregnancy
- Serenoa repens Birth Control
- Serenoa repens Pregnancy
I wanted to go right to the heart of the matter and see if anyone had gotten pregnant while taking this herb. No reviews or case reports describing women having an unplanned pregnancy while taking saw palmetto could be located. In other words, there seems to be no direct evidence of anyone getting pregnant while taking this herb.
But, if that's the case, why are people saying this can happen?
Turns out, there is a reason.
Research suggests saw palmatto has anti-estrogen effects. In other words, it lowers estrogen levels. The evidence for this is that in men with BPH, saw palmetto (480 mg/day, taken for 3 months) reduced estrogen levels. This seems to be one of the main arguments for cautioning women against using saw palmetto.
In other words, if it reduced estrogen in men, it might also reduce estrogen in women – and interfere with birth control pills.
But, to play devils advocate, this is a theoretical possibility. I cannot locate any saw palmetto research study involving women where estrogen levels were checked. I likewise can't locate any evidence of this herb causing unexpected pregnancy either.
We know women metabolize drugs different than men do. I have long wondered if women might metabolize supplements differently too. I even touched on this in my book on supplements.
That doesn't mean this possibility cannot occur. Rather it just means it may not have occurred or have been noticed by anyone or reported to doctors if it did happen.
One ironic point in this discussion is that as far back as the late 1960s, saw palmetto was recognized as having estrogen-like properties. In other words, it didn't lower estrogen levels – it might raise them. Conflicting evidence about this (it either has estrogen activity or it's antiestrogen ) says to me we are not yet sure how this herb works.
Saw Palmetto And Birth Defects
Testosterone is needed for proper fetal growth. If saw palmetto is anti-estrogenic and anti-DHT, what effect would that have on fetal growth?
Animal studies have noted inhibiting the 5-alpha reductase enzyme during pregnancy is associated with abnormal male genitalia development. These studies used the prostate/hair growth drug finasteride and not saw palmetto. In some cases, the finasteride was injected rather than taken orally.
While there seems to be no direct evidence linking saw palmetto to birth defects, the results from lab animal studies are too important to overlook. If you are pregnant, do not take this herb. The same goes for breastfeeding too. It's not worth the risk.
What's The Bottom Line?
Credible websites do caution women on birth control pills from taking saw palmetto supplements. This is out of a fear the herb may reduce the effects of birth control pills and risk unwanted pregnancy. The evidence they cite is not based on human evidence but rather what can be gleaned from lab animal and test tube studies. The same is true for birth defects also.
No reports of unexpected pregnancies while taking this saw palmetto can be found. As such, the admonition against taking this herb while on birth control pills seems theoretical.
Even if there was a real connection, I cannot locate any credible information on how much of the herb would cause these effects. Is it 160mg, 500mg or might the dosage be based on how much someone weighs? There are many unknowns here.
That said, given the possibility of all this, I can understand how some women might be concerned about saw palmetto while taking birth control pills or during pregnancy.
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