Drug & supplement interaction

Saw Palmetto + Ethinyl Estradiol, Norethindrone

Ethinyl Estradiol, Norethindrone brand names: Femhrt, Loestrin 21, Ovcon 35 21, Ovcon 50 28, Necon 0.5 35 21, and others.

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

Ethinyl Estradiol, Norethindrone falls into 2 drug categories that Saw Palmetto can interact with; the most serious is rated moderate. Saw palmetto might reduce the effectiveness of estrogens.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Saw Palmetto and Ethinyl Estradiol, Norethindrone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Saw Palmetto interacts with whole categories of medication. Ethinyl Estradiol, Norethindrone falls into 2 of those categories, so it can interact with Saw Palmetto in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ESTROGENS

1 of 2

Why this applies to Ethinyl Estradiol, Norethindrone

Ethinyl Estradiol, Norethindrone falls under ESTROGENS — the group Saw Palmetto interacts with.

Saw palmetto might reduce the effectiveness of estrogens.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with estrogens taken concomitantly.
Severity Moderate Likelihood Possible Evidence B

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 your pill (the ethinyl estradiol and norethindrone combination, like Loestrin or Ovcon): saw palmetto is thought to have a mild anti-estrogen effect in the body. In theory, that could work against the estrogen part of your medication and make it a little less effective. This isn't a prodrug situation, so saw palmetto would simply blunt the estrogen, not boost it.

I'll be honest, the evidence here is on the weaker side and mostly theoretical, so I don't want to alarm you. But because this pill may also be used for birth control, even a small dip in reliability matters. If you take both, please check with your pharmacist or doctor before making any changes, and consider a backup method if pregnancy prevention is the goal.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol 1992;21:309-14. PubMed
Moderate

CONTRACEPTIVE DRUGS

2 of 2

Ethinyl Estradiol, Norethindrone also falls under CONTRACEPTIVE DRUGS.

Saw palmetto might reduce the effectiveness of contraceptive drugs.
Saw palmetto might have antiestrogenic effects. Theoretically, it might interfere with contraceptive drugs taken concomitantly.
Severity Moderate Likelihood Possible Evidence B

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

Your pill, a combination of ethinyl estradiol and norethindrone, relies on steady estrogen and progestin levels to prevent pregnancy. The concern here is that saw palmetto may have weak anti-estrogen activity, so in theory it could blunt some of that estrogen effect. If that happened, you might notice things like breakthrough bleeding or spotting, and the bigger worry is reduced protection against pregnancy.

I want to be honest with you though: this is mostly a theoretical concern based on lower-quality evidence, not strong proof that it actually fails in real life. Still, since an unplanned pregnancy is a big deal, I would not rely on this combination as your only safeguard without checking first. Please talk with your doctor or pharmacist, and ask whether a backup method makes sense.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol 1992;21:309-14. 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

Saw Palmetto Also Interacts With Other Medications

Saw Palmetto has 173 moderate known drug interactions in our database — the Ethinyl Estradiol, Norethindrone one above is among them. If you take anything else, check it against the full list below.

Moderate 173 No known interaction 2,657 (incl. Ethinyl Estradiol, Norethindrone)
Taking anything else?

Check Another of Your Medications Against Saw Palmetto

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

From our Q&A

Questions About Saw Palmetto or Ethinyl Estradiol, Norethindrone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Saw Palmetto or Ethinyl Estradiol, Norethindrone, 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 Ethinyl Estradiol, Norethindrone

This page covers Saw Palmetto only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norethindrone page lists 240 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 · 196 moderate · 38 minor.

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

“If you take a birth control pill or hormone therapy containing ethinyl estradiol and norethindrone (Loestrin, Femhrt, and others), a few supplements can genuinely undermine it, so read this page with care. Six of the 240 ingredients on file are rated major, and those six come first.”

Reviewed by 2 · Jul 18, 2026

Open the Ethinyl Estradiol, Norethindrone interaction page

One more smart check

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

We hold 3,466 real supplement products containing Saw Palmetto, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Saw Palmetto. Your product may carry other ingredients that interact with Ethinyl Estradiol, Norethindrone too, on top of Saw Palmetto — 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 Saw Palmetto and Ethinyl Estradiol, Norethindrone 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 Saw Palmetto
Top 5%

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

29 days ago today
Medication Ethinyl Estradiol, Norethindrone
Steady interest

#1,791 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 Saw Palmetto

What is Saw Palmetto?

Saw Palmetto
  • Benign prostatic hyperplasia (BPH) symptoms
  • Urinary problems
  • Hair loss
  • Prostate health
  • Inflammation

Saw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though it is generally well tolerated. Talk to your doctor or pharmacist before using it, especially for prostate or urinary problems that need proper evaluation.

Read the full Saw Palmetto monograph & all interactions
Keep checking

Other Drugs & Saw Palmetto

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

0Major
173Moderate
0Minor
2,656No known interaction
173 Moderate 2,656 No interaction
Moderate

173 interactions

Showing 60 of 173 moderate interactions — see all 173 on the Saw Palmetto page.

No interaction 2,656 drugs checked — show the list

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

Showing the 60 most looked-up of 2,656 medications checked with no known interaction — see the full Saw Palmetto list.

See the full Saw Palmetto interactions page
See every supplement checked against Ethinyl Estradiol, Norethindrone, 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
Saw Palmetto monograph › Uses, safety, and every drug interaction in one place Ethinyl Estradiol, Norethindrone supplement interactions › Every supplement checked against Ethinyl Estradiol, Norethindrone, 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 Saw Palmetto and Ethinyl Estradiol, Norethindrone Together: Common Questions

Can you take Saw Palmetto with Ethinyl Estradiol, Norethindrone?
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 2 interactions listed for Saw Palmetto and Ethinyl Estradiol, Norethindrone?
Ethinyl Estradiol, Norethindrone belongs to more than one drug category, and Saw Palmetto 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 Saw Palmetto and Ethinyl Estradiol, Norethindrone 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

Still Have a Question About Ethinyl Estradiol, Norethindrone and Saw Palmetto?

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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.