Drug & supplement interaction

Ginger + Segesterone Acetate, Ethinyl Estradiol

Segesterone Acetate, Ethinyl Estradiol brand name: Annovera.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Segesterone Acetate, Ethinyl Estradiol falls into 3 drug categories that Ginger can interact with; the most serious is rated moderate. Ginger might increase or decrease the levels of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ginger and Segesterone Acetate, Ethinyl Estradiol

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Ginger interacts with whole categories of medication. Segesterone Acetate, Ethinyl Estradiol falls into 3 of those categories, so it can interact with Ginger in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 3

Why this applies to Segesterone Acetate, Ethinyl Estradiol

Segesterone Acetate, Ethinyl Estradiol falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Ginger interacts with.

Ginger might increase or decrease the levels of CYP3A4 substrates.
In vitro research and some case reports suggest that ginger inhibits CYP3A4 activity. Three case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are CYP3A4 substrates (imatinib, dabrafenib, and crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
Conversely, other in vitro research suggests that ginger induces CYP3A4 activity, leading to reduced levels of CYP3A4 substrates. However, this interaction has not been reported in humans.
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

Annovera is a vaginal ring that releases two active hormones, segesterone and ethinyl estradiol. Your body handles these hormones partly through a liver enzyme called CYP3A4, and ginger may have a small effect on that enzyme. The catch is the lab data points in both directions. Some studies suggest ginger slows the enzyme (which could nudge hormone levels up, possibly meaning more nausea, breast tenderness, or spotting), while others suggest it speeds the enzyme up (which could lower hormone levels).

Here's the honest part: this is based only on test tube and animal research, not real people using birth control. Everyday culinary ginger and typical supplement doses are very unlikely to change how well Annovera works. Still, if you plan on taking concentrated ginger regularly, it is worth a quick check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
  2. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  3. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 3

Segesterone Acetate, Ethinyl Estradiol also falls under P-GLYCOPROTEIN SUBSTRATES.

Ginger might increase the absorption and blood levels of P-glycoprotein (P-gp) substrates.
In vitro research and case reports suggest that ginger inhibits drug efflux by P-gp, potentially increasing absorption and serum levels of P-gp substrates. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking ginger and cancer medications that are P-gp substrates (trametinib, crizotinib). However, the causality of this interaction is unclear due to the presence of multiple interacting drugs and routes of administration.
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

Annovera is the vaginal ring that releases two hormones, segesterone and ethinyl estradiol, to prevent pregnancy. The concern here is that ginger may block a transporter called P-glycoprotein, which can act like a gatekeeper for how much of certain medicines your body holds onto. In theory, that could nudge your hormone levels a little higher, which might mean slightly more of the usual estrogen-type side effects like nausea, breast tenderness, headaches, or spotting.

Honestly, I would not lose sleep over this one. The evidence is very thin, coming mostly from lab studies and a couple of unclear cancer-drug case reports, not from birth control. Ginger in food or normal supplement doses is unlikely to cause trouble. Still, if you take concentrated ginger regularly, it is worth a quick chat with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.
  2. Pochet S, Lechon AS, Lescrainier C, et al. Herb-anticancer drug interactions in real life based on VigiBase, the WHO global database. Sci Rep 2022;12(1):14178. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 3

Segesterone Acetate, Ethinyl Estradiol also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, ginger might increase the levels of CYP1A2 substrates.
In vitro research shows that ginger inhibits CYP1A2 activity. However, this interaction has not been reported in humans.
Severity Minor 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

Annovera is a vaginal ring that slowly releases a progestin (segesterone) and estrogen (ethinyl estradiol) to prevent pregnancy. The estrogen part is partly handled by a liver enzyme called CYP1A2. In test-tube studies, ginger appears to slow this enzyme down a bit, which in theory could let a little more estrogen linger in your system.

Here's my honest take: this is only lab data, and it has never actually been seen in real people. If it did matter, it would more likely mean slightly more typical estrogen-related effects (think mild nausea, breast tenderness, or bloating), not less birth control protection. For everyday ginger in food or normal supplement doses, I wouldn't lose sleep over it. If you use concentrated ginger regularly, just mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Husain I, Dale OR, Idrisi M, et al. Evaluation of the Herb-Drug Interaction (HDI) Potential of Zingiber officinale and Its Major Phytoconstituents. J Agric Food Chem. 2023;71(19):7521-7534.

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

Ginger Also Interacts With Other Medications

Ginger has 873 moderate, 133 minor known drug interactions in our database — the Segesterone Acetate, Ethinyl Estradiol one above is among them. If you take anything else, check it against the full list below.

Moderate 873 Minor 133 No known interaction 1,824 (incl. Segesterone Acetate, Ethinyl Estradiol)
Taking anything else?

Check Another of Your Medications Against Ginger

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

From our Q&A

Questions About Ginger or Segesterone Acetate, Ethinyl Estradiol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ginger or Segesterone Acetate, Ethinyl Estradiol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Segesterone Acetate, Ethinyl Estradiol

This page covers Ginger only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Segesterone Acetate, Ethinyl Estradiol page lists 229 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 5 major · 193 moderate · 31 minor.

From our pharmacist’s overview on the Segesterone Acetate, Ethinyl Estradiol page

“St. John's wort is the interaction I would explain first to anyone using Annovera (segesterone acetate with ethinyl estradiol, a vaginal ring for birth control).”

Reviewed by 2 · Jul 18, 2026

Open the Segesterone Acetate, Ethinyl Estradiol interaction page

One more smart check

Taking Ginger as Part of a Dietary Supplement Product? Check It for Interactions

We hold 9,640 real supplement products containing Ginger, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Ginger. Your product may carry other ingredients that interact with Segesterone Acetate, Ethinyl Estradiol too, on top of Ginger — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Ginger and Segesterone Acetate, Ethinyl Estradiol 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 Ginger
Top 5%

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

29 days ago today
Medication Segesterone Acetate, Ethinyl Estradiol
Steady interest

#2,326 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 Ginger

What is Ginger?

Ginger
  • Nausea and vomiting
  • Motion sickness
  • Morning sickness in pregnancy
  • Digestive upset
  • Menstrual cramps
  • Joint pain and inflammation

Ginger is a widely used culinary spice with a long history in traditional medicine, and it has the strongest evidence for helping with nausea and vomiting, including from motion sickness, pregnancy, and chemotherapy. It is generally safe in food and supplement amounts for most people, though it may cause mild stomach upset. Talk with your pharmacist or doctor before using ginger supplements, especially if you are pregnant, have a bleeding disorder, or take other medicines.

Read the full Ginger monograph & all interactions
Keep checking

Other Drugs & Ginger

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

0Major
873Moderate
133Minor
1,823No known interaction
873 Moderate 133 Minor 1,823 No interaction
Moderate

873 interactions

Showing 60 of 873 moderate interactions — see all 873 on the Ginger page.

Minor

133 interactions

Showing 60 of 133 minor interactions — see all 133 on the Ginger page.

No interaction 1,823 drugs checked — show the list

We also checked Ginger against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,823 medications checked with no known interaction — see the full Ginger list.

See the full Ginger interactions page
See every supplement checked against Segesterone Acetate, Ethinyl Estradiol, ranked by severity
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

Keep exploring
Ginger monograph › Uses, safety, and every drug interaction in one place Segesterone Acetate, Ethinyl Estradiol supplement interactions › Every supplement checked against Segesterone Acetate, Ethinyl Estradiol, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Ginger and Segesterone Acetate, Ethinyl Estradiol Together: Common Questions

Can you take Ginger with Segesterone Acetate, Ethinyl Estradiol?
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.
Why are there 3 interactions listed for Ginger and Segesterone Acetate, Ethinyl Estradiol?
Segesterone Acetate, Ethinyl Estradiol belongs to more than one drug category, and Ginger interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Ginger and Segesterone Acetate, Ethinyl Estradiol 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.