From the FDA Drug Label
Ask a doctor before use if you have ... are pregnant or breast feeding The FDA drug label does not answer the question.
From the Research
Senna is not absolutely contraindicated in pregnancy, but its use should be approached with caution due to potential risks and lack of comprehensive safety data. Pregnant women should avoid using senna, especially during the first trimester and near term, unless absolutely necessary and under medical supervision. The active compounds in senna (sennosides) can cross the placenta and may stimulate uterine contractions, potentially increasing the risk of preterm labor or pregnancy complications, although a study found no association between senna treatment and congenital abnormalities in the offspring of pregnant women with constipation 1. Additionally, senna can cause significant fluid and electrolyte imbalances, which may be harmful to both the mother and developing fetus. While constipation is common during pregnancy, safer alternatives should be used first, including increased dietary fiber, adequate hydration, regular physical activity, and if necessary, bulk-forming laxatives or osmotic agents like psyllium or polyethylene glycol. Some studies suggest that senna may be safe for use in pregnancy, with one study indicating that senna seed is a safe laxative in pregnancy 2, and another finding no increased risk of congenital abnormalities associated with senna treatment 1. However, the most recent and highest quality study on the topic, from 2017, suggests that while senna may be safe, its use should still be approached with caution 2. Stimulant laxatives like senna should only be considered in pregnancy if other methods have failed and only for short-term use under medical supervision. Key points to consider when evaluating the use of senna in pregnancy include:
- Potential risks of uterine stimulation and preterm labor
- Lack of comprehensive safety data
- Availability of safer alternative treatments for constipation
- Importance of medical supervision when using senna in pregnancy. It is essential to weigh the potential benefits and risks of senna use in pregnancy and to consider the individual circumstances of each patient, as the evidence is not conclusive, and different studies have different findings, for example, a study from 2016 recommends the use of macrogol and lactulose as the first-line therapy in treating chronic constipation during pregnancy, and suggests diphenolic laxatives such as bisacodyl and sodium picosulfate as a second-line treatment 3.