Birth Control Pills Should Be Sold Over the Counter

[Historicity]

Good article.

Slate -- Of Course Birth Control Pills Should Be Sold Over the Counter
No, they do not interact badly with antibiotics.
By Anna Reisman  |March 19, 2012

In many ways having the Pill available over the counter would make it more effective, not less. While the Pill has an impressively low failure rate on paper—0.3 percent in the first year; in practice, the actual failure rate is about 8 percent. One important—and fixable—reason: missed pills and gaps in prescriptions. Some physicians won’t provide a refill prescription unless a woman comes in for an appointment (with some doctors insisting on an often unnecessary pelvic and Pap in many cases). And so for women who can’t get an appointment when they need one, or lack health insurance and can’t afford to see a doctor, or can’t get time off of work to get to an appointment, the story is sadly familiar: missed pills, less effective backup methods, and unintended pregnancies.

...
With a new study confirming a low prevalence of contraindications, {Dr. Daniel Grossman} told me that “it’s a no-brainer that the minipill should be available over the counter right away.”

On March 22-23, the FDA will hold a public hearing on ... which medications are considered for over-the-counter status, along with ... “conditions of safe use.” Dr. Grossman and his colleagues are hoping to make the case for the combined Pill.

[Nick]

Sold over the counter?   I thought we were moving to ban them from the USA.

[velkyn]

yes, they should be should over the counter.  It's sad when theists have to use lies again and again. We still see that lie that abortions cause cancer. 

In theory, though I'm not completely sold on the methods claimed, you can use them to induce a miscarriage.  That's why anti-women people want to restrict them.  You can do that a lot of different ways though, lots of herbs will do it.  Pretty soon, they'll insist that women should be raised on farms and tied down since they don't want women to have any choices at all.

[Nick]

I had a dog once that had to go to the farm...hope it is not the same thing.

[Historicity]

BTW, do you know how the birth control pill was discovered?

Someone asked himself the question, why don't pregnant women get pregnant?  Actually they do very rarely and, if nothing goes horribly wrong, a woman may give birth to twins born a month apart.

Hmmmmmmm.    Women keep having sex during pregnancy.   So is there some sort of chemical change that happens?   Women get morning sick around that time.   Could that be the clue?   Sex hormones were isolated in the late 1920s.   

My "someone" above is like a Hollywood historical movie.  I oversimplified the work of several people from 1937 thru 1953.  Hollywood normally focuses on one person and centralizes all credit on him.  He becomes a composite.  Someone in the space program was really surprised by Tom Hank's Apollo 13 that it showed that the rescue was a group effort by many participants.

But anyway the birth control pill prevents birth in 2 ways:  It usually stops fertilization but when that occurs it also stops implantation of the embryo in the uterus about 3 days later.

But here's a thought to think about:  Since preventing implantation is an abortion, some religious groups forbid The Pill.  But it reproduces what a married couple does anyway.  Has any of them weighed in that "marital relations" during pregnancy is an abortion sometimes?

[velkyn]

^^^^^ good point.  I suppose the theist excuse would be "marital relations are god's will".   

[LoriPinkAngel]

NO!!  Although I do feel oral contraceptives should be more accessable they should NOT be sold over the counter.  The writer of this article is assuming the majority of users would be sophisticated and/or educated enough to obtain the safety information available about these pills and that is not the case.  A large number of women who use birth control pills are inner city teenaged girls and young immigrant women. They are unlikely to be surfing their iPads for instructions on the proper use of these pills.  Oral contraceptives contain hormones which can be dangerous if taken incorrectly and anyone who buys them should be councelled by a nurse or pharmacist on risks, side effects and proper use.

[Bereft_of_Faith]

NO!!  Although I do feel oral contraceptives should be more accessable they should NOT be sold over the counter.  The writer of this article is assuming the majority of users would be sophisticated and/or educated enough to obtain the safety information available about these pills and that is not the case.  A large number of women who use birth control pills are inner city teenaged girls and young immigrant women. They are unlikely to be surfing their iPads for instructions on the proper use of these pills.  Oral contraceptives contain hormones which can be dangerous if taken incorrectly and anyone who buys them should be councelled by a nurse or pharmacist on risks, side effects and proper use.

Your point seems to be a rather good argument for Planned Parenthood; Providing less restricted access for everyone, in conjunction with counseling and support.

[oogabooga]

I think that's not the best idea out there, but not for reasons Lori pointed out. There are different birth control pills on the market and the differences aren't in the name or manufacturer alone. A doctor can assess which type certain women can use after taking their thorough history, something that's utterly impossible for a layperson to figure out. They also have side effects (some can exacerbate or even cause acne while others can be used to treat them, for instance, they can also exacerbate problems with varicose veins, which can appear much earlier in life when there's a predisposition for them, some pills can contribute to early onset of estrogen/progesterone receptive cancers and so on), not to mention that they can be ineffective for some women and a simple change of prescription can solve such a problem. In such cases you'd need a trained professional to diagnose and treat such problems - and even suggest different, hormonal or non-hormonal types of contraception.

While I'm all for contraception in all shapes or forms, I'm also a fan of informed use of certain drugs that can potentially cause harm. I don't think it's as easy as the author of that article made it seem.

[Mooby]

Adding to what's been said, birth control pills have a lot of different side effects.  The hormones in many of the pills are the same that can cause uterine cancer if not regulated properly, and in certain women (such as smokers over age 35) they increase the risk of forming dangerous blood clots that can block blood flow to the lungs and cause death.  Also, before starting birth control pills, a woman should have a PAP test with STD screen and a pregnancy test.

Should over-the-counter birth control be available?  Yes, absolutely.  Is all birth control appropriate for over-the-counter distribution?  No, and chemical birth control falls into that category.

Those who may have difficulty filling a script should invest in some backup over-the-counter barrier methods, especially if they are with partners of unknown disease risk.  Only barrier methods can prevent STDs. 

[LoriPinkAngel]

"There are different birth control pills on the market and the differences aren't in the name or manufacturer alone. A doctor can assess which type certain women can use after taking their thorough history, something that's utterly impossible for a layperson to figure out."

I agree with the above plus my previous point.  Birth Control Pills are a medication that should be dispensed by a medical professional.  I also feel Planned Parenthood plays a big role in reproductive and general health for a lot of young, uninsured and underinsured women.  When I was in college my trips to Planned Parenthood to renew my BCP were my only medical exams.  It was the PA there that caught my thyroid problem.  Someone needs to inform the idiot picketers that Planned Parenthood is about a lot more than abortion.

[joebbowers]

... if nothing goes horribly wrong, a woman may give birth to twins born a month apart.

Those are not twins. They are merely siblings.

[screwtape]

Should over-the-counter birth control be available?  Yes, absolutely. 

heretic.  Don't let Pope Dracula find out you said that.  They are talking about excommunication for that sort of thing.

Someone needs to inform the idiot picketers that Planned Parenthood is about a lot more than abortion.

They know.  They just don't care. Abortion matters more to them than women's health.

Also, please learn to use the quoting function.  There is a link in my sig to a tutorial.  Click it and learn.

[Graybeard]

The following is taken from the British National Formulary. This is the authoritative document on all medicines available in the UK.

Of course, over the counter anything is fine.
All that is required is that each applicant for over the counter contraceptive pills is fully aware of the following:

Oestrogens . Antiepileptics (continued) contraceptive effect—see p. 439); oestrogens reduce plasma concentration of .lamotrigine . Antifungals: anecdotal reports of contraceptive failure when oestrogens given with fluconazole, imidazoles, itraconazole or ketoconazole; metabolism of oestrogens accelerated by .griseofulvin (reduced contraceptive effect—see p. 439); occasional reports of breakthrough bleeding when oestrogens (used for contraception) given with terbinafine . Antivirals: plasma concentration of ethinylestradiol increased by .atazanavir—avoid concomitant use; contraceptive effect of oestrogens possibly reduced by efavirenz; plasma concentration of oestrogens increased by fosamprenavir, also plasma concentration of fosamprenavir reduced—alternative contraception recommended; metabolism of oestrogens accelerated by .nelfinavir, .nevirapine and .ritonavir (reduced contraceptive effect—see p. 439) Anxiolytics and Hypnotics: oestrogens increase plasma concentration of melatonin . Aprepitant: possible contraceptive failure of hormonal contraceptives containing oestrogens when given with .aprepitant (alternative contraception recommended) . Barbiturates: metabolism of oestrogens accelerated by .barbiturates (reduced contraceptive effect—see p. 439) Beta-blockers: oestrogens antagonise hypotensive effect of beta-blockers Bile Acids: elimination of cholesterol in bile increased when oestrogens given with bile acids . Bosentan: possible contraceptive failure of hormonal contraceptives containing oestrogens when given with .bosentan (alternative contraception recommended) Calcium-channel Blockers: oestrogens antagonise hypotensive effect of calcium-channel blockers Ciclosporin: oestrogens possibly increase plasma concentration of ciclosporin Clonidine: oestrogens antagonise hypotensive effect of clonidine Corticosteroids: oral contraceptives containing oestrogens increase plasma concentration of corticosteroids Diazoxide: oestrogens antagonise hypotensive effect of diazoxide Diuretics: oestrogens antagonise diuretic effect of diuretics Dopaminergics: oestrogens increase plasma concentration of ropinirole; oestrogens increase plasma concentration of selegiline (increased risk of toxicity) Lipid-regulating Drugs: plasma concentration of ethinylestradiol increased by atorvastatin and rosuvastatin Methyldopa: oestrogens antagonise hypotensive effect of methyldopa . Modafinil: metabolism of oestrogens accelerated by .modafinil (reduced contraceptive effect—see p. 439) Moxonidine: oestrogens antagonise hypotensive effect of moxonidine Muscle Relaxants: oestrogens possibly increase plasma concentration of tizanidine (increased risk of toxicity) Nitrates: oestrogens antagonise hypotensive effect of nitrates Sitaxentan: plasma concentration of oestrogens increased by sitaxentan Somatropin: oestrogens (when used as oral replacement therapy) may increase dose requirements of somatropin Sugammadex: plasma concentration of oestrogens possibly reduced by sugammadex Tacrolimus: metabolism of oestrogens possibly inhibited by tacrolimus; ethinylestradiol possibly increases plasma concentration of tacrolimus Theophylline: oestrogens reduce excretion of theophylline (increased plasma concentration) Thyroid Hormones: oestrogens may increase requirements for thyroid hormones in hypothyroidism Vasodilator Antihypertensives: oestrogens antagonise hypotensive effect of hydralazine, minoxidil and sodium nitroprusside 

Progestogens Note Interactions of combined oral contraceptives may also apply to combined contraceptive patches ACE Inhibitors: risk of hyperkalaemia when drospirenone given with ACE inhibitors (monitor serum potassium during first cycle) Analgesics: risk of hyperkalaemia when drospirenone given with NSAIDs (monitor serum potassium during first cycle) Angiotensin-II Receptor Antagonists: risk of hyperkalaemia when drospirenone given with angiotensin- II receptor antagonists (monitor serum potassium during first cycle) . Antibacterials: metabolism of progestogens accelerated by .rifamycins (reduced contraceptive effect— see p. 439) . Anticoagulants: progestogens may enhance or reduce anticoagulant effect of .coumarins; progestogens antagonise anticoagulant effect of .phenindione . Antidepressants: contraceptive effect of progestogens reduced by .St John’s wort (avoid concomitant use) Antidiabetics: progestogens antagonise hypoglycaemic effect of antidiabetics . Antiepileptics: metabolism of progestogens accelerated by .carbamazepine, .oxcarbazepine, .phenytoin, .primidone, .rufinamide and .topiramate (reduced contraceptive effect—see p. 439); progestogens reduce plasma concentration of .lamotrigine . Antifungals: metabolism of progestogens accelerated by .griseofulvin (reduced contraceptive effect—see p. 439); occasional reports of breakthrough bleeding when progestogens (used for contraception) given with terbinafine . Antivirals: plasma concentration of progestogens increased by fosamprenavir, also plasma concentration of fosamprenavir reduced—alternative contraception recommended; contraceptive effect of progestogens possibly reduced by nelfinavir; metabolism of progestogens accelerated by .nevirapine (reduced contraceptive effect—see p. 439) . Aprepitant: possible contraceptive failure of hormonal contraceptives containing progestogens when given with .aprepitant (alternative contraception recommended) . Barbiturates: metabolism of progestogens accelerated by .barbiturates (reduced contraceptive effect—see p. 439) . Bosentan: possible contraceptive failure of hormonal contraceptives containing progestogens when given with .bosentan (alternative contraception recommended) . Ciclosporin: progestogens inhibit metabolism of .ciclosporin (increased plasma concentration) Diuretics: risk of hyperkalaemia when drospirenone given with potassium-sparing diuretics and aldosterone antagonists (monitor serum potassium during first cycle) Dopaminergics: progestogens increase plasma concentration of selegiline (increased risk of toxicity) Lipid-regulating Drugs: plasma concentration of norethisterone increased by atorvastatin; plasma concentration of norgestrel increased by rosuvastatin Muscle Relaxants: progestogens possibly increase plasma concentration of tizanidine (increased risk of toxicity) Sitaxentan: plasma concentration of progestogens increased by sitaxentan Sugammadex: plasma concentration of progestogens possibly reduced by sugammadex Tacrolimus: metabolism of progestogens possibly inhibited by tacrolimus .

I have had a glance through, and it is nothing that a 15 year old girl of limited intellect from some small, sleepy town in the middle of nowhere or the ghetto would not understand or at least, be aware of.

I suppose there will be the odd death or severe illness but I don’t think we should bother ourselves with that.

More seriously, in the UK, we have "repeat prescriptions" these work indefinitely once a medicine has been prescribed. It is up to the doctor to check every, say, year with the patient to endure nothing has changed and also for the patient to report any changes to the doctor as soon as they occur.

[Mooby]

Don't let Pope Dracula find out you said that.  They are talking about excommunication for that sort of thing.

Oh?

[screwtape]

Oh?

http://www.dummies.com/how-to/content/catholicism-excommunication-and-other-penalties.html

Catholics are automatically excommunicated for committing these offenses:
...

• Heresy: The obstinate post-baptismal denial of some truth, which must be believed with divine and Catholic faith.

The RCC teaches that any kind of birth control is pure, unadulterated evil.[1]  You are obstinately denying that truth.  You my friend, are in line for automatic excommunication.  In fact, it may have already happened.  Do you feel it?  Do you feel excommunicated? 

1.	including, but not limited to condoms, spermicide, vasectomy, "pulling out", or the "rhythm" method

[Mooby]

A "truth which must be believed with divine and Catholic faith" is dogma.  I'm pretty sure that saying "birth control should be available in stores" does not violate any Catholic dogma.

[pianodwarf]

The RCC teaches that any kind of birth control is pure, unadulterated evil including, but not limited to condoms, spermicide, vasectomy, "pulling out", or the "rhythm" method

The Catholic Church does permit use of the rhythm method.  (Probably because it means that you have to refrain from having sex for it to work.)  Even this one, though, is permitted only for limited reasons.  You're not allowed to use it simply because you want to control your reproduction, which is, of course, the main reason people use contraception.

"If there are serious reasons to space out births, reasons which derive from the physical or psychological conditions of husband and wife, or from external conditions, the Church teaches that it is morally permissible to take into account the natural rhythms of human fertility and to have coitus only during the infertile times in order to regulate conception without offending the moral principles which have been recalled earlier" (Humanae Vitae, 16).

[nogodsforme]

Catholic Italy and Spain have among the lowest birth rates in Europe. Either they are very self-controlled people, who only have intercourse once or twice in their entire lives, or they are all going to hell.  Or they are all gay. And they are also going to hell.

[screwtape]

A "truth which must be believed with divine and Catholic faith" is dogma.  I'm pretty sure that saying "birth control should be available in stores" does not violate any Catholic dogma.

Anti-contraception is dogma.  You are so going to burn in hell.

http://www.catholic.com/tracts/birth-control

Contraception is "any action which, either in anticipation of the conjugal act [sexual intercourse], or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible" (Humanae Vitae 14). This includes sterilization, condoms and other barrier methods, spermicides, coitus interruptus (withdrawal method), the Pill, and all other such methods.
...
The Church has always maintained the historic Christian teaching that deliberate acts of contraception are always gravely sinful, which means that it is mortally sinful if done with full knowledge and deliberate consent (CCC 1857). This teaching cannot be changed and has been taught by the Church infallibly.

bold mine

This is the same logic the church gives for it's position against artifical insemination, seat belts and vaccination.[1]

Then you've go this, from pope paul 6:
http://en.wikipedia.org/wiki/Christian_views_on_contraception#Current_view

One can find no period of history, no document of the church, no theological school, scarcely one Catholic theologian, who ever denied that contraception was always seriously evil. The teaching of the Church in this matter is absolutely constant

bold mine

and why?  To protect papal infalability:
http://en.wikipedia.org/wiki/Christian_views_on_contraception#Dissent

If it should be declared that contraception is not evil in itself, then we should have to concede frankly that the Holy Spirit had been on the side of the Protestant churches in 1930 ..., in 1951 ..., and in 1958 ... It should likewise have to be admitted that for a half century the Spirit failed to protect Pius XI, Pius XII, and a large part of the Catholic hierarchy from a very serious error. This would mean that the leaders of the Church, acting with extreme imprudence, had condemned thousands of innocent human acts, forbidding, under pain of eternal damnation, a practice which would now be sanctioned. The fact can neither be denied nor ignored that these same acts would now be declared licit on the grounds of principles cited by the Protestants, which popes and bishops have either condemned or at least not approved

Admit Popes make errors?  Heaven forbid.  Can't have that.

The Catholic Church does permit use of the rhythm method.

I included that because in some of the things I have read several articles about unnatural as well as natural birth control being heinous crimes against baby jesus.

1.	seat belts and vaccination are, of course, not against chruch doctrine, but by that logic, should be

[nogodsforme]

People should not do anything that would make their lives different from life in Europe circa 330 AD. Or else. 

[LoriPinkAngel]

 [/quote]

I included that because in some of the things I have read several articles about unnatural as well as natural birth control being heinous crimes against baby jesus.
[/quote]
 
Must not waste one...

[Mooby]

Anti-contraception is dogma.  You are so going to burn in hell.

http://www.catholic.com/tracts/birth-control

Contraception is "any action which, either in anticipation of the conjugal act [sexual intercourse], or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible" (Humanae Vitae 14). This includes sterilization, condoms and other barrier methods, spermicides, coitus interruptus (withdrawal method), the Pill, and all other such methods.
...
The Church has always maintained the historic Christian teaching that deliberate acts of contraception are always gravely sinful, which means that it is mortally sinful if done with full knowledge and deliberate consent (CCC 1857). This teaching cannot be changed and has been taught by the Church infallibly.

Humanae Vitae is an encyclical.  Encyclicals aren't dogmatic.  And CCC 1857 doesn't mention contraception.

One can find no period of history, no document of the church, no theological school, scarcely one Catholic theologian, who ever denied that contraception was always seriously evil. The teaching of the Church in this matter is absolutely constant

The main question is whether the teaching is ordinary and universal or just ordinary magisterium. 

Vademecum For Confessors Concerning Some Aspects of The Morality of Conjugal Life claims that the teaching against contraception is "definitive and irreformable," but it doesn't say the teaching is infallible.  There's speculation that it might be if one can infer that the teaching is both ordinary and universal (as opposed to just ordinary magisterium), but there's been no official statement either way.

Even if it is to be taken as infallible, it has not been the product of a Church Council or ex-cathedra Papal teaching, so it is not dogmatic.  Thus, disobeying it does not confer excommunication.

At any rate, those documents all have to do with using contraception.  I'm not aware of any teaching about allowing contraceptives to be made available (as opposed to, say, abortion, where helping someone procure abortion results in excommunication.)

and why?  To protect papal infalability:

Contraception has never been a part of any dogmas derived from Papal Infallibility.

[screwtape]

It is not clear to me what is or is not dogma, that there are different types of magesterium or that fatwas need be pronounced ex cathedra to be considered infallible.  If you could link some sources, it would help me evaluate.

I said excommunication had been discussed, and it has:
http://newsinfo.inquirer.net/breakingnews/nation/view/20100930-295226/Bishop-threatens-Aquino-with-excommunication-over-birth-control

[Mooby]

It's clearly a contentious issue within the Church.


Moving on...

So yeah, medically, we should try to make contraception as available as possible to the public.  However, the desire to do this should be balanced with managing personal health risk.  As I and a couple others mentioned, there are some valid medical reasons for wanting to keep hormonal birth control at the prescription level, while leaving barrier methods at non-prescription.

[joebbowers]

I don't even think access to contraception is the problem, I think it's about education. Most kids don't even use condoms when they're freely available. Hell they don't even bother to pull out. They need to be taught better.