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TOPIC: Grapefruit and Birth control?

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January 14, 2013 2:35 PM
My husband read that grapefruit juice can counteract the effects of birth control, unless its progestin only. This definitely freaks me out because I am on a progesterone/estrogen birth control, and we DO NOT EVER want kids. I eat grapefruit at least every other day. They are cheap, filling, and delicious so I really do not want to have to stop. I have read around online and it seems like people either say it does make BC ineffective, or that is does not.

There isn't any clear cut answers...
has anyone else heard this before?
Edited by rockymtnlove On January 14, 2013 2:47 PM
January 14, 2013 2:39 PM
I have heard of that. Not sure how accurate it is however when I was on BC I never tested the theory.
January 14, 2013 2:41 PM
I know St Johns Wort completely over rides the pill, but have never heard about grapefruit.
Ill be back in about 10 minutes after doing some googling
  15638779
January 14, 2013 2:48 PM
food can not control hormon pills.

the only thing that makes bc unaffective are antibiotics.
  34113732
January 14, 2013 2:53 PM
There is evidence to back up the claim.
There are 85 medications that have interactions with grapefruit juice

http://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951.DC1/grape-bailey-1-at.pdf

If you take a combined pill then, yes it can affect the effectiveness of the pill. I would talk to your Dr about it and avoid grapefruits completely, or use a barrier method, or both!

From what I can understand this knowledge is fairly recent in the medical field so not a lot of research has been done IMO it, but IMO better safe than sorry.
  15638779
January 14, 2013 2:57 PM
QUOTE:

There is evidence to back up the claim.
There are 85 medications that have interactions with grapefruit juice

http://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951.DC1/grape-bailey-1-at.pdf

If you take a combined pill then, yes it can affect the effectiveness of the pill. I would talk to your Dr about it and avoid grapefruits completely, or use a barrier method, or both!

From what I can understand this knowledge is fairly recent in the medical field so not a lot of research has been done IMO it, but IMO better safe than sorry.


for sure. Damn! I have tried every type of birth control and multiple different pills and finally found ortho tri-cyclen which I am satisfied with, and hate using condoms with my husband, so I guess I will just stop eating grapefruit.
Bummer! definitely better safe than sorry though. I wouldn't be so worried if we maybe wanted kids someday, but we are 110% sure we don't so I really don't want an unplanned
January 14, 2013 3:46 PM
Well this is what I found after a 10 minute google session and I'm not a Dr so you might be safe. I would definitely talk to your Dr or try to find out more but if you don't want kids you gotta be doubly careful just in case.
Best bet stay away from the grapefruit. Or the husband.
I know what I'd rather avoid though lol
  15638779
January 15, 2013 9:42 AM
I actually had my yearly pelvic appt yesterday, and came across your post beforehand, so I for sure added your question to my list for my gyno.

She said there are medications it can interfere with, but no, BC was not one of them.

Now, I am on the highly paranoid side when it comes to this type of stuff, and even after her telling me that, deep down I don't believe her. I will most likely avoid grapefruit, I don't need or want any surprises in this area...have 1 darling girl, I'm good.

Just wanted to pass on her answer, you could always give your dr's office a call and ask the question of them as well, a little more reassurance maybe from someone you know.

Another item (worry) for my list of why life would be so much easier as a man!

smile
  31038530
January 16, 2013 12:02 PM
QUOTE:

I actually had my yearly pelvic appt yesterday, and came across your post beforehand, so I for sure added your question to my list for my gyno.

She said there are medications it can interfere with, but no, BC was not one of them.

Now, I am on the highly paranoid side when it comes to this type of stuff, and even after her telling me that, deep down I don't believe her. I will most likely avoid grapefruit, I don't need or want any surprises in this area...have 1 darling girl, I'm good.

Just wanted to pass on her answer, you could always give your dr's office a call and ask the question of them as well, a little more reassurance maybe from someone you know.

Another item (worry) for my list of why life would be so much easier as a man!

smile


For sure, thanks for asking her!
Yeah I don't want to chance it either so I will probably just not eat them more than once a week or so.
I actually don't have a doctor... I get my BC free from the county. The doc I got it from has only seen me once, so I don't even know her really
July 7, 2013 7:29 AM
The components of combination oral contraceptives are metabolized by the CYP450 enzyme system, specifically CYP3A4. Grapefruit juice is a CYP3A4 inhibitor, thus consumption of grapefruit or grapefruit juice will INCREASE exposure to these hormones. The danger in this combination is not reduced efficacy, but increased risk of side-effects, some of which are serious, e.g., thrombosis. Seville oranges, which is found in orange marmalade, behaves similarly.
July 7, 2013 7:30 AM
Maybe you should call your doctor and talk to them about it?
July 7, 2013 7:37 AM
I googled grapefruit and statins, which I have heard about from my mother in law, I got hits from the Mayo Clinic, the NHS and the FDA.

I googled grapefruit and birth control and I got Marie Claire.

I wouldn't worry too much.
July 7, 2013 7:50 AM
QUOTE:

The components of combination oral contraceptives are metabolized by the CYP450 enzyme system, specifically CYP3A4. Grapefruit juice is a CYP3A4 inhibitor, thus consumption of grapefruit or grapefruit juice will INCREASE exposure to these hormones. The danger in this combination is not reduced efficacy, but increased risk of side-effects, some of which are serious, e.g., thrombosis. Seville oranges, which is found in orange marmalade, behaves similarly.

This. It's difficult to estimate the clinical outcomes because there are large inter-individual differences in drugs metabolism and not many clinical trials have been made (check this: http://www.ncbi.nlm.nih.gov/pubmed/12749182.
Just to be sure, doctors tend to discourage patients from eating grapefruit on a regular basis. (I'm not a doc, I'm a med student)
  19237370
July 7, 2013 7:52 AM
For what it's worth, I called my BC's hotline when I was on a vitamin C regimen, which is what interacts in the way you're concerned with.

They basically said that yes, vitamin C interacts, but you need to take a lot to do it. Like grams. Like a grapefruit diet, you know? With studies, everything that has a probable side effect or interaction, however small, has to be included in the warnings. If you're having a grapefruit with breakfast, you're probably okay.
July 7, 2013 7:54 AM
I've heard this warning before from my doctor when I started my pill. I was told by the gyno that certain pills can be counteracted by specific antibiotics, and grapefruit. Mine is not one of them, but yours should say on the information package if it is. If it does not simply call your doctor or the company phone line and find out. It'll save you a lot of worrying.

It's probably dose related too, so find out how many grapefruit might cause a problem.
Edited by crimsoncat On July 7, 2013 7:55 AM
July 7, 2013 7:55 AM
QUOTE:

QUOTE:

The components of combination oral contraceptives are metabolized by the CYP450 enzyme system, specifically CYP3A4. Grapefruit juice is a CYP3A4 inhibitor, thus consumption of grapefruit or grapefruit juice will INCREASE exposure to these hormones. The danger in this combination is not reduced efficacy, but increased risk of side-effects, some of which are serious, e.g., thrombosis. Seville oranges, which is found in orange marmalade, behaves similarly.

This. It's difficult to estimate the clinical outcomes because there are large inter-individual differences in drugs metabolism and not many clinical trials have been made (check this: http://www.ncbi.nlm.nih.gov/pubmed/12749182.
Just to be sure, doctors tend to discourage patients from eating grapefruit on a regular basis. (I'm not a doc, I'm a med student)


That study tested the response of eight women, with no control group. Pretty sad, really.
July 7, 2013 7:58 AM
QUOTE:

QUOTE:

This. It's difficult to estimate the clinical outcomes because there are large inter-individual differences in drugs metabolism and not many clinical trials have been made (check this: http://www.ncbi.nlm.nih.gov/pubmed/12749182.
Just to be sure, doctors tend to discourage patients from eating grapefruit on a regular basis. (I'm not a doc, I'm a med student)


That study tested the response of eight women, with no control group. Pretty sad, really.


I hate it when these studies have a small group or no control. Why did they even bother doing the study if we're looking at data that is not representative of the population nor even statistically sig? Didn't they take the same science classes I did warning us that this simply doesn't fly?
Edited by crimsoncat On July 7, 2013 7:58 AM
July 7, 2013 8:09 AM
QUOTE:

QUOTE:

QUOTE:

This. It's difficult to estimate the clinical outcomes because there are large inter-individual differences in drugs metabolism and not many clinical trials have been made (check this: http://www.ncbi.nlm.nih.gov/pubmed/12749182.
Just to be sure, doctors tend to discourage patients from eating grapefruit on a regular basis. (I'm not a doc, I'm a med student)


That study tested the response of eight women, with no control group. Pretty sad, really.


I hate it when these studies have a small group or no control. Why did they even bother doing the study if we're looking at data that is not representative of the population nor even statistically sig? Didn't they take the same science classes I did warning us that this simply doesn't fly?

Pretty sad indeed, that's why I haven't said "STOP EATING GRAPEFRUIT OR YOU'LL DIE TOMORROW" :)
There's not enough clinical data, so doctors prefer to "play it safe" and discourage patients from eating grapefruit.
  19237370
July 7, 2013 8:10 AM
I don't know, crimson. I am not in the health sciences.

My sceptical side wants to say:

Dodgy trial for dodgy drug company
Dodgy people trying to keep their grants or
Dodgy government spending money on "science" to look modern and sciency.

For consideration:




OBJECTIVE:

To verify if and to which extent the interaction with grapefruit juice can increase bioavailability of orally administered sexual steroids.

DESIGN:

Pilot pharmacokinetics study.

SETTING:

Department of Obstetrics and Gynecology and Institute of Pharmacology, Medical Faculty, Palacký University, Olomouc; Department of Nuclear Medicine, University Hospital, Olomouc.

METHODS:

2 mg of estradiol valerate and 100 mg of micronized progesterone were given to eight healthy postmenopausal volunteers. Blood samples were collected at time 0, 2, 3, 5 and 24 hours after tablets application. The same trial was repeated a week later but tablets were swallowed with 200 ml of grapefruit juice. Serum levels of estradiol and progesterone were measured by RIA. Results were statistically evaluated using the Wilcoxon's nonparametric paired test.

RESULTS:

Though grapefruit juice on average slightly increased serum levels of estradiol (E2) and progesterone, this increase reached statistical significance only for the E2 level 24 hours after application of tablets. The mean area under curve (AUC) of estradiol rose significantly to 117%. The even greater increase in the mean AUC of progesterone (to 125%) was not statistically significant because of marked individual variability of response.

CONCLUSIONS:

Our results suggest that grapefruit juice may increase bioavailability of orally administered estradiol and progesterone. The response varies markedly between individuals. This observation may be of some importance also for users of OC and HRT.
July 7, 2013 8:17 AM
I further point out that this study regards hormone replacement therapy in post meno-pausal women, not oral contraceptives for fertile women, in case that needed it.
July 7, 2013 8:18 AM
QUOTE:

I further point out that this study regards hormone replacement therapy in post-menopausal women, not oral contraceptives for fertile women, in case that needed it.


Edit spleling
July 7, 2013 8:25 AM
QUOTE:

QUOTE:

QUOTE:

QUOTE:

This. It's difficult to estimate the clinical outcomes because there are large inter-individual differences in drugs metabolism and not many clinical trials have been made (check this: http://www.ncbi.nlm.nih.gov/pubmed/12749182.
Just to be sure, doctors tend to discourage patients from eating grapefruit on a regular basis. (I'm not a doc, I'm a med student)


That study tested the response of eight women, with no control group. Pretty sad, really.


I hate it when these studies have a small group or no control. Why did they even bother doing the study if we're looking at data that is not representative of the population nor even statistically sig? Didn't they take the same science classes I did warning us that this simply doesn't fly?

Pretty sad indeed, that's why I haven't said "STOP EATING GRAPEFRUIT OR YOU'LL DIE TOMORROW" :)
There's not enough clinical data, so doctors prefer to "play it safe" and discourage patients from eating grapefruit.


Could you quote the doctors recommending women limit their intake of grapefruit in case it reduces the efficacy of their oral contraceptive? That is what the author was looking for, I think.
July 7, 2013 8:27 AM
Maybe you could get a copper IUD? It makes sense since you NEVER want kids and they last 10 years... and the copper one is nonhormonal so it probably won't interact with grapefruit juice.
Edited by tinylightsbelow On July 7, 2013 8:28 AM
  46280058
July 7, 2013 8:27 AM
Maybe you could get a copper IUD? It makes sense since you NEVER want kids and they last 10 years... and the copper one is nonhormonal so it probably won't interact with grapefruit juice.
  46280058
July 7, 2013 8:37 AM
QUOTE:

Could you quote the doctors recommending women limit their intake of grapefruit in case it reduces the efficacy of their oral contraceptive? That is what the author was looking for, I think.

Yes, not because it reduces efficacy (as already stated) but because it increases estrogen levels. It's written on my texbooks and I experienced it during my training. Doctors know it's probably an excess of caution (at least in this case, NOT when dealing with other drugs like carbamazepine) but it's common practice to do so.
  19237370

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