Abstract for Bioforce Conference March 2003 By Margaret R. Ritchie e-mail m.r.ritchie@dundee.ac.uk tel. 01382-496481 fax. 01382-633952 Evidence of a herb/drug interaction in pre-menopausal women using contraceptive medication By M.R.RITCHIE1, A.M.THOMPSON2, M.S.MORTON3, N.DEIGHTON4, A.BLAKE4 L.J.MORTON5 and J.H.CUMMINGS1 1Department of Molecular and Cellular Pathology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, 2Department of Surgery and Molecular Oncology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, 3 Department of Medical Biochemistry, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN, 4Scottish Crop Research Institute, Invergowrie, Dundee, DD2 5DA, 5Carnoustie Medical Group, Dundee Street, Carnoustie, DD7 7RB Background There is increasing use of Complementary and Alternative Medicine by the general public with a variety of plant based supplements that may contain active compounds, available over the counter. Opportunities for a herb/drug interaction between these plant compounds and active components of prescription drugs in vivo are therefore increasing. Contraceptive medication is widely used and may be affected by antibiotic use. To date however, few studies have investigated the interaction between contraceptive medication and phyto-oestrogens (PE) - plant compounds available through dietary sources or food/herbal supplements capable of provoking an oestrogenic response in the body. Since both agents can alter hormone levels in vivo, an assessment of their combined effects is essential for providing information for patients, practitioners and health care professionals. Aim To observe the effects of a herb/drug combination in healthy pre-menopausal women using contraceptive medication while taking a phyto-oestrogen supplement. Methods Pre-menopausal women with regular menstrual cycles and breast pain lasting at least five days were recruited through General Practitioners throughout Scotland, Breast Clinics, Well Woman Clinics and local advertisement. Subjects initially completed two months of breast pain recording prior to taking a placebo tablet for one menstrual cycle. Only subjects experiencing less than 30% reduction in breast pain after placebo ‘run-in’ were eligible to continue. During the next three month phase subjects took either placebo or active (35 mg/d PE) capsules and recorded breast pain. Food diaries were used to estimate dietary PE intake and 24 hour urine collections were used to check compliance. Relevance for Policy and Practice 1) This study is the first to provide evidence of a herb/drug interaction between a phyto-oestrogen supplement and contraceptive medication in pre-menopausal women. 2) Investigation of herb/drug interactions and dissemination of the findings are essential for assisting all health care professionals involved in the provision of care and advice. 7/03 The author, Margaret R. Ritchie sent us this abstract with the following comment: " What was very interesting was that we found evidence of a herb/drug interaction when we gave isolated isoflavones to women, yet we found no evidence of an interaction between contraceptive medication and isoflavones when they were administered within the food matrix. The different forms of the isoflavones also affected excretion. This may have implications for the future use of isolated plant compounds vs the use of whole extracts. I hope that this information is of some interest and assistance". In reponse to Ann Fonfa's 7/22/03 query on what isoflavones were being used, Dr. Mitchie responded: "The pill contained isoflavones (mainly in their precursor form) extracted from red clover. There was a much higher ratio of Biochanin-A, the precursor of Genistein relative to Formonontetin (the precursor of Daidzein). When we gave pre-menopausal women the tablet there was evidence of a herb/drug interaction. In another study we gave volunteers soy bars which contained the isoflavones, mainly as glycosides, but present in the food matrix. In addition, the ratio of genistein: daidzein was lower i.e. more like 1: 1. In this study there was no reported herb/drug interaction in women (using contraceptive medication) taking the bar". Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.