Prescription-Free Contraception – should it be available?

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By Eirian Jones | Comment Editor

According to the NHS Confederation, “unsustainable numbers of people are not visiting A&E, seeing their GPs and calling ambulances. Overwhelming demand is putting severe and unprecedented strain on the urgent care systems.” In other words – if making a GP appointment was difficult pre-Covid-19, it’s next to impossible nowadays. With many GP’s resorting to randomly scheduled phone calls and the completion of an online questionnaire – the theory behind an over-the-counter prescription free contraception pill, such as Hana or Lovima 75 has never been more desirable. 

Launched on the NHS 60 years ago, the Pill remains the most popular form of female contraception in the UK, taken by around 3.5 million women. In a bid to ‘increase choice for women’, similar to New Zealand, it is being made available over-the-counter at pharmacies, rather than solely via prescription. This is a ground- breaking change after years of campaigning against ‘unnecessary barriers’ for women and girls and has made obtaining basic women’s health services much more convenient and accessible. These progestogen pills reduce the ‘stress’ behind acquiring the pill; no scheduling appointments, no more awkward sex life talks with the doctor, no more panicking if you’ve lost a pack… all that would need to be done is a trip to the local pharmacist, answer a few questions and you now have your pill! 

However, the side effects of taking contraception have a long history of not being taken seriously by medical professionals. According to research, the combined pill has long been associated with an increase in risk for cervical and breast cancer, but it also has been seen to contribute to a rise in suicidal thought. The less severe but still serious side effects of acne, fatigue, nausea, weight gain and fluctuating libido have caused more that 46% of people to stop taking the pill due to the side effects alone. Figures from the MHRA in 2017 showed there had been 553 deaths in the UK with suspected links to the Pill since 1963.

It is not surprising then that the Therapeutic Goods Administration of Australia decided against allowing contraceptive pills to be sold over the counter for the second time since 2015, stating that the risks of the proposals outweighed the benefits. They believe that medical practitioner involvement is required. Although women must answer a short online questionnaire, reviewed by a pharmacist, it is generally thought that they are not fully trained to deal with the severe potential side effects such as depression and suicidal thoughts that may occur. Most importantly, pharmacists do not have automatic access to a person’s medical history, which could be extremely dangerous if a woman is unaware about certain family history or if she is particularly susceptible to certain side effects (such as increase in blood clots). 

The easier accessibility to the contraceptive pill will ultimately reduce the number of unplanned pregnancies and increase safety for women and girls, it also means not visiting a GP with repeat prescription requests during a post-pandemic NHS. However, questions will always remain over the pill’s safety. Time will only tell if this newfound accessibility is an overall positive or negative decision.

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