Over-the-counter contractive pills to be offered without prescription
For the first time, women will now be able to buy certain progestogen-only oral contraceptive pills (POPs) from pharmacies without a medical prescription in the UK after the announcement from the Medicines and Healthcare products Regulatory Agency (MHRA).
Hana and Lovima, two brands of daily mini-pills that contain 75-micrograms desogestrel, were reclassified as pharmacy-only medicines by the UK’s drug regulator. This reclassification will improve access to contraception for women who are struggling to obtain pills through traditional avenues such as their GPs and sexual health clinics. Apparently, this is one of the landmark opportunities in women’s health in the 60 years since the contraceptive pill was first introduced on the NHS in 1961.
Asha Kasliwal, the president of the Faculty of Sexual and Reproductive Healthcare (FSRH) said,
“The fragmented sexual and reproductive healthcare system is notoriously difficult for women to navigate, and successive cuts to public health budgets have made it harder for women to get the contraception they need.”
Additionally, further cuts for local authorities could cause an increase in unplanned pregnancies and missed opportunities to optimise pre-pregnancy health. Currently, a third of births in the UK are unable to access contraception services from their preferred source and 45% of pregnancies are unplanned, according to Public Health England’s guidance on health matters.
Ashar also mentioned that funding and commission challenges had led to “overstretched” and “underfunded” services which were not sustainably supported to provide care to women and girls “either before or during a pandemic.” This means that GPs are not incentivised to provide these contraceptive services.
She said that the reclassification might reduce unnecessary pressures on GPs, who need to see patients for repeat prescriptions.
“However, reclassification of some brands is only the first step, and buying contraception should definitely not be the only solution,” she added. “We are calling for these pills to be available to everyone for free in community pharmacies, as well as the reclassification of other contraceptives.”
Tiffany Cheung, a Glasgow-based midwife, agreed that reclassifying other brands would be a good move.
Yet, she insisted that this would not solve “the root of the problem of not having enough GPs/sexual health clinics”.
“Since there are so many different contraception choices which will work for some people and some not as much, it’s very beneficial for women to speak to GPs before starting on a certain type of contraception.”
Unlike a traditional POP, desogestrel pills like Hana and Lovima can not only prevent pregnancy by thickening the cervical mucus but also inhibit ovulation. They are considered safe for most women of childbearing ages to take, whereas combined oral contraceptive pills (COCPs), which contain both synthetic estrogen and synthetic progesterone, require a doctor’s prescription as they carry risks to smokers aged over 35.
Buyers will need a brief consultation with a pharmacist before purchasing the tablets, which cost as little as £7.50 for a month’s supply. According to Maxwellia, a pioneering British pharma company that produced Lovima, the pills will be sold from the end of July at a retail price £10 per month. HRA Pharma, a European leader in emergency contraception that manufactures Hana said it would cost £9.95 for one month and £21.95 for three.
“It makes sense that COCPs still need a prescription since they carry an increased risk of blood clots which is mitigated by having regular blood pressure checks at the GP.”, said Dorothea*, a Scottish chemistry student that interviewed with The New Feminist.
She took Dianette as her first combined pills after having unbearable period cramps, which forced her to miss a few days of school every month. She further explained, “On Dianette, my cramps became manageable, my acne cleared and my mood swings became much less severe. My quality of life was improved. I did gain some weight, but I do not blame the pill”
However, Dorothea maintained that women should not have to pay for contraception due to a lack of availability on the NHS. “Being able to purchase them without prescription only increases access for those who can afford them”, she said. “It could also be handy in those situations when you forget to organise your next prescription before your pack runs out!”
“I am not keen on the idea of the contraceptive pill”, said Sandi Bishop, a British mother of three and violinist based in Paris who also interviewed with us. “I am concerned about the side effects of taking any medications. and I have only taken it for one month in my whole life.”
Instead, she strongly urged the use of condoms to avoid unplanned pregnancies. In fact, condoms are free and easier to obtain from some GPs, surgeries, commissioned services and sexual health clinics in the UK.
Meanwhile, the MHRA’s decision to change rules around desogestrel products follows a safety review by the Commission on Human Medicines (CHM) and a three-week public consultation.
Dr. June Raine, MHRA’s Chief Executive, pointed out that this ruling was “good news for women and families.”
She said, “Pharmacists have the expertise to advise women on whether desogestrel is an appropriate and safe oral contraceptive pill for them to use and to give women the information they need, to make informed choices.”
Dr. Edward Morristhe, the president of Royal College of Gynaecologists (RCOG) praised that this change was “a huge win for women and girls who will no longer face unnecessary barriers when accessing this type of contraception.”
He added, “Even before the pandemic, too many women and girls were struggling to access basic women’s health services. The consequences of this include an increase in the number of unplanned pregnancies, which can result in poorer outcomes for women and their babies. Enabling women and girls to access POP more easily and conveniently will give them more control over their reproductive health, which can only be a good thing.”
*Dorothea is a pseudonym used for student’s anonymity