Drug & supplement interaction

Equol + Ethynodiol Diacetate, Mestranol

Ethynodiol Diacetate, Mestranol brand name: Ovulen.

Moderate Interaction
The bottom line Moderate

Equol has a moderate interaction with Ethynodiol Diacetate, Mestranol. Theoretically, equol might increase the levels and clinical effects of ethinyl estradiol found in contraceptive drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Equol and Ethynodiol Diacetate, Mestranol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CONTRACEPTIVE DRUGS

Why this applies to Ethynodiol Diacetate, Mestranol

Ethynodiol Diacetate, Mestranol falls under CONTRACEPTIVE DRUGS — the group Equol interacts with.

Theoretically, equol might increase the levels and clinical effects of ethinyl estradiol found in contraceptive drugs.
In vitro research shows that equol inhibits the binding of estradiol to serum proteins. Theoretically, this might increase the concentration of free, bioactive estradiol, thereby increasing the risk of adverse effects from ethinyl estradiol, including headaches, breast tenderness, dysmenorrhea, and weight gain.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Ovulen is a combination birth control pill, pairing a progestin (ethynodiol diacetate) with an estrogen (mestranol, which your body converts to ethinyl estradiol). The thinking here is that equol, a soy-based phytoestrogen, may bump up the amount of free, active estrogen floating around in your blood. In plain terms, more of the estrogen part of your pill could be available to act, which might mean more of the usual estrogen-related nuisances: headaches, tender or sore breasts, painful periods, bloating, or a little weight gain.

I want to keep this in perspective. This is a theoretical concern based only on lab studies, not real-world cases, so it may never amount to anything noticeable. Still, if you are considering equol supplements, it is worth a quick chat with your pharmacist or doctor first. Please don't change how you take your pill on your own.

References
  1. Martin ME, Haouriqui M, Pelissero C, et al. Interactions between phytoestrogens and human sex steroid binding protein. Life Sci 1996;58:429-36. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Equol Also Interacts With Other Medications

Equol has 57 moderate, 75 minor known drug interactions in our database — the Ethynodiol Diacetate, Mestranol one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Equol

Covers the 2,830 medications we’ve checked against Equol. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Ethynodiol Diacetate, Mestranol

This page covers Equol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethynodiol Diacetate, Mestranol page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 140 moderate · 42 minor.

From our pharmacist’s overview on the Ethynodiol Diacetate, Mestranol page

“Ethynodiol diacetate with mestranol (Ovulen) is a combined birth control pill, and this list of 188 supplements and herbs warrants genuine care, with six rated major. Most entries affect the liver enzyme (CYP3A4) that breaks the pill down.”

Reviewed by 2 · Jul 18, 2026

Open the Ethynodiol Diacetate, Mestranol interaction page

How much people look this up

Where Equol and Ethynodiol Diacetate, Mestranol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Equol
Steady interest

#874 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ethynodiol Diacetate, Mestranol
Top half

#1,134 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Equol

What is Equol?

  • Menopause symptoms (hot flashes)
  • Bone health support
  • Skin aging
  • Prostate health
  • General hormone balance

Equol is a compound made in the gut when some people break down soy isoflavones, and it is also sold as a supplement. Early research links it to possible benefits for menopause symptoms and bone or skin health, but the evidence is still limited and far from proven. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Equol monograph & all interactions
Keep checking

Other Drugs & Equol

Browse every other medication we’ve checked against Equol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
57Moderate
75Minor
2,697No known interaction
Moderate

57 interactions

Minor

75 interactions

Showing 60 of 75 minor interactions — see all 75 on the Equol page.

No interaction 2,697 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Equol and Ethynodiol Diacetate, Mestranol Together: Common Questions

Can you take Equol with Ethynodiol Diacetate, Mestranol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Equol and Ethynodiol Diacetate, Mestranol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.