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Should We Need a Prescription for Birth Control Pills?
The Food and Drug Administration is charged with, among other things, protecting the public health by regulating prescription and non-prescription drugs. As part of that responsibility, they decide which drugs are safe for over-the-counter use and which can be obtained only with a doctor’s prescription. Drugs that are intended to be taken daily for an unlimited amount of time are never approved for use without a prescription. But when it comes to birth control pills, is this kind of restricted access really in the best interest of women?
Members of the Oral Contraceptive Over-the-Counter Working Group think not. They are working to make a progestin-only pill available as an over-the-counter, daily-use oral contraceptive. This ‘mini-pill’ differs from what most women take in that it does not contain synthetic estrogen, which is known to increase the risk of stroke, heart attack and blood clots as well as clear up acne, relieve cramps and lessen flow.
Considering the fact that the so-called morning after pill, which contains the same synthetic progesterone, is already approved for use without a prescription, the matter would seem to be a no-brainer. But making birth control pills available without a prescription is a complicated issue that has both positive and negative implications for women.
On the plus side, making birth control pills available without a prescription would likely prevent a whole lot of unwanted pregnancies, particularly in teens who may not be able to see a doctor without parental approval. In addition, those who cannot afford an annual pelvic exam would no longer be denied access to this safe and effective birth control method.
But what about that yearly pap smear? According to Dr. Daniel Grossman, it has no place in this discussion. “Holding birth control hostage until women have had a pelvic exam is a paternalistic attitude to women’s health,” he says. “The Pap smear is for cancer screening, not contraception, and we shouldn’t spread misinformation by linking the two.”
But, surprisingly, while making birth control pills available over-the-counter would in theory make them more accessible to more women, the opposite might end up being true. Dr. Vanessa Cullins, vice president for medical affairs of the Planned Parenthood Federation of America, says that when any medication is offered over-the-counter, it often becomes out of reach for women on federal programs like Medicaid, which doesn’t cover non-prescription drugs.
Despite all that, the FDA has shown a willingness to consider the idea. FDA representative Shelly Burgess urges interested companies to present the data that demonstrate that “the proposed oral contraceptive can be used appropriately and safely by consumers without the input of a health-care provider.”
What do you think? Would you like to see the pill go over-the-counter? If you didn’t need to see your doctor to get it, would you still make appointments for regular pelvic exams?
Image: nateOne/Flickr
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0 Comments
JBoogie commented on Jul 08 10 at 11:33 amI think it’s a good idea except the whole insurance issue–I take the progestin only pill right now because of breastfeeding, and it’s only $8 with my insurance. I really don’t want that to go up if it goes over-the-counter.
Bec commented on Jul 08 10 at 11:38 amI had to go through three different brands of birth control pills before my doctor and I found one that didn’t induce either heavy, painful, and long periods or hormone-related mood problems. Surely I’m not the only one? I had to have a follow up three months into any new pill in order to determine whether or not it was the right one for me. Hormones are pretty powerful, and that’s the part where a prescription makes sense to me. How am I supposed to know what levels of estrogen and progesterone will be exactly the right mix for THIS body to stop ovulating but not go psycho?
jenny tries too hard commented on Jul 08 10 at 11:47 amHmmm…there are certainly some major pros and cons. On principle, I think most medicines should be available without prescription for adults, but not for teenagers/kids. As much as I’d like to see fewer teenage pregnancies, I still feel that people who are considered too young to make other medical decisions shouldn’t be making this one without a parent.
As far as keeping the access for indigent women on Medicaid, I do know that my SIL actually gets a prescription for things that are usually OTC (tylenol, neosporin, even Dr. Bordeaux’s ButtPaste) and it’s covered by Medicaid, so I don’t see why they couldn’t do this for birth control. Also, drug co’s would likely anticipate that a lot of women would still get bc through insurance, and release one kind for OTC, and another for prescription use.
CocoStrange commented on Jul 08 10 at 11:55 amMy main concern with this is that POP’s are a lot less forgiving then combined hormone pills – meaning that if you miss one, even by only a few hours, you can become pregnant. The manufacturer would need to make this abundantly clear in the product literature.
Marj commented on Jul 13 10 at 11:56 amThere is over the counter birth control available. It’s called a condom. It is easy to use, very effective and protects against STDs. It has few health dangers. Much as I would love to see fewer unwanted pregnancies in general, birth control pills present significant risks and should be prescribed. Not everyone should take them, and their use should be explained carefully, in full, with opportunities to address issues and ask questions. At this point in my life, at 35, happily married, I do not choose to take them, because the risks they present are more scary to me than the risk of another child. Also, I know how to use condoms.
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