What You Need to Know About CBD & Birth Control

Written by Cathy Rozyczko — Edited by Jason Brett on September 27, 2021

Birth control remains one of the greatest biomedical advances in the last century, giving women and couples the opportunity to plan or avoid pregnancy based on their personal wants and goals. In recent years, cannabidiol (CBD) has come onto the scene as an alternative treatment for a variety of conditions. 

So, what happens when you want to experience the benefits of long term use of CBD oils, edibles, and other products, but you want to avoid pregnancy? 

The answer to this question varies greatly based on the type of CBD products you wish to take and the type of birth control you are using.

This guide offers in-depth information about how CBD impacts the body, how CBD interacts with different birth control methods, and the side effects of mixing the two. Finally, we offer ways you can safely combine CBD products and contraceptives, so you can enjoy the benefits of CBD without causing illness or interfering with your birth control.

CBD and the Endocannabinoid System

An understanding of the ways CBD products interact with the female reproductive system and birth control requires a crash course on how CBD impacts a person's body in general. CBD is one of more than 100 cannabinoids found in the cannabis plant. Unlike tetrahydrocannabinol (THC), the cannabinoid which causes feelings of euphoria, CBD is not psychoactive. 

When a person takes CBD, it interacts with their endocannabinoid system (ECS). Endocannabinoids are molecules produced by the human body that send and receive signals to maintain balance, called homeostasis, in the body. Human bodies have numerous endocannabinoid receptors throughout the nervous system, the skin, the immune system, the endocrine system, and many other places throughout the body. 

These receptors participates in a wide variety of bodily functions, processes, and reactions including:

• Responses to pain
• Memory function
• Mood
• Appetite
• Responses to stress
• Sleep cycles
• Metabolism function
• Immune function
• Reproductive function

Using CBD products does not directly impact these functions. Instead, CBD binds with the receptors in the ECS system and activates or blocks endocannabinoid activity, specifically by interacting with the enzymes which break down endocannabinoids, including those in the female reproductive system.

CBD and Birth Control Interaction

To be clear, when we talk about CBD interacting with birth control, we are referring to hormonal birth control solutions which include:

• birth control implants
• hormonal intrauterine devices (IUDs)
• birth control shots
• hormone-releasing vaginal rings
• birth control patches
• birth control pills

Hormones control ovulation in a woman's body and prepare the body to accept a fertilized egg. Hormonal contraceptives have small amounts of progestin and estrogen which interfere with natural hormone cycles and prevent pregnancy through three mechanisms:

1. Birth control stops ovulation.
2. Birth control changes the mucus on the cervix, making it more difficult for sperm to reach an egg.
3. Birth control changes the lining of the womb, so a fertilized egg will not attach.

As previously stated, CBD binds with receptors in different areas of the body, including the endocrine (hormone) system and reproductive system, so it's not unreasonable to believe CBD might interfere with hormonal birth control solutions. 

But most evidence is anecdotal, suggesting the need for further research. An early study from the 1980s suggests that when a woman uses CBD products, the CBD binds with estrogen receptors in the reproductive system. This puts the CBD in direct competition with estradiol, a female hormone which also binds to the same receptors. The study concluded that CBD reduces the amount of estradiol which can bind with receptors, potentially impacting the efficacy of estrogen-based birth control solutions. 

No studies have been done on how CBD affects progestin-based birth control.

Alternatively, CBD might interact with birth control in a more direct way. Some research has homed in on cytochrome p450 pathways (CYPs). Cytochrome p450 is the enzyme in the liver responsible for helping our bodies process the majority of medications people take. The enzymes break down the medication before the body metabolizes it. Most hormonal birth control medications utilize CYPs.

And research shows CBD also uses these pathways, which, in theory, might make hormonal birth control less effective when a woman uses CBD products.

CBD Might Reduce the Side Effects of Birth Control

Some women suffer side effects when taking hormonal birth control. Examples include gaining weight, headaches, sore breasts, irregular bleeding, mood changes, decreased libido, acne, and nausea. Although some evidence exists for CBD negatively impacting hormonal birth control, other reports highlight CBD's alleviation of unpleasant side effects which some women experience when taking birth control. 

Note that this evidence which points to CBD offering therapeutic effects to birth control side effects is anecdotal. 

Those who experience relief from cramping, headaches, and sore breasts when taking CBD and birth control might be experiencing CBD's impact on pain. Research supports the idea that cannabinoids treat pain, especially pain which hasn't responded well to other treatments. 

Research has also shown that manipulating the endocannabinoid system (ECS) can relieve nausea and vomiting, but this research has focused on chemotherapy patients who suffer nausea and vomiting as a result of treatment, not those who suffer nausea from using birth control. 

Yet, research suggests that the external cause of nausea doesn't play a large role in how CBD provides relief, which means it's not unrealistic to conclude using CBD products can reduce nausea caused by birth control use.

The reality of the situation is that endocannabinoid research is fairly new and our understanding of the ECS system is still developing, especially in terms of birth control and CBD use. This means you need to carefully weigh the potential risks and benefits of taking CBD products while taking birth control, consult with your doctor, and choose what is best for you.

Using CBD and Birth Control Safely

If you choose to use CBD and birth control together, you can make some choices which can eliminate or reduce the potential risk of an interaction between the two substances. They include:

• Take progestin-only birth control pills. The research concerning hormonal birth control use and CBD focuses on the potential risks of mixing estrogen-based birth control methods with CBD. Thus far, little research has been done on mixing progestin-only birth control pills and CBD products. Similarly, anecdotal evidence about this mixture is non-existent. Progestin-only pills, often called mini-pills, are typically prescribed to women who have reservations about taking estrogen or have a history of other health problems. Progestin does not use the same cytochrome p450 pathways as estrogen, so the likelihood of interaction with CBD is far less.
• Change to a non-hormonal birth control method. If you are concerned about the potential risk of mixing hormonal birth control with CBD, your best option is to change to non-hormonal birth control methods. This, of course, includes condoms, but can also include other devices such as non-hormonal IUDs, internal condoms, diaphragms, birth control sponges, and spermicides. There are also natural ways to monitor your cycle to avoid pregnancy with ovulation tests, apps, etc. Keep in mind that some of these methods may be less effective than the pill or a shot, but they will enable you to experience the benefits of using CBD without worry.
• Use the lowest dosage of CBD possible to reap the benefits. The lowest doses of CBD products will have less of a chance of interacting with hormonal birth control methods. As you find which dosage amount works the best for you, try to use the least amount possible for you to still enjoy the benefits of CBD use.

Consult with your physician. You should always inform your physician if you are taking CBD products. Your physician will typically be informed of the most up-to-date research about CBD and birth control methods. In addition to protecting you from potential issues with birth control and CBD, your physician can also prevent your CBD use from causing any problems with other medications you might be taking.

Best CBD Products to Use with Birth Control

Whether you are using a hormone-based birth control method or not, it's crucial to always put the highest quality CBD products in your body. Additionally, your body absorbs CBD differently depending on which CBD product you use. Below are some factors to consider when searching for the best CBD products to use with birth control:

Ingredients

CBD product manufacturers who make high-quality products use minimal ingredients, and they are transparent about what they do use. You should always know exactly what you are putting into your body and avoid extra preservatives or ingredients which could also interact with hormonal birth control. Some CBD extracts are pure cannabidiol, while others have other cannabinoids, including THC, the compound which causes feelings of euphoria in marijuana users.

Many of the highest quality CBD products are vegan and non-GMO. Traditional gummies like those kids eat and capsules used for vitamin supplements are made with gelatin, which is collagen that comes from animal skin, bone, and cartilage, typically that of a pig. The best CBD products replace gelatin with a vegan alternative. Currently, genetically modified hemp isn't a major concern, but this might change in the future as the demand for CBD products grows.

Extraction methods

When CBD product manufacturers extract CBD from the hemp plant, they primarily rely on two different methods which result in two different types of extract. Crystalline isolate is a powder-like substance which is pure CBD. Full spectrum CBD oil is a raw oil which has CBD and trace amounts of many other cannabinoids found in the hemp plant, including THC.  The isolate process involves using solvents or CO2 to strip away the other cannabinoids. With lower quality vendors, these solvents might not be fully stripped, so it’s always a good idea to check out an independent residual solvents test before purchasing a CBD product.

Lab testing

The United States Food and Drug Administration (FDA) currently does not regulate CBD products, yet responsible companies make sure their products are safe for public consumption to avoid lawsuits. Legitimate companies send out their CBD products to a third-party testing facility to have them evaluated. The lab analysis typically includes checking CBD and THC levels to ensure compliance with state laws and testing for harmful compounds including solvents and pesticides.

To ensure you aren't putting low-quality CBD products into your body, which could lead to negative interactions with birth control and other medication, it's in your best interest to confirm the company which manufacturers your CBD products sends them out for testing. 

You can verify this by asking for a Certificate of Analysis (COA) or asking for access to batch reports. Usually, the most trusted CBD vendors will post these on their website.

The best CBD products for birth control have been tested in third-party labs, and the manufacturers are transparent about the information. If a company refuses to provide a COA or batch results to confirm their third-party testing claims, you should find a different CBD brand.

Delivery method

If you choose to use CBD while taking birth control, you can choose between a variety of delivery methods which differ based on how quickly they affect you and how long they last in your body. If you are looking for short-term relief or benefits, vaping is the quickest way to experience the effects of CBD. Yet, ample research has condemned smoking of any kind while taking estrogen-based birth control. The long-term effects of vaping are still not known, so it might be in your best interest to skip vaping if you are using birth control.

On the opposite side of the spectrum are oral CBD delivery methods such as gummies and capsules, which take the longest to absorb into the body. Birth control, CBD, and any other compound you put in your body will absorb at different rates. The slow absorption of oral CBD products can help ensure you don't experience a severe interaction, especially when using estrogen-based birth control methods.

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