Modafinil and Birth Control | What You MUST Know

Tomas Thorne

Last Updated: February 2, 2023

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What would happen if you took Modafinil and birth control together? Nobody knows for sure — it’s certainly not a combination you see every day.

Modafinil’s role is clear: It is one of the world’s most powerful and safest nootropics for enhanced focus and all-day concentration.

Birth control, on the other hand, is a different story. It is used by women as a contraceptive to prevent pregnancy and comes in many different forms.

But can birth control and Modafinil be safely taken together? Are there any positive effects that take place, or is it unsafe to use both medications at the same time?

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What is Modafinil?

Modafinil is a wakefulness-promoting agent that is FDA-approved to treat two conditions [1]:

  • Excessive daytime sleepiness induced by shift work sleep disorder
  • Obstructive sleep apnea

We don’t know its precise mechanism of action, but scientists have been able to discover some clues. Modafinil has the ability to enhance areas of the brain which are associated with wakefulness and sleepiness.

However, unlike other stimulants and nootropics, it can do so without activating the sympathetic nervous system.

This means you won’t have a faster heartbeat or feel the “jitters” you would with caffeine and medications used to treat ADHD. And here’s another great benefit:

Once the effects of Modafinil wear off, your normal sleep patterns will not be compromised.

For many people, Modafinil is a life-saving medication for many people who have certain types of sleep disorders.

But for healthy individuals seeking a cognitive boost, Modafinil can be used off-label to deliver laser-like focus that lasts for several hours.

In fact, this is why it is the most popular nootropic amongst entrepreneurs, surgeons, and students at Ivy League schools.

Where does birth control fit into this? What could Modafinil and birth control possibly have in common?


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Modafinil and Birth Control | The Basics

Nobody wakes up and thinks, “Gee, wouldn’t it be nice to combine birth control and Modafinil together to see what happens?”

Here’s generally what happens…

A female is using some form of hormonal birth control if she is sexually active and does not plan on having kids.

The most common forms of birth control include:

  • Skin patches
  • Vaginal rings
  • “The pill”
  • IUD (intrauterine device)

As any user of birth control already knows, mood swings are one of the most common side effects. Somewhere down the line, she decides to use Modafinil to help her get a LOT of work done in an unreasonable period of time.

However, she has no idea how Modafinil will interact with her birth control.

And the science behind how birth control affects brain structure and function is surprisingly non-existent [2]:

“There’s really very little research I’m aware of on this topic, despite the fact that the pill has been around for more than half a century”

“…by essentially “replacing” your body’s real progesterone and estrogen with the synthetic versions, the pill may tinker with your brain”

Modafinil, on the other hand, is more clear-cut in its purpose and use.

Anybody who has a prescription for Modafinil is primarily taking it to stay awake for longer periods of time. It can be used during the day, but its real power shines through when it keeps you awake for an all-nighter session.

This was extensively proven in military soldiers who have used Modafinil to remain alert for several hours at a time [3]:

“Military studies have repeatedly demonstrated that modafinil has the ability to promote wakefulness and improve cognitive performance during sustained periods of sleep deprivation associated with military operations”

Combined with an outstanding safety profile and very limited capacity for abuse, you have the recipe for a near-perfect nootropic.

But this begs the question…

Can Modafinil and birth control be safely used together, or will one medication reduce the effectiveness of the other?

First, it’s important to get a clearer picture of the scientific studies done on both drugs to date.


What the Science Says About Modafinil and Birth Control?

Birth control and Modafinil have been extensively studied in the medical field.

Considering how long they have been in use, we have a good idea of the cognitive benefits they provide to their users.

Modafinil Benefits

  • Modafinil Has Long-Lasting Wakefulness Effects

One little-known study examining Modafinil’s effectiveness in healthy 20-something adults used eight French Air Force men.

Half of the subjects were given 200 mg of Modafinil a total of 6 times over a period of 60 hours where they were deprived of all sleep.

Despite this, they were able to maintain the same level of alertness and cognitive performance across tests such as reaction time and mathematical processing [4].

The people taking the placebo? Their performance continued to decrease across all cognitive measures.

  • Modafinil May Help Highly Impulsive People Inhibit Bad Behaviors

If you know somebody who has a very difficult time getting off alcohol, this next point might be of interest to you.

Alcohol-dependent patients were recruited in a study and given 200 mg of Modafinil.

For the patients who initially had poor control over their responses, Modafinil significantly reduced their impulsivity [5].

However, the opposite effect was slightly noticed in patients who initially had better response control. This finding implies that Modafinil may be useful for treating non-stimulant addictions, and possibly behavioral addictions such as gambling.

  • Modafinil Can Improve Logical And Emotional Intelligence

There are generally two types of cognition: “Hot” cognition has to do with information processing, whereas “cold” cognition is about emotional intelligence.

It turns out that Modafinil can effectively increase both kinds of cognition, which could make any ordinary human being a better version of themselves for a few hours [6].

It’s no wonder people are already worried about the so-called ethics behind using Modafinil!


Birth Control Benefits

  • Birth Control May Increase Verbal Memory

Verbal memory can be best defined as the ability to recall words, definitions, and any language abstractions.

A systematic review exploring the effect of oral contraceptives on cognition discovered an improvement in verbal memory to be the most consistent outcome [7].

To nobody’s surprise, it is still highly debated as there aren’t any published studies that dictate the opposite effect.

  • Birth Control May Improve Working Memory While Sleep-Deprived

An interesting study conducted in 1998 found that women who took oral contraceptives had better working during sleep deprivation compared to women who weren’t using any form of birth control [8].

Working memory is what allows you to immediately recall new information you just attained.

Considering how sleep deprivation is known to decrease working memory, this small discovery is quite fascinating!

  • Birth Control Could Potentially Elevate Resilience To Stress

When we get stressed out, our body releases the stress hormone known as cortisol. Chronic stress is often believed to impair memory recall.

It appears as if women who are taking oral contraceptives have a reduced sensitivity to sudden rises in cortisol, and thus their memory recall is not as severely impacted [9].


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Understanding The Benefits of Birth Control and Modafinil

This section is not an attempt to suggest that people should be taking Modafinil and birth control together for an enhanced nootropic effect.

It is NOT recommended to take Modafinil when on birth control.

But we wanted to educate you as best we can. At best, these are hypothetical benefits that one MAY experience when both medications are taken together at the same time.

Let’s dig in:

  • Modafinil and Birth Control Could Improve Emotional Memory

We already know about Modafinil’s power to increase emotional intelligence, but what are the potential effects of birth control on a woman’s emotions?

It turns out that hormonal contraceptives increase emotional memory — the types of memories that are attached to a deep emotion within our psyche [10].

So if you’re taking both drugs at once and a significant event happens, you would be far more likely to remember it for a long tie.

  • Modafinil and Birth Control May Reduce ADHD Symptoms

An interesting article postulated that a woman with ADHD will respond to her prescribed medications differently — such as Ritalin or Adderall — depending on which hormone is most elevated.

If it’s estrogen, she’ll have a better response. If it’s progesterone, the response will be diminished [11].

This one is definitely in the “grey” area. If Modafinil is improving focus, then theoretically a female ADHD patient with high levels of estrogen will fare better when taking her medication.

  • Modafinil and Birth Control Could Improve Quality Of Sleep

Remember the statement I shared earlier about Modafinil not affecting sleep patterns once the drug wears off?

With birth control, it is hypothesized that a female’s sexual hormones are crucial in getting better sleep at night.

A systematic review published in 2018 looked at a few human trials involving oral contraceptives and came to some interesting conclusions…

Women on hormonal contraceptives tend to snore less, wake up fewer times during the night, and have more efficient sleep overall [12].


Side Effects

The benefits of birth control and Modafinil if taken together are merely speculative.

However, the side effects are better established and are worth your attention.

Make sure you take the time to read this section before you think about taking the two together!

  • Kids!

This is not a joke — Modafinil literally reduces the effectiveness of birth control.

For the women reading this…your chances of getting pregnant are much higher if you are using Modafinil at the same time.

According to one study involving drug interactions, Modafinil lowers the bodily levels of ethinyl estradiol by as much as 18% [13].

(FYI: Ethinyl estradiol is commonly used in birth control pills alongside other hormones)

This is because Modafinil increases the activity of the CYP3A4/5 enzyme, which is used to metabolize hormonal contraceptives.

In fact, the four types of birth control negatively affected by Modafinil use are as follows: Subdermal implants, a pill consisting of one or several hormones, the patch, and vaginal rings.

However, the three types of birth control which aren’t affected by Modafinil are the copper IUD, DMPA (depot medroxyprogesterone acetate), and LNG-IUS (Levonorgestrel releasing intrauterine system).

Any scientist will notice that none of these methods are affected by drug interactions [14].

It’s a hard road for sexually active women who want to take their mental focus to the next level.

Men don’t have to worry about any of these problems when taking Modafinil and having sex. Nevertheless, make sure the man is using protection too!

  • Birth Defects

Another unfortunate outcome of using Modafinil and birth control simultaneously could be fetal harm.

To provide some context, the FDA categorizes Modafinil as a “Category C” drug [15]:

“Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.”

Some of the potential birth defects include heart deformations, fetal toxicity and poor physical development.

In case you think people are freaking out, Health Canada issued a warning about this finding and every label attached to Modafinil lists birth defects as a potential side effect in pregnant women [16].

In short: Taking Modafinil and birth control together increases your chances of being pregnant, and continuing Modafinil while pregnant may not be the best idea.

  • Lower Perseverance

The basis for this comes from a single scientific study claiming that women taking birth control have lower levels of perseverance when completing cognitive tasks.

This apparently held true regardless of how simple or complex the tasks were [17].

Why is this important?

As you’ve probably gathered by now, Modafinil can help you persevere through tasks you would otherwise perceive to be impossible.

If this study I quoted is taken at face value, it would appear as if birth control lowers the mental edge being provided by Modafinil.

Just something to think about.


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Is It Worth the Risk? | Verdict

So what can we conclude about Modafinil and birth control?

Obviously…

Women are not advised to be taking both drugs at the same time if they want to avoid getting pregnant and/or minimize the possibility of their newborn child having a birth defect.

In terms of the cognitive benefits, it is entirely individual to the woman taking it. Some may feel better while taking birth control and Modafinil, and others may feel worse.

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References

  1. O’Malley MB, Gleeson SK, Weir ID. Wake-Promoting Medications: Efficacy and Adverse Effects. 2011:527-541. doi:10.1016/B978-1-4160-6645-3.00045-1.
  2. We Know Surprisingly Little Information About How Birth Control Affects Our Brains. Retrieved April 1, 2020. health.com
  3. Westcott KJ. Modafinil, sleep deprivation, and cognitive function in military and medical settings. Mil Med. 2005 Apr;170(4):333-5.
  4. Lagarde D, Batejat D. Disrupted Sleep-Wake Rhythm and Performance: Advantages of Modafinil. Mil. Psychol. 1995;7(3):165-191. doi:10.1207/s15327876mp0703_2.
  5. Schmaal L, Joos L, Koeleman M, Veltman DJ, van den Drink W, et al. Effects of modafinil on neural correlates of response inhibition in alcohol-dependent patients. Biol Psychiatry. 2013;73(3):211-218. doi:10.1016/j.biopsych.2012.06.032.
  6. Brühl AB, d’Angelo C, Sahakian BJ. Neuroethical issues in cognitive enhancement: Modafinil as the example of a workplace drug?. Brain Neurosci Adv. 2019;3:2398212818816018. doi:10.1177/2398212818816018
  7. Warren AM, Gurvich C, Worsley R, Kulkarni J. A systematic review of the impact of oral contraceptives on cognition. Contraception. 2014;90(2):111-116. doi:10.1016/j.contraception.2014.03.01.
  8. Wright KP Jr, Badia P. Effects of menstrual cycle phase and oral contraceptives on alertness, cognitive performance, and circadian rhythms during sleep deprivation. Behav Brain Res. 1999;103(2):185-194.
  9. Kuhlmann S, Wolf OT. Cortisol and memory retrieval in women: influence of menstrual cycle and oral contraceptives. Psychopharmacology (Berl). 2005;183(1):65-71.
  10. Spalek K, Loos E, Schicktanz N, Hartmann F, de Quervain D, et al. Women using hormonal contraceptives show increased valence ratings and memory performance for emotional information. Neuropsychopharmacology. 2019;44:1258-1265.
  11. Women, Hormones, and ADHD. Retrieved April 2, 2020. additudemag.com
  12. Bezerra AG, Andersen ML, Pires GN, Tufik S, Hachul H. Effects of hormonal contraceptives on sleep – A possible treatment for insomnia in premenopausal women. Sleep Sci. 2018;11(3):129–136. doi:10.5935/1984-0063.20180025.
  13. Robertson P Jr, Hellriegel ET, Arora S, Nelson M. Effect of modafinil on the pharmacokinetics of ethinyl estradiol and triazolam in healthy volunteers. Clin Pharmacol Ther. 2002;71(1):46-56.
  14. Modafinil taken by students as a “smart drug” could reduce effectiveness of hormonal contraception: CEU Clinical Update. Retrieved April 2, 2020. fsrh.org
  15. FDA Pregnancy Categories. Retrieved April 2, 2020. drugs.com
  16. Preliminary Data Raises Concerns About Modafinil Use in Pregnancy. Retrieved March 28, 2020. womensmentalhealth.org
  17. Women taking hormonal contraceptives have reduced perseverance on cognitive tasks, study finds. Retrieved March 31, 2020. psypost.org

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