How will Melatonin interact with the effect of birth control pills?

Question

Hello doctor,

I have read that Melatonin could possibly lessen the effectiveness of birth control pills. My understanding is that there is little to no peer-reviewed scientific studies to support this claim, but I am still worried, as I am sexually active and take 3 mg of Melatonin each night (and I am on the progestin-only pill). I am looking for a doctor to weigh in on this issue.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern here and you are right that there are not many or in fact hardly any articles or peer-reviewed papers on Melatonin and birth control interactions. But I would like to keep it simple for you to understand. Melatonin is produced during the night to ease the sleep pattern in humans post-sunset with maximum levels at 9 PM and by morning 9 AM, the levels found are almost negligible. So, it is produced by the pineal gland in the dark cycle and metabolized at night by the liver. Now liver also is known to metabolize the birth control pills be it progesterone-only or combinations pills.Hence, if taken together then there is a likelihood of slower metabolism of either compound and thereby prolonged residual effect may be seen on concurrent use of pills and Melatonin together. The effects could be prolonged sleepiness and also Melatonin induced increased progesterone levels in the body causing bloating and noticeable progestogenic side effects. However, the efficacy or effectiveness of the pill is not compromised but metabolism is delayed as Melatonin competes with the pill with the liver. So ideally the better way would be to switch the POP in the morning hours and the Melatonin pill at night 12 hours apart. This would prevent any interference with either action on the body or cause any interaction.