Birth control pills over the counter

[lunallena]

I also think that some bcp's should be available at low cost or free and OTC.I have noticed that a lot of pregnancies occur when a woman's bcp prescription is over and she doesn't have the time or money to go to the doctor for a renewal. trust me this is annoying! This is how a lot of pregnancies on bc occur, when someone STOPs taking the pills after a while. Once you stop taking pills or miss more than a few pills you have to wait a certain # of days for the pills to kick in your system, and this is widely ignored. This is just my opinion as an user of bcps. Nice topic to discuss.

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[Beau Geste]

I also think that some bcp's should be available at low cost or free and OTC.I have noticed that a lot of pregnancies occur when a woman's bcp prescription is over and she doesn't have the time or money to go to the doctor for a renewal. trust me this is annoying! This is how a lot of pregnancies on bc occur, when someone STOPs taking the pills after a while. Once you stop taking pills or miss more than a few pills you have to wait a certain # of days for the pills to kick in your system, and this is widely ignored. This is just my opinion as an user of bcps. Nice topic to discuss.

There are condoms, foams, female condoms, spermicides, etc. that are available OTC for low-cost or even free from clinics.

Why can't a female have a supply herself for when her prescription runs out?

 

[lunallena]

then again, not everyone likes using these methods of contraception. I'm just saying for those who use bcpills it is an inconvenience having to go every 6 months to the doctor to get a prescription. Plus low cost bcp's will make them accessible to more women, many of whom don't even have health insurance.

There are condoms, foams, female condoms, spermicides, etc. that are available OTC for low-cost or even free from clinics.

Why can't a female have a supply herself for when her prescription runs out?

 

[Beau Geste]

then again, not everyone likes using these methods of contraception. I'm just saying for those who use bcpills it is an inconvenience having to go every 6 months to the doctor to get a prescription. Plus low cost bcp's will make them accessible to more women, many of whom don't even have health insurance.

If it's so inconvenient, why not do Depo Provera or other long-term type prescriptive.

You don't have to get a pap smear every time you get a new pack if you have a regular doctor. All it takes is a phone call for a new prescription, and it can be ready by the time you get to the pharmacy. Laziness is the culprit, not inconvenience.

 

[bananaface]

If it's so inconvenient, why not do Depo Provera or other long-term type prescriptive.

You don't have to get a pap smear every time you get a new pack if you have a regular doctor. All it takes is a phone call for a new prescription, and it can be ready by the time you get to the pharmacy. Laziness is the culprit, not inconvenience.

You don't need a pap smear to be prescribed BC pills. Some providers bundle services unnecessarily.

 

[deleted87716]

There are condoms, foams, female condoms, spermicides, etc. that are available OTC for low-cost or even free from clinics.

Why can't a female have a supply herself for when her prescription runs out?

Because hormonal contraceptive products, unlike the other OTC products you mentioned, carry a small, but very real risk of potentially fatal blood clots (particularly in smokers over 35 y/o), breast cancer (particularly in women with a personal history of breast CA), menstrual irregularities, and other side effects (nausea, breast tenderness, etc.)

Also, because there are myriad choices in oral contraceptives (monophasic, triphasic, different estrogens and progestins in different doses, etc.), and there's no way a patient is going to be able to decide for herself which pill she needs. If only one pill is made available OTC, which one? "One size fits all" definitely doesn't apply to OCs.

OCs are most safely and effectively used in in patients who have received appropriate screening and counseling in their use and potential side effects, along with ongoing monitoring for safety and efficacy. That's what the annual doctor's visit is for.

 

[deleted87716]

Laziness is the culprit, not inconvenience.

Honestly, if a patient can't manage to get to her doctor once a year to have her OC prescription renewed, I'd have to question her ability to reliably take a pill at the same time, every day in the first place. OCs aren't for the unmotivated.

 

[Beau Geste]

You don't need a pap smear to be prescribed BC pills. Some providers bundle services unnecessarily.

This I know.

Women who are using BCPs, though are typically using them for sex, not hormone regulation. Sex carries risk of STDs and pregnancy, therefore girls who are at the beginning of their sexual activity or those engaged in sexual activity (especially casual sexual activity) probably ought to think about the yearly pap.

 

[Beau Geste]

Because hormonal contraceptive products, unlike the other OTC products you mentioned, carry a small, but very real risk of potentially fatal blood clots (particularly in smokers over 35 y/o), breast cancer (particularly in women with a personal history of breast CA), menstrual irregularities, and other side effects (nausea, breast tenderness, etc.)

Also, because there are myriad choices in oral contraceptives (monophasic, triphasic, different estrogens and progestins in different doses, etc.), and there's no way a patient is going to be able to decide for herself which pill she needs. If only one pill is made available OTC, which one? "One size fits all" definitely doesn't apply to OCs.

OCs are most safely and effectively used in in patients who have received appropriate screening and counseling in their use and potential side effects, along with ongoing monitoring for safety and efficacy. That's what the annual doctor's visit is for.

Either you misred my post or I was not clear enough, but I meant, why can't a female have a BACK-UP supply of things such as condoms, spermicides, foams, etc. when her pills run out and she can't get to the pharmacy?

You made my point, though, BTW, thanks .

 

[nikibean]

Because hormonal contraceptive products, unlike the other OTC products you mentioned, carry a small, but very real risk of potentially fatal blood clots (particularly in smokers over 35 y/o), breast cancer (particularly in women with a personal history of breast CA), menstrual irregularities, and other side effects (nausea, breast tenderness, etc.)

Also, because there are myriad choices in oral contraceptives (monophasic, triphasic, different estrogens and progestins in different doses, etc.), and there's no way a patient is going to be able to decide for herself which pill she needs. If only one pill is made available OTC, which one? "One size fits all" definitely doesn't apply to OCs.

OCs are most safely and effectively used in in patients who have received appropriate screening and counseling in their use and potential side effects, along with ongoing monitoring for safety and efficacy. That's what the annual doctor's visit is for.

Yup. And the every-three-months issue allows a doc to change a woman to another method if she's got certain side effects. It's a re-evaluation. We actually have a "supply only" option in family pact for people who are just able to pick up a prescription and are on top of their healthcare needs. You'd be surprised how often I hear a "by the way" when I do simple OC refills. It's a good thing to check in once in a while with someone who can give (hopefully!) good advice.

 

[peterpansy]

Honestly, if a patient can't manage to get to her doctor once a year to have her OC prescription renewed, I'd have to question her ability to reliably take a pill at the same time, every day in the first place. OCs aren't for the unmotivated.

I agree with most of what's been said on this post about why birth control pills shouldn't be made available OTC. However, I find comments like this one a bit annoying. Here's why - I'm not sexually active, I've been on birth control for a few years to regulate my periods. I've tried going off several times, and I get a slew of symptoms that I don't want to have to deal with. Obviously at this point, I know which bcp's work for me, i don't have any side effects, i know the risks - but considering my age and that i don't smoke, they're not that significant. Still, I have to call in for a refill every month or two (because for whatever reason my PCP insists on only renewing the Rx for that long) which means I have to remember to do it at least a week before i need a new pack. That in itself is inconvenient (don't tell me it's not - most people forget to call their mom for mother's day, and that's only once a year, not once every two months). Add to that the fact that I'm currently in London for five months and can't get a refill at all. So I'm not on birth control any longer. It's fine for me since, as I said, I'm not sexually active, but I can't imagine how women in similar situation who are active deal with all the hassle.
As for having to have a pap smear and pelvic once a year - can someone explain to me why I have to go through the discomfort just because I'm over 18, even if I'm not active? And besides the physical discomfort I also mean the weird look I get from my PCP (who's also my gyno) every time i tell him I'm not sexually active.
Also, what's the point of having all the different options of OC's on the market if my insurance won't cover them?

 

[deleted87716]

I find comments like this one a bit annoying.

That certainly wasn't my intention.

I have to call in for a refill every month or two (because for whatever reason my PCP insists on only renewing the Rx for that long)

I find that very unusual. Have you requested of your PCP that he/she allow you more refills? Most physicians refill OCs for one year. You may consider changing doctors if this is a major issue for you.

Add to that the fact that I'm currently in London for five months and can't get a refill at all.

Did you discuss your travel plans with your doctor prior to your trip? I have patients who travel all the time, and we figure out a way for them to get their medications refilled. This issue comes up with all prescriptions, not just OCs.

I can't imagine how women in similar situation who are active deal with all the hassle.

I have yet to have a patient tell me that seeing me once a year is a "hassle." You're supposed to see your dentist twice a year. I hope you don't consider taking care of your teeth a hassle, too.

 

[peterpansy]

That certainly wasn't my intention.



I find that very unusual. Have you requested of your PCP that he/she allow you more refills? Most physicians refill OCs for one year. You may consider changing doctors if this is a major issue for you.



Did you discuss your travel plans with your doctor prior to your trip? I have patients who travel all the time, and we figure out a way for them to get their medications refilled. This issue comes up with all prescriptions, not just OCs.



I have yet to have a patient tell me that seeing me once a year is a "hassle." You're supposed to see your dentist twice a year. I hope you don't consider taking care of your teeth a hassle, too.

Most of the problems I have are actually with my PCP and not with the fact that OC's aren't available over the counter. The rant is just a result of being moody and hormonal (one of the resons i would rather stay on OC) And I am planning on switching to a new PCP, it's just difficult to work things like that out when I'm only home for a few weeks out of the year (the rest of the time I'm away at college). But thanks for responding and being nice about it. And I do see my dentist twice a year (at least), and I enjoy every visit (even having a wisdom tooth removed was a rather pleasant experience - blame it on lidocaine).

 

[vesper9]

That certainly wasn't my intention.



I find that very unusual. Have you requested of your PCP that he/she allow you more refills? Most physicians refill OCs for one year. You may consider changing doctors if this is a major issue for you.



Did you discuss your travel plans with your doctor prior to your trip? I have patients who travel all the time, and we figure out a way for them to get their medications refilled. This issue comes up with all prescriptions, not just OCs.



I have yet to have a patient tell me that seeing me once a year is a "hassle." You're supposed to see your dentist twice a year. I hope you don't consider taking care of your teeth a hassle, too.

how easy it is to label all women lazy without knowing the facts.

My Kaiser plan only allows me 3 months of BC at a time. I can't refill that until I have finished the first week of the 3rd month (which I found out after waiting and waiting for a refill that was cancelled b/c I requested it right before my last month's pack). Exceeding these limits is VERY hard through managed care. When my ex-roommate was going abroad she also got a big hassle from Kaiser when she asked for 6 months (2 refills). I don't remember if she finally got them to acquiesce or went to PP.

oh and if my boyfriend had to be on BC you can bet we'd have at least 3 children already


I think this is a good, informative article about the pros and cons of OTC BC...lost of opinions from pharmacists, doctors, PP, community activists...etc
http://eastbayexpress.com/Issues/2005-06-22/news/feature.html

 

[deleted87716]

how easy it is to label all women lazy without knowing the facts.

If you can point out where I did that, I'll happily apologize (Hint: I didn't, so don't waste your time).

 

[PineappleGirl]

I think there really needs to be some reforms made on the issue of OCs. While OTC would be nice for me, and for other people who have been on the same OC for a long time, have no ill effects and are well aware of the risks, it's just not too practical for people who are just starting OCs, who are not aware of the risks, and who probably shouldn't be taking OCs, such as people who smoke and are over 35, etc. What I would like to see is some sort of long standing "prescription" card for people like myself who have been consistently taking OTCs and have no issues with them. I say prescription in quotes because it would not really be an Rx, but a sort of certification, signed by a doctor, showing that people have been taking the OC for awhile, are cleared medically, and are aware of the risks. People could then present this certification/ "prescription" to any pharmacist and get their OC with no problems: no insurance issues, etc and they could ask the pharmacists questions or discuss any problems. Virtually OTC. Of course, this would only be really great if the OCs were low cost. I wouldn't want to pay the $45 a pack they cost without insurance just to have this convenience, but this would be great with low cost Rxs. Just an idea.

I also think it's totally ridiculous to expect women to submit to a pap just to get OCs, especially if they have never been sexually active. I understand the public health perspective on this in screening for HPV/ cervical cancer, but I feel it is somewhat oppresive to women. You don't make men submit to prostate exams before they can buy condoms!

And I thought I'd throw this quote into the mix too. Not that I entirely agree, but I think it raises a good point:

"I've often felt that on public health grounds, oral contraceptives should be available over the counter and cigarettes by prescription only"
David Grimes, MD

 

[DownonthePharm]

I hope birth control pills dont hit OTC status. They will end up 3x as expensive.