Can Neem Cause a Miscarriage?

The neem tree, Azadirachta indica, a relative of mahoghany, is native to the tropical and subtropical areas of the Indian subcontinent. Over many centuries, the leaves, bark, oil, other parts and extracts of the neem tree have been used for multiple healing purposes. Yet neem may pose dangers for pregnant women and their unborn children. As with any other herbal supplement, ask your doctor any questions you may have about the benefits and risks of neem.

As they have for millennia, many Indians still brush their teeth daily with neem twigs. Ayurveda, India's ancient and still-flourishing medical system, has applied parts and extracts of the neem tree to prevent and heal infections, including parasitic infections, inflammation, fever, skin disorders like leprosy, ulcers, diarrhea, diabetes, urinary disorders, and eye diseases, among other health concerns. A first-century BCE Ayurvedic physician, Charaka, gave instructions for neem oil as an intravaginal contraceptive.

Neem is now known to contain an abundance of pharmaceutically active compounds. According to literature reviews on the website of the Neem Foundation and in the journal "Current Science," evidence supports neem as a potential treatment for parasitic infections with intestinal worms, head lice and malaria; some bacterial, viral and fungal infections; inflammatory conditions such as eczema, psoriasis and gastrointestinal ulcers; diabetes; hypertension; and cancer. Intravaginal neem shows promise as an inexpensive, nonirritating contraceptive that works by killing sperm cells and hindering their migration into cervical mucus. Neem has also been proposed as a possible male birth control pill or an alternative to vasectomy.

According to a 2008 "African Health Sciences" study of rats, neem flower extract could suppress ovulation and thus prevent egg cells from meeting sperm. It did not abort already conceived embryos or cause prenatal disabilities. However, in a 1996 study from the journal "Contraception," high oral doses of extract from neem seeds, not flowers, aborted the pregnancies of baboons and bonnet monkeys, animals far more closely related to humans. According to a 1997 review from "Immunology and Cell Biology," the seed extract may somehow stimulate an immune system attack on embryos soon after their implantation into the wall of the uterus.

A Drugs.com monograph warns that for neem, "information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use." Although such safety data is lacking for humans, the fact that neem can induce miscarriages in other primates is yet another reason for caution. If you are pregnant or breastfeeding, ask your doctor about the safety of neem for you and your baby, whether you use neem in dental care, apply it topically, or ingest it orally. Make sure that your doctor explains what other treatment options, including complementary or alternative health-care options, may be open to you.