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Hypericum perforatum
Severe· well-documented
Avoid this combination unless your prescriber explicitly approves it with appropriate monitoring.
St. John's Wort significantly reduces the effectiveness of birth control pills, leading to breakthrough bleeding and unintended pregnancies. Multiple case reports of contraceptive failure exist.
Hyperforin in St. John's Wort induces CYP3A4 and P-glycoprotein, increasing metabolism of ethinyl estradiol and progestins, reducing their plasma levels by up to 50%.
Source: WHO Monographs · Reviewed April 2026
St. John's Wort + Oral Contraceptives: high risk. Avoid this combination unless your prescriber explicitly approves it with appropriate monitoring. St. John's Wort significantly reduces the effectiveness of birth control pills, leading to breakthrough bleeding and unintended pregnancies. Multiple case reports of contraceptive failure exist.
Hyperforin in St. John's Wort induces CYP3A4 and P-glycoprotein, increasing metabolism of ethinyl estradiol and progestins, reducing their plasma levels by up to 50%.
Do not stop either abruptly on your own. Talk to your prescriber or pharmacist promptly — bring this page to your appointment.
Educational information only — not medical advice. Always verify with a healthcare professional.