Depletes Folic Acid. This medication is commonly used for Contraception
Women using oral contraceptives (OCs) for extended periods may experience a decrease in their folate levels. Studies suggest that OC use might lower blood folate levels by up to 40%. This depletion can be a concern because folate plays a crucial role in red blood cell production. One research finding highlights a case where a patient developed anemia and nerve problems (polyneuropathy) after stopping vitamin B12 therapy, suggesting that folate deficiency might have been the main underlying issue. Supplementation of folate should be considered during oral contraceptive use.
Shikh EV, Makhova AA, Chemeris AV, Tormyshov IA. [Iatrogenic deficits of micronutrients]. Vopr Pitan. 2021;90(4):53-63. Russian. Shere M, Bapat P, Nickel C, Kapur B, Koren G. Association Between Use of Oral Contraceptives and Folate Status: A Systematic Review and Meta-Analysis. J Obstet Gynaecol Can. 2015 May;37(5):430-438. Kornberg A, Segal R, Theitler J, Yona R, Kaufman S. Folic acid deficiency, megaloblastic anemia and peripheral polyneuropathy due to oral contraceptives. Isr J Med Sci. 1989 Mar;25(3):142-5. PMID: 2540115. Bielenberg J. Folsäure- und Vitaminmangel durch orale Kontrazeptiva [Folic acid and vitamin deficiency caused by oral contraceptives]. Med Monatsschr Pharm. 1991 Aug;14(8):244-7. German. PMID: 1921842.
Folate (0.2mg as L-5-Methylfolate) — 0.34 DFE
Low folate status contributes to elevated homocysteine, a metabolite that has been associated with endothelial dysfunction, arterial stiffness, and a higher risk of stroke and coronary heart disease. Large observational studies consistently show that individuals with higher homocysteine levels have greater rates of cardiovascular events, and folate intake is one of the key nutritional determinants of homocysteine. Clinically, folic acid supplementation (often combined with vitamins B6 and B12) can lower homocysteine and appears to modestly reduce stroke risk in some populations, making the identification and correction of folate deficiency an important part of broader cardiovascular risk reduction.
Folate deficiency in the periconceptional period significantly increases the risk of neural tube defects (NTDs) such as spina bifida and anencephaly, because adequate folate is required for proper closure of the embryonic neural tube in the first month of pregnancy. Large observational datasets and randomized trials have shown that appropriate folic acid supplementation before conception and in early pregnancy can reduce NTD risk by roughly 50–70% in the general population, with even greater risk reduction in women with a prior NTD‑affected pregnancy. The practical implication is that all women of childbearing potential, not just those actively planning pregnancy, are typically advised to maintain adequate daily folic acid intake so that red‑cell folate stores are sufficient well before conception occurs.