Drug & supplement interaction

Moringa + 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 Moringa can interact with; the most serious is rated moderate. Theoretically, moringa might increase or decrease 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

Moringa and Segesterone Acetate, Ethinyl Estradiol

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

Why Are There 3 Interactions?

Moringa interacts with whole categories of medication. Segesterone Acetate, Ethinyl Estradiol falls into 3 of those categories, so it can interact with Moringa 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 Moringa interacts with.

Theoretically, moringa might increase or decrease levels of CYP3A4 substrates.
Some in vitro research suggests that moringa inhibits cytochrome P450 3A4 (CYP3A4). However, other in vitro research suggests that moringa extract induces CYP3A4 enzymes. A pharmacokinetic study in patients with HIV shows no change in the pharmacokinetics of nevirapine, which is partially metabolized by CYP3A4, when administered concomitantly with moringa leaf powder 1.85 grams daily for 14 days.
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 works by steadily delivering two hormones, segesterone and ethinyl estradiol, both of which your body breaks down partly through a liver enzyme called CYP3A4. The concern with moringa is that, at least in lab studies, it has pushed this enzyme in both directions: some research suggests it slows the enzyme down, while other research suggests it speeds it up. So we genuinely can't say which way it would go.

Here's the honest bottom line: this is a theoretical worry based on test-tube data, and a small human study with another CYP3A4 drug showed no real change. If the enzyme sped up, hormone levels could drop and reduce protection against pregnancy. Since that's a serious outcome, it's worth a quick chat with your pharmacist or doctor before adding moringa supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Monera TG, Wolfe AR, Maponga CC, et al. Moringa oleifera leaf extracts inhibit 6beta-hydroxylation of testosterone by CYP3A4. J Infect Dev Ctries 2008;2:379-83.
  2. Monera-Penduka TG, Maponga CC, Wolfe AR, Wiesner L, Morse GD, Nhachi CF. Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study. AIDS Res Ther. 2017;14:12. doi: 10.1186/s1 PubMed
  3. 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
Moderate

P-GLYCOPROTEIN SUBSTRATES

2 of 3

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

Theoretically, moringa leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that moringa leaf extract inhibits renal P-glycoprotein transport activity. So far, this reaction 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

Here's the gist with Annovera (the segesterone and ethinyl estradiol vaginal ring) and moringa. In lab dish studies, moringa leaf extract slowed down a transporter called P-glycoprotein, which helps move certain drugs out of the body. If that happened with your hormones, the theory is that levels could nudge a little higher, which might mean more of the usual estrogen-type side effects like nausea, breast tenderness, headaches, or bloating.

Now the honest part: this is only test-tube research and has never been reported in real people. Food amounts of moringa in cooking are very unlikely to matter. If you want to take concentrated moringa supplements, just run it by your pharmacist or doctor first so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Amaeze O, Marques ES, Wei W, et al. Evaluation of Nigerian Medicinal Plants Extract on Human P-glycoprotein and Cytochrome P450 Enzyme Induction: Implications for Herb-drug Interaction. Curr Drug Metab. 2021;22(14):1103-1113. PubMed
Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

3 of 3

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

Theoretically, moringa might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that moringa extract induces CYP1A2 enzymes.
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

Here's the gist with Annovera (the segesterone and ethinyl estradiol vaginal ring) and moringa. Lab studies suggest moringa may speed up an enzyme called CYP1A2, which helps break down estrogen. In theory, that faster breakdown could lower your hormone levels a little. With birth control, the worry is always whether anything might make it work less reliably, which could mean breakthrough bleeding or, at the far end, reduced protection against pregnancy.

That said, I want to keep this in perspective. This is rated a minor, theoretical interaction based only on test-tube research, not real people. Occasional culinary amounts of moringa are very unlikely to matter. If you take concentrated moringa supplements regularly, just mention it to your pharmacist or doctor so they can weigh in.

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

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

Moringa Also Interacts With Other Medications

Moringa has 716 moderate, 152 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 716 Minor 152 No known interaction 1,962 (incl. Segesterone Acetate, Ethinyl Estradiol)
Taking anything else?

Check Another of Your Medications Against Moringa

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

From our Q&A

Questions About Moringa 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 Moringa 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 Moringa 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 Moringa as Part of a Dietary Supplement Product? Check It for Interactions

We hold 738 real supplement products containing Moringa, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Moringa. Your product may carry other ingredients that interact with Segesterone Acetate, Ethinyl Estradiol too, on top of Moringa — 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 Moringa 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 Moringa
Top 25%

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

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

#2,317 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 Moringa

What is Moringa?

  • Nutritional supplement
  • Blood sugar support
  • Cholesterol support
  • Inflammation
  • Skin conditions

Moringa is a nutrient-rich plant whose leaves are widely used as a food and supplement, especially in parts of the world where malnutrition is common. Early research hints at possible benefits for blood sugar, cholesterol, and inflammation, but the human evidence is limited and not strong enough to recommend it as a treatment. Talk with your pharmacist or doctor before using moringa, especially if you are pregnant, breastfeeding, or taking medications.

Read the full Moringa monograph & all interactions
Keep checking

Other Drugs & Moringa

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

0Major
716Moderate
152Minor
1,961No known interaction
716 Moderate 152 Minor 1,961 No interaction
Moderate

716 interactions

Showing 60 of 716 moderate interactions — see all 716 on the Moringa page.

Minor

152 interactions

Showing 60 of 152 minor interactions — see all 152 on the Moringa page.

No interaction 1,961 drugs checked — show the list

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

Showing the 60 most looked-up of 1,961 medications checked with no known interaction — see the full Moringa list.

See the full Moringa 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
Moringa 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 Moringa and Segesterone Acetate, Ethinyl Estradiol Together: Common Questions

Can you take Moringa 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 Moringa and Segesterone Acetate, Ethinyl Estradiol?
Segesterone Acetate, Ethinyl Estradiol belongs to more than one drug category, and Moringa 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 Moringa 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.