Should contraception be available prescription-free?
Georgia Balmer investigates the introduction of prescription-free contraceptive pills and the potential dangers this could hold.
In theory, the idea of an over the counter contraceptive pill should be ushered in with bells and whistles. With GP waiting lists news-worthily overstretched, and many surgeries resorting to randomly scheduled phone-call consultations, getting a prescription for birth control is neither easy nor private, particularly post-COVID19. Whilst some may like discussing their sex life with a GP whilst grabbing some student essentials in Waitrose, I prefer to stare awkwardly at a stool chart within the privacy of the consultancy room.
The launch of Hana and Lovima 75 should therefore be a blessing; available prescription-free over the counter in pharmacies and online, these newly classified progestogen pills take most of the hassle out of procuring contraception. No more having to pre-plan picking up your next prescription, no more waiting for an appointment, and no more panicking if you lose a pack, buying the pill is now almost as easy as buying a condom. Yet the decision to take the pill is still complicated, prescription or no prescription.
Since the contraceptive pill became universally available in the UK on 4 December 1961, many variations have flooded the market. Choosing from the combined pill or the mini-pill (of which Hana and Lovima are descendants), the coil, the injection, the implant, the hormonal ring, or simply hoping and praying, means that even when easily accessible, picking a method of contraception is a minefield regardless of your reason for doing so.
female contraception and its side effects have a long history of not being taken seriously by medical professionals
The list of side effects for each method can be staggering, with a 2018 BBC documentary finding that the combined pill contributed to a rise in suicidal thoughts in some users, while the pill has long been associated with a small increase in risk for cervical and breast cancer. It is generally recommended that you take the combined pill for no longer than ten years, whilst progestogen-only pills have been proven to have less concerning side effects. However, among female friends, the side effects of weight gain, fluctuating libido, skin issues, fatigue and depression are anecdotally hard to ignore. In fact, a ground-breaking 1998 study found that 46 per cent of users who stopped taking contraception did so solely due to their side effects.
Whilst consumers need to answer set questions with a pharmacist or via an online questionnaire before purchasing Hana or Lovima, the lack of clear monitoring for potential side effects is concerning. The idea that an online questionnaire, which took me 15 seconds to complete, is equivalent to a trained GP’s opinion undermines the severity of these aforementioned side effects and could further discourage women from seeking help if they feel that their method of birth control is no longer healthy.
Although Dr Hardman has stated that she is “impressed” by the training materials given to pharmacists before they sell these new pills, pharmacists are not equipped to properly handle all of the potential side effects such as escalating depression or suicidal thoughts. Pharmacists also do not receive automatic access to a patient’s medical history, which could prove disastrous to women with a family history of certain conditions like heart murmurs.
There is also the issue of cost. Whilst Dr Harman has stated that these prescription-free pills should be free of charge because they’re “not a luxury item”, I am still paying for the pleasure of using a dry tampon each month so I’m not sure quite how much weight that opinion holds.
The Medicines and Healthcare products Regulatory Agency, who licensed the selling of Hana and Lovima, have stated that women will be able “to purchase” the pills, luxury items or not. Charging for the right to buy the pill prescription-free over the counter hardly seems to fit with Hana’s claim “that access to contraception should be convenient”, unless of course you can afford the £7.89 a month.
For some, the licencing of Hana and Lovima may well be the breakthrough that their manufacturers are touting. However, female contraception and its side effects have a long history of not being taken seriously by medical professionals. Marketing the pill as being as easy and hassle-free a purchase as a packet of condoms could potentially harm efforts to make birth control safer and, therefore, truly more ‘convenient’ for women.