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medpundit |
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Thursday, December 18, 2003Ah, you say, but the morning after pill is only a one-time pill, to be used only infrequently, so it's side effects aren't as potentially harmful as a once-a-day birth control pill taken over a period of years. Except there's no reason to think that the morning-after pill will be used appropriately, especially by teen-agers and others who are less discriminating about their health. It doesn't take much imagination to conjure the scenario of a woman taking the morning after pill once or twice a week just to avoid the hassle of going to the doctor to get regular birth control pills. The problem is, doing so would put her at risk for developing such potentially serious side effects as blood clots or high blood pressure - the same risks that are inherent in taking long-term birth control pills. Although it may seem paternalistic to require a doctor's visits to get a drug, there is a legitimate reason behind the requirement. Prescription drugs all share the same characteristic - they have side effects that must be screened for. Not everyone does well with oral contraceptives, and there are some who should never take them (such as those who have had blood clots, or a history of liver disease, or strokes, or coronary artery disease.) Making the morning after pill over the counter ignores all of these potential threats to the health of young women. It is, in the end, more of a political decision than a medical one. (You notice no one's clamoring to make medication for enlarged prostates over the counter, even though they're just as safe as the morning after pill - maybe safer.) And that's unfortunate, because it opens the way for other medications that should also remain prescription based, to go over the counter. UPDATE: Another view: Despite the warning labels being virtually the same with plan B (levnorgestrel) and ordinary pills, the real risk of Plan B is much lower. The risk of thrombosis with progestin-only pills is really quite low, if there is any risk at all. Morning -after pills used to be off-label Ovral or Lo-ovral, which do contain estrogen, Preven, with estrogen, is the other FDA-approved morning after pill. Plan B turned out to be less nauseating and more effective, and it is the one being approved for OTC use. Personally, I predict there will be a lot of irregular bleeding and first-trimester progestin exposure from Plan B and its improper use. I also think it will increase the number of unwanted pregnancies as women forgo the inconvenience and expense of a trip to the doctor's for an OC prescription which is more effective than Plan B. Not to mention an increase in STD's and cervical cancer as condom use falls by the wayside and diagnoses are delayed because of the aforementioned avoidance of a checkup. I could be a chicken little about all this, but many women will do just about anything to get out of an annual gyn checkup. That's true. posted by Sydney on 12/18/2003 08:01:00 AM 0 comments 0 Comments: |
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