{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T20:46:24Z","timestamp":1778186784451,"version":"3.51.4"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2014,8,26]],"date-time":"2014-08-26T00:00:00Z","timestamp":1409011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects. Aim: In a longitudinal study, 1011 women obtaining oral contraception through the public health system in rural Cambodia were allocated to either intervention or control groups, receiving either daily Vitamin B6 supplement or care as usual (without placebo). Results: The intervention participants (n = 577) reported fewer side effects in three categories: nausea\/no appetite, headache, and depression compared with control group participants (n = 434). Conclusion: Women taking Vitamin B6 supplement were less likely to report side effects in a nutritionally vulnerable population. Underlying nutrition status should be considered by clinicians and reproductive health policy makers in the context of providing contraceptive services. Further investigation into micronutrient supplementation, particularly with B6, in reproductive-aged women using hormonal contraception should be conducted in other settings to determine the potential for widespread adoption.<\/jats:p>","DOI":"10.3390\/nu6093353","type":"journal-article","created":{"date-parts":[[2014,8,26]],"date-time":"2014-08-26T08:57:03Z","timestamp":1409043423000},"page":"3353-3362","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Supplementation with Vitamin B6 Reduces Side Effects in Cambodian Women Using Oral Contraception"],"prefix":"10.3390","volume":"6","author":[{"given":"Chivorn","family":"Var","sequence":"first","affiliation":[{"name":"Reproductive Health Association of Cambodia, No. 14, St. 335, Phnom Penh 12151, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheryl","family":"Keller","sequence":"additional","affiliation":[{"name":"Reproductive Health Association of Cambodia, No. 14, St. 335, Phnom Penh 12151, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rathavy","family":"Tung","sequence":"additional","affiliation":[{"name":"National Center for Maternal Child Health, Ministry of Health, Royal Government of Cambodia, No. 31A, St.47, Phnom Penh 12151, Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Freeland","sequence":"additional","affiliation":[{"name":"Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-2626","authenticated-orcid":false,"given":"Alessandra","family":"Bazzano","sequence":"additional","affiliation":[{"name":"Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2014,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1016\/j.ijgo.2004.11.012","article-title":"Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: Evidence from the demographic and health surveys","volume":"89","author":"Rutstein","year":"2005","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0140-6736(12)60609-6","article-title":"Contraception and health","volume":"380","author":"Cleland","year":"2012","journal-title":"Lancet"},{"key":"ref_3","unstructured":"National Institute of Statistics, Directorate General for Health, and ICF Macro (2011). Cambodia\u2014Demographic and Health Survey 2010, ICF Macro."},{"key":"ref_4","unstructured":"National Institute of Statistics, Directorate General for Health, and ORC Macro (2006). Cambodia\u2014Demographic and Health Survey 2005, National Institute of Public Health."},{"key":"ref_5","unstructured":"Consulting, D.R.A. (2005). Family Planning Survey: Contraception among Married Women of Reproductive Age in Cambodia, Ministry of Health and KfW."},{"key":"ref_6","unstructured":"Sedgh, G., Hussain, R., Bankole, A., and Singh, S. (2007). Women with an Unmet Need for Contraception in Developing Countries and Their Reasons for Not using a Method, Guttmacher Institute."},{"key":"ref_7","first-page":"33","article-title":"Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: A randomized, double-blind placebo-controlled study","volume":"78","author":"Sahakian","year":"1991","journal-title":"Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/0002-9378(95)90359-3","article-title":"Pyridoxine for nausea and vomiting of pregnancy: A randomized, double-blind, placebo-controlled trial","volume":"173","author":"Vutyavanich","year":"1995","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","first-page":"899","article-title":"Effect of pyridoxine hydrochloride (vitamin B6) upon depression associated with oral contraception","volume":"1","author":"Adams","year":"1973","journal-title":"Lancet"},{"key":"ref_10","first-page":"71","article-title":"Effect of oral contraceptives upon the metabolism of vitamin B6, folic acid, serum iron, glycemia, hemoglobin and hematocrit (author\u2019s transl)","volume":"92","author":"Araujo","year":"1982","journal-title":"J. Bras. Ginecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1079\/BJN19860117","article-title":"The effect of oral contraceptives on the apparent vitamin B6 status in some Sudanese women","volume":"56","author":"Salih","year":"1986","journal-title":"Br. J. Nutr."},{"key":"ref_12","unstructured":"Var, C., Keller, S., and Somphos, S. (2004). Clinic Based Study of Vitamin B6 Supplementation., Reproductive Health Association of Cambodia."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3634","DOI":"10.3390\/nu5093634","article-title":"Biological variability and impact of oral contraceptives on vitamins B6, B12 and folate status in women of reproductive age","volume":"5","author":"McArthur","year":"2013","journal-title":"Nutrients"},{"key":"ref_14","unstructured":"Food and Agricultural Organization (1999). Nutrition Country Profiles: Cambodia, Food and Agricultural Organization."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0010-7824(84)90102-1","article-title":"Vitamin metabolism and the effects of multivitamin supplementation in oral contraceptive users","volume":"30","author":"Amatayakul","year":"1984","journal-title":"Contraception"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0083-6729(08)60982-6","article-title":"The interactions between vitamin B6 and hormones","volume":"36","author":"Rose","year":"1978","journal-title":"Vitam. Horm."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1136\/jcp.25.3.252","article-title":"Oral contraceptives and tryptophan metabolism: Effects of oestrogen in low dose combined with a progestagen and of a low-dose progestagen (megestrol acetate) given alone","volume":"25","author":"Rose","year":"1972","journal-title":"J. Clin. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/0026-0495(73)90267-9","article-title":"Urinary excretion of quinolinic acid and other tryptophan metabolites after deoxypyridoxine or oral contraceptive administration","volume":"22","author":"Rose","year":"1973","journal-title":"Metabolism"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/0009-8981(73)90291-X","article-title":"The effect of oral contraceptives on vitamin B6 status","volume":"49","author":"Salkeld","year":"1973","journal-title":"Clin. Chim. Acta"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/0010-7824(85)90044-7","article-title":"Vitamin supplements to Indian women using low dosage oral contraceptives","volume":"32","author":"Bamji","year":"1985","journal-title":"Contraception"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0010-7824(97)00005-X","article-title":"Effect of vitamin B6 on the side effects of a low-dose combined oral contraceptive","volume":"55","author":"Grubb","year":"1997","journal-title":"Contraception"},{"key":"ref_22","first-page":"46","article-title":"Early effect of a low dose (30 micrograms) ethinyl estradiol-containing Triphasil on vitamin B6 status. A follow-up study on six menstrual cycles","volume":"66","author":"Masse","year":"1996","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_23","first-page":"263","article-title":"Women\u2019s nutrient intakes and food-related knowledge in rural Kandal province, Cambodia","volume":"23","author":"Wallace","year":"2014","journal-title":"Asia Pac. J. Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/6\/9\/3353\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:15:14Z","timestamp":1760217314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/6\/9\/3353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,26]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2014,9]]}},"alternative-id":["nu6093353"],"URL":"https:\/\/doi.org\/10.3390\/nu6093353","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,26]]}}}