Evening Primrose Oil Controversy??

[AverysMomma]

Hiya Birth Professionals! Hope everyone is well and enjoying many blessed births this fall!

I'm wondering if any of you have any information or idea about this "new" controversy over Evening Primrose Oil and it's supposed risk for increasing bleeding in a laboring woman who has taken it to try and bring on or ease labor.....have any of your heard of this?

I guess there was a study of some sort, some midwives in my area have been buzzing a bit about it, etc....any of you ladies here know anything about it? Know of an actual study and not just gossip? That seems to be all I can find...gossip and some talk of a new study on the subject...which no one seems to be able to tell me how to locate! Isn't that how it goes??

Thanks in advance...I appreciate your help birth women!

[MsBlack]

I have not yet heard of this and it puzzles me. I mean, OK, we surely don't know all there is to know about EPO--and I also think that it is being overused by a lot of mamas (often recommended routinely by mws for every pregnancy, and often in what I consider to be excessive doses). But I can't imagine, based on what we do know about EPO, that it could cause bleeding.

This reminds me of the buzz that went around about Red Rasp Leaf tea a couple years ago--also implicating that in excess bleeding. I never saw anything like evidence, never did believe that at all.

Would definitely want to know of any studies on EPO and bleeding that you find.

[MamaRabbit]

Hmm, totally anecdotal but 100s of births...

The clinic I worked at in Indonesia uses EPO a lot. The leading cause of death in women of child-bearing age in Indonesia is PPH. The clinic gives prenatals and does EPO and their rates of PPH are very low and never lost a mother.

[AverysMomma]

Oh yes...anything I find I will surely spread around and most certainly will post here. All I can find is gossip and "well I heard" type of stuff...no one can point me in the direction of anything solid. My MIL seems to have some info on it...she is going to get back to me when she can get her hands on it directly from the woman in her office who is working with it...should be interesting!

EPO is not something I use myself...but I want to know if there is something legitimately "not so hot" about it, you know? Just because so many women use it....

[nashvillemidwife]

Pak J Pharm Sci. 2009 Oct;22(4):355-9.
Assessment of anticoagulant effect of evening primrose oil.
Riaz A, Khan RA, Ahmed SP.

Department of Pharmacology, University of Karachi, Karachi-75270, Pakistan.

Effect of evening primrose oil (EPO) was assessed on coagulation parameters following 30 and 60 days administration of 90, 180 and 360 microl/kg oil to healthy rabbits of either sex. There was significant increase in all assays except Fibrinogen time. These effects might be due to inactivation or inhibition of factors affecting coagulation. The intake of evening primrose oil also significantly decreased platelet count. Results of this study suggest that evening primrose oil shows considerable anti-anticoagulant and anti-platelet activity in animals and has potential to reduce cardiovascular morbidity and mortality.

http://www.ncbi.nlm.nih.gov/pubmed/1...m&ordinalpos=3

So to see these effects in a 150 pound woman, 90-360 mc/kg would be roughly 6 to 24 mg/day. By comparison, OTC EPO gelcaps come in 500 and 1000 mg.

[mwherbs]

and yet there is an actual human study done 10 years before the pharm rat study showing little effect from EPO

J Obstet Gynaecol. 1999 Jan;19(1):56-8.

The effect of prostanoid precursors and inhibitors on platelet angiotensin II
binding.
Walker T, Singh PK, Wyatt KM, O'Brien PM.
Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital Trust, Stoke on Trent, UK.
----- some of the intro cut--------
" The aim of this study was to investigate the value of combining low dose aspirin with dietary fatty acid supplementation and its effects on platelet angiotensin II binding in non-pregnant women."
I am cutting this here to stay within the publishing rules-- what is missing here is a discription that they tested 60 healthy non-pregnant women and how they were randomly given 1 of the 6 treatments aspirin taken alone and in combination with fish oil or evening primrose oil. A control group took no treatment. Platelet binding was determined before and after treatments for 1 month. They had no changes in platelet binding in the control group nor in the women who took EPO or fish oil alone ---- back to quoting---

"A significant decrease in binding was found in those who took aspirin in
combination with fish oil (P = 0.03). An increase in binding was seen in those
who took aspirin only, although this was not statistically significant (P =
0.14). A decrease was found in those who took aspirin in combination with evening primrose oil but again this was not statistically significant (P = 0.07). This study found that the combined effect of low-dose aspirin and fish oil causes a significant decrease in platelet angiotensin II binding not caused by either compound taken alone."


there are 2 other studies done on pregnant women-
this one did not study platelets but it does discuss positive changes

Br J Nutr. 2008 Feb;99(2):360-9. Epub 2007 Aug 3.
Co-supplementation of healthy women with fish oil and evening primrose oil increases plasma docosahexaenoic acid, gamma-linolenic acid and dihomo-gamma-linolenic acid levels without reducing arachidonic acid concentrations.

Geppert J, Demmelmair H, Hornstra G, Koletzko B.

Division of Metabolic Diseases and Nutrition, Dr von Hauner Children's Hospital,
Ludwig Maximilians University of Munich, Germany.
---------------
and this study shows some negative effects on labor

J Nurse Midwifery. 1999 May-Jun;44(3):320-4.
Oral evening primrose oil: its effect on length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women.

Dove D, Johnson P.

Birth Center: Holistic Women's Health Care, L. L. C., Wilmington, DE 19805, USA.

A two group retrospective quasi-experimental design conducted on a sample of women who received care in a birth center, compared selected outcomes of 54 women taking evening primrose oil in their pregnancy with a control group of 54 women who did not. Findings suggest that the oral administration of evening primrose oil from the 37th gestational week until birth does not shorten gestation or decrease the overall length of labor. Further, the use of orally administered evening primrose oil may be associated with an increase in the incidence of prolonged rupture of membranes, oxytocin augmentation, arrest of descent, and vacuum extraction.

[busybusymomma]

It's anecdotal, but we've seen great results with EPO recently when we've used it instead of sterile lube for exams.

I was also very pleased to see good dilation for a mom who had stalled... she had scar tissue on her cervix so we used EPO and borage oil for VEs along with massaging her cervix and she started dilating again (4 to 10cm in just over an hour after being 4cm almost all day). We thought it was quite fast, but she wanted it to go faster.

[MamaRabbit]

^^^ I was also referring to it used vaginally. I believe the studies were for it taken orally.

[DocsNemesis]

So does that mean taking it orally *may* result in more bleeding problems, while vaginal use doesn't?

I find this interesting since I've taken it with all but my first. It works very very well for me-I took it vaginally twice and vaginally and orally twice. I did have PPH with one (vaginal only) but it was a result of a very short umbilical cord that tugged on her way out. I've never had any other bleeding issues and I'm planning on using it again. (My cervix tends to swell badly; the EPO makes the swelling go away and results in a baby within about 12 hours, lol)