• February 4, 2023

Contraception: Should the pill be sold over the counter?

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The government is asking the public if some birth control pills should be sold over the counter for the first time without a prescription.

A public consultation runs until Friday affects two progestin-only pills: Lovima 75-microgram tablets and Hana 75-microgram tablets.

Some people on social media have welcomed the idea of ​​improving women’s access to contraception, but others are concerned about whether women would receive the same standard of advice that they receive from general practitioners and sex clinics.

Here’s what doctors and pharmacists had to say.

What pills are we talking about?

The pills at the center of the consultation contain a hormone called progestin. When only progestogen pills became popular, they became known as the “mini-pill” because they do not contain estrogen like the combo pill does.

The Lovima and Hana pills are newer and contain a certain type of progestin called desogestrel – which is more effective than the original “mini pill”. Desogestrel can prevent pregnancy by stopping ovulation – the production of eggs every month.

Would they still be available from a family doctor?

Oral contraceptives, including the Lovima and Hana pills, require a prescription from general practitioners and sex clinics. The Medicines and Health Products Regulator (MHRA), which launched the consultation, says nothing will change if they are made available over the counter – but buying them from pharmacies would be another option.

Dr. Sonia Adesara, an NHS doctor and gender equality campaigner, says having additional availability at pharmacies will help the “many women” who are “unable to access their primary care physician and sexual health clinic.” make appointments in good time “.

“We need to think about the barriers that keep people from getting the access they need,” she says.

Image rightsDr. Sonia AdesaraImage descriptionAccording to Dr. Sonia Adesara, cuts in public health funding led to the restriction and closure of sexual health services.

Would the pill be free in pharmacies?

Contraception is free for most people on the NHS, and Dr. Adesara believes that the Hana and Lovima pills should also be pharmacy free if they are re-classified and available without a prescription.

“It’s not a luxury item, it’s a necessity for a lot of women,” she says.

According to the MHRA, women should “buy” the pills after “consulting a pharmacist”.

What about the health risks?

Dr. Sarah Hardman, who develops contraceptive guidelines for the Faculty of Sexual and Reproductive Health (FSRH), says she has “absolutely no concerns” that there will be “significant problems” with the progestin-only pill.

She says the progestin-only pill is “completely different” than the combined pill that has been linked to a slightly increased risk of developing health problems. No blood pressure controls are required for the progestin-only pill.

Dr. Hardman said she was “impressed” with the training materials that pharmacists were provided, including Checklists about health conditions and other medications go through with the patient.

Helga Mangion of the National Pharmacy Association says pharmacists in the community are “easily accessible health care professionals.”

“Pharmacists can identify a product’s suitability and any issues that need further advice,” she says.

What about side effects?

Dr. Adesara and Dr. Hardman agree that women can experience different side effects from the progestogen-only pill, such as: B. Changes that affect bleeding patterns, mood, and skin.

Dr. Hardman suggests that pharmacists should tell anyone using it for the first time to come back if they have “problems”.

But Laura Buckley, a pharmacist in the East Riding of Yorkshire and a member of the Primary Care Pharmacy Association, says pharmacists “make sure the patient understands any side effects that might arise”.

“We have to give patients the information so they can make an informed decision,” she says.

Can pharmacists access your medical records?

Laura says pharmacists in the community can access patient summary medical records when needed and with permission – one electronic recording of important information created from GP medical records.

She says pharmacists are “experts in medicine” and make sure “it is safe for sale”.

“We would ask all the relevant questions, ‘Have you had it before? Are you taking any other medication? What do you think and think of the drug?'” She says.

“The pills have a long history of safety and any monitoring that needed to be done could be done at the pharmacy or, if absolutely necessary, if you are concerned about anything, it could be referred back to a general practitioner.”

Image rightsLaura BuckleyImage descriptionPharmacist Laura Buckley says it would be “positive” if more contraceptives were considered for sale in pharmacies.

What if you need space to speak?

According to Laura, pharmacists can discuss concerns with patients in private consulting rooms without the need for pre-arranged appointments.

“If you walk by and think I want to ask a few questions, you are never obliged to buy anything,” she says.

“You don’t have to tell anyone what this is about, you can just ask to speak to the pharmacist and the pharmacist will come out and talk to you in the office as soon as possible.”

What about first birth control?

Dr. Adesara says she would advise anyone new to birth control, especially young women and teenagers, to research different methods because “each has different benefits and different side effects”.

“In fact, when you first start using birth control, I would advise you to speak to your doctor, doctor, or pharmacist – and then you can find out what is best for you,” she says.

Will women miss broader discussions with their family doctor?

A concern raised on social media in response to the public consultation was that making the pill over the counter could mean women spend less time talking to their GP and sexual health clinic on broader topics such as Discuss sexually transmitted infections and smear tests.

Dr. Adesara says it is “really important that people have the opportunity to speak to a healthcare professional”. She says the solution would be to train more general practitioners and allocate more resources to sexual health services.

But Laura says pharmacists “are in a great place” to discuss areas like sexual health in private counseling rooms.

Could other birth control pills be available over the counter in the future?

The MHRA is considering the Hana and Lovima pills because their manufacturers – Laboratoire HRA Pharma and Maxwellia Limited – have made reclassification requests.

The aim of the consultation is to seek the fullest possible view on the proposal to reclassify these products and “to seek the views of all stakeholders, including the public, before making a final decision on the proposed reclassification,” said a spokeswoman.

She added that “individual company reclassification requests for their products will be considered on a case-by-case basis”.

Jack

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