Dr. Anis Rehman
Dr. Rehman, M.D., is a board-certified physician in Internal Medicine as well as Endocrinology, Diabetes, and Metabolism.
Melatonin is a naturally occurring hormone produced by the brain after exposure to darkness. This hormone works as part of our daily fluctuating circadian rhythms and helps us feel sleepy when it’s time for bed. Without enough melatonin, we would continue feeling alert later than usual and likely have trouble sleeping. Melatonin is the primary reason our sleep-wake schedules correspond with darkness and daylight.
Synthetically made melatonin is available over the counter without a prescription and primarily used as a sleep aid. Experts say supplemental melatonin works best for jet lag, delayed sleep-wake phase disorder, some sleep disorders that children experience, and anxiety before surgery. However, many people use melatonin on a short-term basis to help themselves fall asleep faster or stay asleep longer.
Since melatonin is a hormone, many people wonder if it interacts with or impacts the effectiveness of hormonal birth control. We cover how melatonin affects the body, how it may interact with hormonal birth control, and discuss other ways to improve sleep.
Melatonin is naturally produced by the body and controlled by the suprachiasmatic nuclei (SCN), a part of the brain that regulates our circadian rhythms, or 24-hour internal clock. Light exposure suppresses melatonin, so its levels usually increase in the evening. Increased melatonin levels provoke tiredness, helping us feel ready for sleep. Melatonin is not a sedative, however, and the sleepiness it causes usually occurs about two hours after its levels increase, whether naturally or through supplementation.
Most research on melatonin focuses on how it affects the sleep-wake cycle, but this hormone likely impacts many other aspects of the body as well. Limited research suggests melatonin could potentially help treat liver injuries and disease, protect against skin damage, prevent and treat cancer, treat dental disease, improve physical performance, and treat cardiovascular disease. Melatonin appears to be involved in multiple bodily systems, so future research will likely uncover even more of its effects.
In the U.S., melatonin is considered a dietary supplement by the Food and Drug Administration (FDA). As a result, it isn’t closely regulated like prescriptions or over-the-counter medications. Some studies of melatonin supplements found that they don’t always contain the correct dosage or exact ingredients listed on their packaging. In some other countries, melatonin is categorized as a drug and only available by prescription. To be on the safe side, consult with your doctor before beginning melatonin supplementation.
Although melatonin supplements help promote sleep, not all professionals recommend them for chronic insomnia, which is insomnia that lasts over a month. Instead, sleepers struggling with insomnia for over a month may benefit from cognitive behavioral therapy for insomnia (CBT-I). Studies suggest that melatonin works well for certain other sleep issues, however, such as jet lag. Melatonin supplementation might also be useful for shift workers, but more research is required.
Research suggests melatonin supplements and birth-related hormones likely affect one another. How they affect one another isn’t entirely clear, however. Researchers once suggested melatonin as an active ingredient for birth control pills and hypothesized that a melatonin-progestin birth control pill could help prevent breast cancer. However, in another study melatonin supplementation positively affected fertility in women undergoing fertility treatments. Melatonin levels likely fluctuate depending on where a person is in their menstrual cycle, which could help explain these conflicting results.
Research on hormonal birth control and natural melatonin levels have also returned inconsistent results. One study found that oral contraceptive use altered the circadian rhythm of melatonin, although average levels remained the same. Another study found that women on birth control had similar melatonin levels to women not on birth control. A third study found that oral contraceptives with progestin significantly increased melatonin levels. Differences in results could be due to differences in how and when melatonin was measured, or differences in types of birth control.
Unfortunately, there isn’t much research on how melatonin supplements and birth control interact. People taking an oral contraceptive might worry, does melatonin cancel out birth control? It isn’t likely, but since there isn’t conclusive research on how these items interact, it’s best to be cautious. If you’re on hormonal birth control and interested in trying melatonin supplements, check with your doctor. They might recommend you try other sleep-promoting methods first.
If you’re on birth control and having trouble sleeping, consider following more general sleep tips before trying out melatonin supplements. Improving your overall sleep hygiene may help you fall asleep faster and sleep better. Good sleep hygiene includes:
Some people also find that alternative medicine techniques, such as massage, herbal tea, hypnotherapy, and acupuncture, help them sleep. There isn’t enough research to conclude these strategies work for most people, however. Experts advise against taking the supplements kava and L-tryptophan for sleep, which can both cause health issues.
If you’ve tried improving your sleep through sleep hygiene techniques and you’re still having trouble, see your doctor to eliminate the possibility of a sleep disorder. Sleep disorders are fairly common. Your doctor can ask you questions and order tests, if necessary, to determine whether or not you have a sleep disorder. To prepare for your doctor’s appointment, bring notes about your symptoms and a diary of your sleep schedule and disturbances over the previous week, if possible. This information helps your doctor better understand what type of sleep problem you might be dealing with.