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Letters
Wednesday, April 26, 2006 12:00 AM

Teen sex cults!

Looks like the FDA has really lost it.

The letters thread is now closed.

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Wednesday, April 26, 2006 10:03 AM

To Charlie

The reason why plan B needs to be OTC is simple: It must be taken within 72 hours for it to be at all effective. Now this may not seem like much of a hardship to you, but imagine this (not uncommon, unfortunately) scenario. It's Friday night, your doctor's office is closed until Monday and you live in a rural small town where the closest access to emergency services for this could be more than 100 miles away. You somehow manage to get a prescription in time, you take it to the one pharmacy in the area and the pharmacist refuses to fill it, citing religous beliefs that it is evil. Not only do they refuse to fill it, they confiscate it (Oh yes, it has happened) so that you can't take it anywhere else to get it filled. By the time you manage to get another prescription and have found a pharmacy to fill it it's way to late. Throw in the fact that this type of scenario has happened to rape victims, and I should hope that it is now clear why access needs to be widely available. Especially now that there are several states with plans to adopt bills protecting pharmacists that refuse to fill (and also confiscate) prescriptions for Plan B and even birth control based on religious freedom grounds. Plan B is the only medication that I know of that can prevent a pregnancy AFTER the sex has already happened. And for all of the rape victims alone, it needs to be available OTC.

Wednesday, April 26, 2006 09:26 AM

I agree with alajrogers

That birth control should be doled out by your doctor. There are too many different types and they do many different things to your body. Ortho-Tri Cyclen caused severe mood swings in me and it took me months of going from depression to anger to elation in a matter of days to realize the pill was making me crazy.

Plus the side effects of the pill need to be discussed with you by a doctor as opposed to a once in a while usage of emergency contraception.

Wednesday, April 26, 2006 09:12 AM

I stand corrected

I admit, my understanding of the exact mechanics of Plan B, and the deleterious effects there of were lacking, however I think my central argument remains.

Plan B should not be the primary method of birth control available to young women over the counter.

There are better and less deleterious methods of birth control that should be made available first.

Focusing on Plan B when a better case can be made for other pharmaceutical methods of birth control to be sold over the counter is counterproductive and a waste of resources.

My issue was never that Plan B shouldn’t be made available over the counter (that is something that should be determined by a panel of disinterested scientists who would hopefully not be under the influence of any political agenda), but that a better argument can be made for over the counter status for the Pill, and as such a push for that should be a higher priority for those concerned about women’s reproductive health.

In addition, with regard to the idea that the pain involved with the use of Plan B would prevent it from being a regularly used method of birth control, I am not convinced.

If the first dose of Plan B causes the rapid onset of an intense menstruation, what would a second dose a week later result in? Will the woman’s body have replenished all that it had recently shed? If not, perhaps repeated dosing would result in a lesser effect, and would in fact encourage such use to prevent the harsh effect experienced when taken infrequently. Additionally, if there is an equally unpleasant effect each time the drug is used would that not encourage women to simply cross their fingers and hope, that this last time they weren’t fertile and as such Plan B is unnecessary?

Approval of Plan B for over the counter use, without first having the Pill approved would result in women (especially those who are economically disadvantaged) receiving less, and less safe medical care.

The purpose of Roe v. Wade was to ensure that safe access to reproductive health products and services would be available to women without government interference. It would seem a shame if this good was undone by the hubris of its own supporters.

This issue must be approached as a whole, a half solution (Plan B with out the Pill) may well be worse than no solution at all.

Again, I thank you for your consideration of my humble opinions.

Wednesday, April 26, 2006 08:54 AM

I don't think the Pill should be OTC

I'm in favor of Plan B being OTC because its side effects are unpleasant and one-time-only. You don't take cumulative damage from one dose of Plan B; it just makes you sick as a dog for a few days and then you're done with it.

However, I nearly killed myself because Ortho-Cyclen makes me paranoid and depressed, and neither my gynecologist nor my psychiatrist seemed to have any idea that my pills could even be in the running for my condition. If two doctors can't advise me that my pills are killing me, what happens if I don't have to see a doctor at all to get the stuff?

Also, the Pill is not $50. I have spent most of my adult life buying Pills (Ortho-Cyclen, Nordette, Levlen, and Yasmin) which were less than the $30 co-pay my insurance plan mandated for them on their formulary. And I live in the Northeast, where stuff is expensive in general. Admittedly even $30 may be a stretch if you're a teen; that's six Big Mac meals or two CDs, and teen priorities being what they are, I can see this being problematic. The trip to the doctor or NP to get the prescription is probably the bigger hurdle. I'm sympathetic to this. But there are so many different formulations of the Pill that there is no possible one "generic"; a generic of Nordette is not the same as a generic of Ortho-Cyclen is not the same as a generic of Mircette. It's hard enough for ordinary people buying OTC medications to keep track of what has pseudoephedrine or acetaminophen in it, and I can't tell you how many times someone has handed me acetaminophen when I asked them for ibuprofen or aspirin (acetaminophen does next to nothing for my headaches). Are ordinary women supposed to keep track of what has estrogens and what has progestins and in what dosages? There would be twenty generic Pills, all different, and women wouldn't know that they all have very different side effects which vary wildly from individual to individual, that the side effects can include not just weight gain (which I think everyone knows about) but exotic problems like depression and blood clots, and that they're not interchangeable (good luck with getting halfway through a pill pack, losing it, and deciding to pick up a mini-pill to replace it...) Teens, the very people going OTC is supposed to benefit, would be least savvy and understanding about what pill they need and what it can do to them without the advice of a doctor or nurse practitioner guiding them.

On the other hand, Plan B is consistent. It has, to the best of my knowledge, one basic formulation. Its side effects are well understood (although somehow never manage to be mentioned in the popular media, or we could kill this "teen sex cult" meme with "yeah, because every teen wants to spend three days with cramps and nausea all the time. Get a life.") And it's an emergency medication -- if you need it odds are you do not have time to get to a doctor and you don't have time to screw around with obnoxious pharmacists who won't fill it for you. Birth control, you have time to get -- it takes seven days to kick in anyway so it's not like you have to get it in a big rush because you're having sex tonight.

I'd like to see BC get cheaper too, but it's not like condoms are cheap -- my husband and I saved a lot of money when we were first dating and we switched from condoms to the Pill. If you have an active and monogamous sex life, the Pill is an infinitely better bargain than condoms even *if* you aren't insured, in my experience. (Of course, if you're active and non-monogamous, condoms are better because they protect from disease.) And given how many different Pills there are and how much every individual woman varies in her reaction to the different kinds, I think making it OTC is foolish. I am also not sure the price would drop much, given the sheer number of different formulations. Plan B, as an emergency med, has a much better rationale for going OTC than a maintenance med like BC.

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