16 ms·

FDA approves first nonprescription daily oral contraceptive

285 points by pg_1234 3y ago

fswd 3y ago
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- nkohari 3y ago
  No, you definitely did not read that right.
- rimunroe 3y ago
  You did not. Some breast cancers are highly responsive to hormones. One of the ways these are treated is by altering the production of certain sex hormones.
  - genocidicbunny 3y ago
    Hormone therapy is fairly common for shrinking the cancer tumors prior to surgery or chemo, and also for post-treatment to reduce the chances of the cancer coming back. Birth control pills target those same hormones, and thus there can be unforeseen or dangerous interactions. The cancer warning in this post strikes me as the usual "do not take X if you're taking Y" warning they do in drug ads on TV in the US. Like when they used to show ads for SSRIs, they usually had a "Do not take $DrugName if you are already taking a MAOI"
- zffr 3y ago
  > Opill should not be used by those who have or have ever had breast cancer. Consumers who have any other form of cancer should ask a doctor before use. Opill also should not be used together with another hormonal birth control product such as another oral contraceptive tablet, a vaginal ring, a contraceptive patch, a contraceptive implant, a contraceptive injection or an IUD (intra-uterine device). you did not read this right at all.
  - fswd 3y ago
    > Consumers who have any other form of cancer should ask a doctor before use. I wonder why?
    - rimunroe 3y ago
      > I wonder why? Yes, I also wonder why you'd take that to mean it caused cancer. The thing you quoted doesn't indicate anything about it causing cancer. It says people with a certain medical condition shouldn't take it. Hormones can influence how fast certain cells get replicated, and it's important to not encourage cancer cells to replicate even more.
    - jabroni_salad 3y ago
      It's because cancer treatment fucks you up, big time, permanently, and a lot of your healthcare thereafter is going to need to be changed to accomodate it.
      - pc86 3y ago
        This is a big part of it. Most cancer treatment is literally "we're going to get as absolutely close to killing you as we can, and then stop at the last second, over and over and over again, and hopefully get you into remission." You can't do that and then turn around take drugs that mess with your hormones and expect everything to be totally fine without even a single conversation with a physician.
- candiddevmike 3y ago
  No, but maybe blood clots: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025417/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025417/
  - jxramos 3y ago
    Interesting never knew they had an ascribed mechanism in place. I like how the article funneled in from the generic physical causes MECHANISMS OF VENOUS THROMBOSIS to the particular HORMONE-INDUCED THROMBOTIC STATE, that was a great transition.
- marl0 3y ago
  Yes it can. It does cause an elevated risk in some people. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156851/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156851/ This is dangerous. While it gives people more access to contraceptives, someone should absolutely see a doctor first before beginning hormone therapy.
  - pevey 3y ago
    That is ridiculous. It's not like a doctor properly screens you for cancer before prescribing BCP. It's all about gatekeeping. It's not about health.
willcipriano 3y ago
> The contraceptive efficacy of norgestrel was established with the original approval for prescription use in 1973. HRA Pharma applied to switch norgestrel from a prescription to an over-the-counter product. For approval of a product for use in the nonprescription setting, the FDA requires that the applicant demonstrate that the product can be used by consumers safely and effectively, relying only on the nonprescription drug labeling without any assistance from a health care professional It took 50 years to make packaging that users could understand?
- huthuthike 3y ago
  More like no one bothered to apply to make it OTC until a year ago. In the US there is more money to be made from selling prescription medication.
  - ghaff 3y ago
    Generics at least aren't big moneymakers. With totally pedestrian insurance I pay next to nothing (or nothing) for the variety of meds that I take. Would probably cost more if I could buy them OTC.
    - parasense 3y ago
      Given the 50 years, I'd say the original investment has paid off many times over, and all the generic brands got their cut. It's more than fair to society to allow the medicine to go over the counter.
      - ghaff 3y ago
        Oh I'm not disagreeing in general. There are probably some classes of drugs like antibiotics which probably lend themselves to overuse/misuse and are probably best kept prescription only for the most part (agriculture overuse notwithstanding). But in general, if there's no good reason something shouldn't be OTC, it probably should be. I'm just saying generic prescription drugs don't necessarily have a huge price uplift vs. OTC.
lalaithion 3y ago
This is amazing, it will help a lot of people have access to a drug that can vastly improve quality of life without being gatekept by their doctor. Just one note about the phrasing of all the headlines: they’re phrased as if the FDA did a good thing, but it’s better to imagine this as the FDA _stopping_ doing a bad thing. The only reason that we haven’t had over the counter oral contraceptive for the last fifty years is because the FDA _didn’t_ allow it over the counter.
- jokowueu 3y ago
  What's odd is that in most of the middle east all non abusable drugs are over the counter . Not sure why it's not a thing in the US . Insulin was recently non otc because body builders abuse it ( deaths )
- candiddevmike 3y ago
  There's a bit more nuance here. There is certainly a political angle, but there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly.
  - pyuser583 3y ago
    We saw this with Theranos. They lobbied really hard to stop doctors from being gatekeepers to blood tests.
    - jrockway 3y ago
      What's the problem? Theranos committed fraud and their founder is in prison. Meanwhile, you can order blood tests. Early in the COVID pandemic I thought I had it at the very start. I got myself an antibody test and found that I didn't. Good data, and I didn't need to go wait in a doctor's office with a bunch of COVID patients.
  - runako 3y ago
    > but there may be risks, especially if folks don't take the medicine correctly. This describes every over-the-counter drug that has ever been sold. Keeping contraception prescription-only has always been about politics.
quantumstar4k 3y ago
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rozal 3y ago
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hanniabu 3y ago
This is great, now it can easily be shipped across state lines and given to women that can't access it because the state deemed it illegal
- giantg2 3y ago
  Which states have deemed it illegal?
  - phone8675309 3y ago
    None yet, but you have to have your head buried in the sand to think that at least a few won't make it illegal in the next decade.
    - rcstank 3y ago
      Is this not a slippery slope fallacy?
      - jshier 3y ago
        Not when people have publicly stated they're actively working to ban birth control, no.
      - giraffe_lady 3y ago
        It is not. Significant minorities of the anti-abortion movement are also anti-contraceptive. There are articles and even draft legislation published by these groups from 15+ years ago detailing the ultimate goal being bans on contraceptives. You could believe they can't achieve those goals, I guess, but believing they want to is not a fallacy in this context come on.
        giantg2 3y ago
        I can see that. It's very similar to significant minorities in the gun control movement. On either issue, premature movement to counteract them could bring more harm than good. Edit: why disagree?
NateEag 3y ago
This reminded me to look up Vasalgel again (a single-application, non-hormonal, long-lasting, reversible male contraceptive that is unfortunately not yet commercially available), and I see that it seems to have taken a meaningful step forward: https://www.parsemus.org/humanhealth/male-contraceptive-research/vasalgel-male-contraceptive/ https://www.parsemus.org/humanhealth/male-contraceptive-rese... Apparently a company's moving forward with an attempt to productize it: https://www.planaformen.com/ https://www.planaformen.com/ With an option like that in the wings, and not yet shown to have any ill effects in men so far, it's hard not to cynically think that hormonal birth control is pushed forward because a monthly or daily pill is far more profitable than a once-in-a-decade injection / flushing.
- raybb 3y ago
  Thanks for sharing about this. Looks like they're hoping for a wide market release in 2026. https://idahocapitalsun.com/2023/04/11/viable-male-birth-control-options-could-be-on-the-horizon/ https://idahocapitalsun.com/2023/04/11/viable-male-birth-con...
- babyshake 3y ago
  One thing that has occurred to me about these types of medications is men are seemingly more willing to lie than women about being on contraception. IMO that's just a reason to criminalize that type of deceptive behavior and not prevent people from having access to the drug.
  - webinvest 3y ago
    You could have a medical procedure certification card.
  - hombre_fatal 3y ago
    That doesn't make much sense to me since you can lie about a vasectomy or, more simply, about pulling out. Only the woman, at the end of the day, when it comes to men she can't trust, can either avoid getting raw-dogged OR take a contraceptive to be sure, herself, since she's the one at risk of getting pregnant.
jncfhnb 3y ago
Hmm idk. My anecdata of one wife had a really bad time with oral contraceptives. I feel like behavioral side effects are pretty insidious. She got pretty bad anger problems that would only appear to manifest with those she was very close to (and 95% of the time was me). It was difficult to convince her that her emotions were being selectively biased. Which is a bit of a causality minefield to get into. I worry that many women could just start taking this and have it derail their lives invisibly to them. Not that the doctors prescription step made this better per se. But it’s hard for someone to take a drug that can potentially materially alter your perception of things in ways that are not intuitive for you to observe. Switching birth control methods sucks. But this shit is not talked about enough. I lean towards believing the pill is riskier than it’s worth. Hormonal IUDs or copper IUDs feel like they’re a much safer choice (higher switching costs though and probably daunting for the very young).
- EatingWithForks 3y ago
  Counter anecdata: I know several women where oral contraceptives noticeably improved their lives, because their hormones were now being regulated. They got less mood swings and were way more stable. Also, women generally have a larger friend group than men and their friends are more encouraged to stage interventions if their lives are spinning out of control than men.
  - Astronaut3315 3y ago
    My wife included. She does far better with the pill than without. It’s not taken for birth control.
  - jncfhnb 3y ago
    That’s not a counterpoint. It’s a possible upside, but these things don’t net out across patients. > Also, women generally have a larger friend group than men and their friends are more encouraged to stage interventions if their lives are spinning out of control than men. This is a nonsense argument even if the premise may be true. This, in no way, makes the harm ok.
- thebooktocome 3y ago
chillydawg 3y ago
The pill can have pretty severe mental health impacts on women. I think as long as these are clearly signposted so that women know what they might be getting themselves into, then fair enough. Also tons of other side effects, some of which are pretty severe if taken in combination with the correct (eg most unlucky) underlying health issues.
- tiny_ta 3y ago
  I was on birth control for 5 years and had some friends on it too. My very anecdotal data is that: while none of us faced any mental health changes, there were some physiological changes that I did not like. You're right that there are women who maybe severely impacted mental-health wise. But I think the benefits outweigh this as the lack of ability to control one's reproductive life can also be debilitating, mentally. And I like to think that impact is not much worse than what alcohol, drugs, even cough syrup can do to one's mental health. At least birth control can be stopped and is not addictive.
  - basisword 3y ago
    Unless you’re an addict you’re not taking alcohol/drugs/cough syrup on a daily basis though. From my reading of this comment thread in general the issue really seems to be that you can’t see a doctor for free (at the point of use) in the US. Anecdotally I know a few people who have had difficult side effects on the pill, or medical issues which preclude them from using specific types. Speaking to a doctor once to get put on the best one for you, and then picking them up from the pharmacy monthly seems to work well and doesn’t seem like the “gatekeeping” people are ranting about in this thread. The idea that your pharmacist or doctor would have political or moral views on contraception that impacts their ability to do their job is crazy (to me). If that’s the case the entire system needs reviewed as opposed to making drugs available OTC.
    - pixl97 3y ago
      >The idea that your pharmacist or doctor would have political or moral views on contraception that impacts their ability to do their job is crazy (to me) Do you want to know how I know you're not from the US? Medicine is stupidly fucking political and religious here in the US. The system will be reviewed by your Christian elected official and validated by your Catholic hospital and affirmed by the SCOTUS and deemed satisfactory.
waihtis 3y ago
There's some interesting data on how contraceptives are changing the behaviour of people. Sounds straightforward given it's a hormone, but at the same time it's a bit alarming it's not any kind of discussion point when this topic is brought up
zackmorris 3y ago
This is a bigger deal than it might seem. When birth control pills arrived in the 1960s, they were seen as a tool of liberation that would free women from forced pregnancy. Then the pope came out against them in 1968: https://www.pbs.org/wgbh/americanexperience/features/pill-pope-issues-humanae-vitae-human-life/ https://www.pbs.org/wgbh/americanexperience/features/pill-po... That caused a population explosion everywhere, but especially Central and South America, which were predominantly Catholic. IMHO it all comes down to patriarchy. When I hear certain wealthy people and billionaires worrying about population collapse due to low birth rates, it reeks of that same male-dominated worldview. The same good ol' boy power structure which went to such great lengths in 2016 to block the first woman president and capture the Supreme Court to overturn Roe v. Wade. It's amazing to me that in 2023, women still had to get permission from their doctor to not get pregnant. And that the thousand whatabouts in the details of that are still discussed online and in otherwise polite conversation, as if that's anyone else's business.
- deleted 3y ago
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- regus 3y ago
  From the article: 'The Pill, Humanae Vitae declared, "... Man, growing used to contraceptive practices, may lose respect for the woman and come to the point of considering her as a mere instrument of selfish enjoyment, and no longer as his respected and beloved companion."' This statement seems pretty prophetic when you take a look at the dating scene today.
  - triceratops 3y ago
    > Man...may...come to the point of considering her as a mere instrument of selfish enjoyment And you think this never, ever happened pre-Pill? At least in today's dating scene, women are free to do the same thing. I personally think respect for women has never been higher than today - though there's still a long way to go. Because women have been able to achieve much more, now they have more choice over if or when to become a mother.
- 3y ago
stuckinhell 3y ago
As a woman, I fear most people don't understand how much hormonal birth control can increase blood clots, cancer risk, mood changes, and all sorts of side effects. There doesn't seem to be a free lunch when it comes to biological modifications. :(
- mberning 3y ago
  I agree. What are the chances that a young person taking this for the first time will recognize the side effects and know that it is from this vs something else. I guess they can always go to the doctor after the fact, but in some cases the harm will have already been done.
- lotsofpulp 3y ago
  Vasectomies are pretty close to a free lunch.
  - bamfly 3y ago
    Big advocate. They're awesome. Main downside is reversals are 1) another surgery—and maybe not covered by insurance—and 2) often fail. Not a great option if you do want kids, just not right now. I guess that's the not-a-free-lunch part. Excellent option if you are certain you're forever-done with having kids, though.
  - nodogoto 3y ago
    Chronic post-vasectomy pain syndrome negatively impacts quality of life in 1-2% of cases. Even a small chance of chronic pain should be weighed carefully against the benefits and alternatives.
- deleted 3y ago
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- deleted 3y ago
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jjkeddo199 3y ago
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- 38 3y ago
  This is the biggest red herring. Global population is at an all time high. We could lose 2 billion and be totally fine.
  - jjkeddo199 3y ago
    I am under 30. At current trajectory, my government (USA) will be unable to fund social security, medicaid, and medicare to care for me in my old age due to worsening working-youth:retired-elderly population ratio. I am concerned about unsustainable tax burden on the next generation youth. This problem will be worse in countries which don't attract immigrants.
    - ssnistfajen 3y ago
      Why are you suggesting that problem is caused by contraceptives? Birth rates in industrialized nations are cratering because the social and economic conditions in these countries have evolved to be fundamentally hostile to those who choose to have children. Pregnant women are almost universally punished by their employers especially in the private sector, childcare costs have gone through the roof, while the "career above all" koolaid is being shoved down our throats every single day. If people take contraceptives, it's because they don't want to have kids at that moment. Forcing these people to have kids will create broken parents and broken kids, who go on to become broken parents themselves and perpetuate the cycle. Most of modern society's problems can be traced to parents who should not have been parents in the first place. We don't need more of that.
      - jjkeddo199 3y ago
        The problems you mentioned are real, but I am not convinced they are the root cause for low birthrates. Do you think that Sweden, Norway, and Finland are hostile to parenthood?
gadflyinyoureye 3y ago
Good time to invest in a Burke for all your potable water needs. So many more hormone disrupting chemicals will be in traditional tap water.
prepend 3y ago
What will the cost be? It’s great that the medicine will be easier to get, but generic prescriptions are only $5. I pay $5 for a month of oral contraceptives, prescribed by doctor, and $10 for 90 days. My fear is that will be $40 at CVS and will actually be harder for people to use. For comparison, my 16g nasal spray (120 sprays) is $5 by prescription but much more over the counter.
- xenospn 3y ago
  Less than one child.
zapdrive 3y ago
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zarathustreal 3y ago
Endocrine-disrupting substances being sold over the counter.. I hope this doesn’t come back to haunt us
- nemo44x 3y ago
  Yeah, more estrogen will be added to the water supply unfortunately. 90% of birth control isn't metabolized and comes out in the urine. This can have effects for wildlife and possibly humans.
JamesAdir 3y ago
Writing this entire message without using the word "woman" once is just amazing. As someone living outside the US, I can't understand this mindset.
- reocha 3y ago
  Trans men and nonbinary people can take norgestrel, the language used is just following standard medical language.
  - nsxwolf 3y ago
    That language has been "standard" for what, about a year or two? Forgive people for being confused.
    - reocha 3y ago
      It's okay to be confused, I was just stating the reason.
- egoisticalgoat 3y ago
  Not sure why tho? A) It's not just women who take these contraceptives, and B) "Consumers" is no less accurate of a description
branon 3y ago
When will they come up with one that men can take? Burden has always been on the women to take the contraceptives. Aren't their reproductive systems more complicated than men's anyway? Will there ever be a pill that can make me shoot blanks for a while?
thinkingemote 3y ago
There's some evidence that oral contraceptives increase the risk of depression. Might be the old style "pill" than any new chemical however.
dayvid 3y ago
I'm amazed that with the level of technology we have, the main form of birth control outside of condoms are adjusting hormones. There has to be some other methods of birth control available that will easily allow couples to effectively manage pregnancy without weird side effects. I always though Vasagel was an interesting form of contraception (easily reversible procedure for men), but I haven't seen much progress.
quags 3y ago
This is great. My own experience with my wife and birth control have included * depo shot - which she did not have great experience with * the pill - which had barriers going to the doctor, to continue getting the prescription. This included a mix of planned parenthood, before we had insurance to get the prescription, and finally getting insurance and finding a doctor. * Finally an IUD For the pill, a once daily med all the information to know is given with the prescription. Having a pharmacist give this OTC, like say pseudoephedrine, giving the basic instructions for it is enough.
deleted 3y ago
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tohnjitor 3y ago
Hormonal birth control and its consequences have been a disaster for the human race. Typical testosterone levels (perhaps not just humans either but in other mammals as well) have been dropping significantly since approximately the time hormonal birth control became widely available. The drugs pro Before you snicker and make jokes, reduced testosterone in men has a strong correlation with depression, which leads to increased use of antidepressants which ALSO get into water supplies. I wonder what effects 50 years of microdosing an entire population with those will have. I believe it is possible that these drugs will someday become illegal or significantly restricted.
- Balgair 3y ago
  Before everyone goes asking : Source?, I want to caution one thing. Smoking increases testosterone levels[0]. Like any drug, nicotine has a variety of side effects, and one of them seems to be increasing testosterone levels (the exact measures here are complicated, read the article for more info). So, trying to untie the decease in smoking to a total decrease in male testosterone seems to be an active area of research and one that the literature is still working on. Maybe there is a falling amount that is not due to less smoking, maybe there isn't. [0] https://pubmed.ncbi.nlm.nih.gov/17163954/ https://pubmed.ncbi.nlm.nih.gov/17163954/
  - tohnjitor 3y ago
    I wasn't familiar with that but very interesting. The other factor besides pharmaceuticals and apparently decrease in tobacco use seems to be increased use of plastics.
jake_morrison 3y ago
I wish that everyone in the US had affordable, convenient, and private access to a doctor who could help them choose contraceptives and ensure no side effects. Unfortunately, that's not the case, so getting them over the counter is an improvement.
ironcurtain 3y ago
Good bye, USA. In 20-30 years all those celebrating this decision will be sitting in the assisted living facilities wondering who will be repairing the robots that are taking care of their parents. Demography is destiny.

285 points by pg_1234 3y ago

fswd 3y ago

[flagged]

nkohari 3y ago
No, you definitely did not read that right.
rimunroe 3y ago
You did not. Some breast cancers are highly responsive to hormones. One of the ways these are treated is by altering the production of certain sex hormones.
- genocidicbunny 3y ago
  Hormone therapy is fairly common for shrinking the cancer tumors prior to surgery or chemo, and also for post-treatment to reduce the chances of the cancer coming back. Birth control pills target those same hormones, and thus there can be unforeseen or dangerous interactions. The cancer warning in this post strikes me as the usual "do not take X if you're taking Y" warning they do in drug ads on TV in the US. Like when they used to show ads for SSRIs, they usually had a "Do not take $DrugName if you are already taking a MAOI"
zffr 3y ago
> Opill should not be used by those who have or have ever had breast cancer. Consumers who have any other form of cancer should ask a doctor before use. Opill also should not be used together with another hormonal birth control product such as another oral contraceptive tablet, a vaginal ring, a contraceptive patch, a contraceptive implant, a contraceptive injection or an IUD (intra-uterine device). you did not read this right at all.
- fswd 3y ago
  > Consumers who have any other form of cancer should ask a doctor before use. I wonder why?
  - rimunroe 3y ago
    > I wonder why? Yes, I also wonder why you'd take that to mean it caused cancer. The thing you quoted doesn't indicate anything about it causing cancer. It says people with a certain medical condition shouldn't take it. Hormones can influence how fast certain cells get replicated, and it's important to not encourage cancer cells to replicate even more.
  - jabroni_salad 3y ago
    It's because cancer treatment fucks you up, big time, permanently, and a lot of your healthcare thereafter is going to need to be changed to accomodate it.
    - pc86 3y ago
      This is a big part of it. Most cancer treatment is literally "we're going to get as absolutely close to killing you as we can, and then stop at the last second, over and over and over again, and hopefully get you into remission." You can't do that and then turn around take drugs that mess with your hormones and expect everything to be totally fine without even a single conversation with a physician.
candiddevmike 3y ago
No, but maybe blood clots: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025417/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025417/
- jxramos 3y ago
  Interesting never knew they had an ascribed mechanism in place. I like how the article funneled in from the generic physical causes MECHANISMS OF VENOUS THROMBOSIS to the particular HORMONE-INDUCED THROMBOTIC STATE, that was a great transition.
marl0 3y ago
Yes it can. It does cause an elevated risk in some people. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156851/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156851/ This is dangerous. While it gives people more access to contraceptives, someone should absolutely see a doctor first before beginning hormone therapy.
- pevey 3y ago
  That is ridiculous. It's not like a doctor properly screens you for cancer before prescribing BCP. It's all about gatekeeping. It's not about health.

willcipriano 3y ago

> The contraceptive efficacy of norgestrel was established with the original approval for prescription use in 1973. HRA Pharma applied to switch norgestrel from a prescription to an over-the-counter product. For approval of a product for use in the nonprescription setting, the FDA requires that the applicant demonstrate that the product can be used by consumers safely and effectively, relying only on the nonprescription drug labeling without any assistance from a health care professional It took 50 years to make packaging that users could understand?

huthuthike 3y ago
More like no one bothered to apply to make it OTC until a year ago. In the US there is more money to be made from selling prescription medication.
- ghaff 3y ago
  Generics at least aren't big moneymakers. With totally pedestrian insurance I pay next to nothing (or nothing) for the variety of meds that I take. Would probably cost more if I could buy them OTC.
  - parasense 3y ago
    Given the 50 years, I'd say the original investment has paid off many times over, and all the generic brands got their cut. It's more than fair to society to allow the medicine to go over the counter.
    - ghaff 3y ago
      Oh I'm not disagreeing in general. There are probably some classes of drugs like antibiotics which probably lend themselves to overuse/misuse and are probably best kept prescription only for the most part (agriculture overuse notwithstanding). But in general, if there's no good reason something shouldn't be OTC, it probably should be. I'm just saying generic prescription drugs don't necessarily have a huge price uplift vs. OTC.

lalaithion 3y ago

This is amazing, it will help a lot of people have access to a drug that can vastly improve quality of life without being gatekept by their doctor. Just one note about the phrasing of all the headlines: they’re phrased as if the FDA did a good thing, but it’s better to imagine this as the FDA _stopping_ doing a bad thing. The only reason that we haven’t had over the counter oral contraceptive for the last fifty years is because the FDA _didn’t_ allow it over the counter.

jokowueu 3y ago
What's odd is that in most of the middle east all non abusable drugs are over the counter . Not sure why it's not a thing in the US . Insulin was recently non otc because body builders abuse it ( deaths )
candiddevmike 3y ago
There's a bit more nuance here. There is certainly a political angle, but there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly.
- pyuser583 3y ago
  We saw this with Theranos. They lobbied really hard to stop doctors from being gatekeepers to blood tests.
  - jrockway 3y ago
    What's the problem? Theranos committed fraud and their founder is in prison. Meanwhile, you can order blood tests. Early in the COVID pandemic I thought I had it at the very start. I got myself an antibody test and found that I didn't. Good data, and I didn't need to go wait in a doctor's office with a bunch of COVID patients.
- runako 3y ago
  > but there may be risks, especially if folks don't take the medicine correctly. This describes every over-the-counter drug that has ever been sold. Keeping contraception prescription-only has always been about politics.

quantumstar4k 3y ago

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rozal 3y ago

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hanniabu 3y ago

This is great, now it can easily be shipped across state lines and given to women that can't access it because the state deemed it illegal

giantg2 3y ago
Which states have deemed it illegal?
- phone8675309 3y ago
  None yet, but you have to have your head buried in the sand to think that at least a few won't make it illegal in the next decade.
  - rcstank 3y ago
    Is this not a slippery slope fallacy?
    - jshier 3y ago
      Not when people have publicly stated they're actively working to ban birth control, no.
    - giraffe_lady 3y ago
      It is not. Significant minorities of the anti-abortion movement are also anti-contraceptive. There are articles and even draft legislation published by these groups from 15+ years ago detailing the ultimate goal being bans on contraceptives. You could believe they can't achieve those goals, I guess, but believing they want to is not a fallacy in this context come on.
      - giantg2 3y ago
        I can see that. It's very similar to significant minorities in the gun control movement. On either issue, premature movement to counteract them could bring more harm than good. Edit: why disagree?

NateEag 3y ago

This reminded me to look up Vasalgel again (a single-application, non-hormonal, long-lasting, reversible male contraceptive that is unfortunately not yet commercially available), and I see that it seems to have taken a meaningful step forward: https://www.parsemus.org/humanhealth/male-contraceptive-research/vasalgel-male-contraceptive/ https://www.parsemus.org/humanhealth/male-contraceptive-rese... Apparently a company's moving forward with an attempt to productize it: https://www.planaformen.com/ https://www.planaformen.com/ With an option like that in the wings, and not yet shown to have any ill effects in men so far, it's hard not to cynically think that hormonal birth control is pushed forward because a monthly or daily pill is far more profitable than a once-in-a-decade injection / flushing.

raybb 3y ago
Thanks for sharing about this. Looks like they're hoping for a wide market release in 2026. https://idahocapitalsun.com/2023/04/11/viable-male-birth-control-options-could-be-on-the-horizon/ https://idahocapitalsun.com/2023/04/11/viable-male-birth-con...
babyshake 3y ago
One thing that has occurred to me about these types of medications is men are seemingly more willing to lie than women about being on contraception. IMO that's just a reason to criminalize that type of deceptive behavior and not prevent people from having access to the drug.
- webinvest 3y ago
  You could have a medical procedure certification card.
- hombre_fatal 3y ago
  That doesn't make much sense to me since you can lie about a vasectomy or, more simply, about pulling out. Only the woman, at the end of the day, when it comes to men she can't trust, can either avoid getting raw-dogged OR take a contraceptive to be sure, herself, since she's the one at risk of getting pregnant.

jncfhnb 3y ago

Hmm idk. My anecdata of one wife had a really bad time with oral contraceptives. I feel like behavioral side effects are pretty insidious. She got pretty bad anger problems that would only appear to manifest with those she was very close to (and 95% of the time was me). It was difficult to convince her that her emotions were being selectively biased. Which is a bit of a causality minefield to get into. I worry that many women could just start taking this and have it derail their lives invisibly to them. Not that the doctors prescription step made this better per se. But it’s hard for someone to take a drug that can potentially materially alter your perception of things in ways that are not intuitive for you to observe. Switching birth control methods sucks. But this shit is not talked about enough. I lean towards believing the pill is riskier than it’s worth. Hormonal IUDs or copper IUDs feel like they’re a much safer choice (higher switching costs though and probably daunting for the very young).

EatingWithForks 3y ago
Counter anecdata: I know several women where oral contraceptives noticeably improved their lives, because their hormones were now being regulated. They got less mood swings and were way more stable. Also, women generally have a larger friend group than men and their friends are more encouraged to stage interventions if their lives are spinning out of control than men.
- Astronaut3315 3y ago
  My wife included. She does far better with the pill than without. It’s not taken for birth control.
- jncfhnb 3y ago
  That’s not a counterpoint. It’s a possible upside, but these things don’t net out across patients. > Also, women generally have a larger friend group than men and their friends are more encouraged to stage interventions if their lives are spinning out of control than men. This is a nonsense argument even if the premise may be true. This, in no way, makes the harm ok.
thebooktocome 3y ago

chillydawg 3y ago

The pill can have pretty severe mental health impacts on women. I think as long as these are clearly signposted so that women know what they might be getting themselves into, then fair enough. Also tons of other side effects, some of which are pretty severe if taken in combination with the correct (eg most unlucky) underlying health issues.

tiny_ta 3y ago
I was on birth control for 5 years and had some friends on it too. My very anecdotal data is that: while none of us faced any mental health changes, there were some physiological changes that I did not like. You're right that there are women who maybe severely impacted mental-health wise. But I think the benefits outweigh this as the lack of ability to control one's reproductive life can also be debilitating, mentally. And I like to think that impact is not much worse than what alcohol, drugs, even cough syrup can do to one's mental health. At least birth control can be stopped and is not addictive.
- basisword 3y ago
  Unless you’re an addict you’re not taking alcohol/drugs/cough syrup on a daily basis though. From my reading of this comment thread in general the issue really seems to be that you can’t see a doctor for free (at the point of use) in the US. Anecdotally I know a few people who have had difficult side effects on the pill, or medical issues which preclude them from using specific types. Speaking to a doctor once to get put on the best one for you, and then picking them up from the pharmacy monthly seems to work well and doesn’t seem like the “gatekeeping” people are ranting about in this thread. The idea that your pharmacist or doctor would have political or moral views on contraception that impacts their ability to do their job is crazy (to me). If that’s the case the entire system needs reviewed as opposed to making drugs available OTC.
  - pixl97 3y ago
    >The idea that your pharmacist or doctor would have political or moral views on contraception that impacts their ability to do their job is crazy (to me) Do you want to know how I know you're not from the US? Medicine is stupidly fucking political and religious here in the US. The system will be reviewed by your Christian elected official and validated by your Catholic hospital and affirmed by the SCOTUS and deemed satisfactory.

waihtis 3y ago

There's some interesting data on how contraceptives are changing the behaviour of people. Sounds straightforward given it's a hormone, but at the same time it's a bit alarming it's not any kind of discussion point when this topic is brought up

zackmorris 3y ago

This is a bigger deal than it might seem. When birth control pills arrived in the 1960s, they were seen as a tool of liberation that would free women from forced pregnancy. Then the pope came out against them in 1968: https://www.pbs.org/wgbh/americanexperience/features/pill-pope-issues-humanae-vitae-human-life/ https://www.pbs.org/wgbh/americanexperience/features/pill-po... That caused a population explosion everywhere, but especially Central and South America, which were predominantly Catholic. IMHO it all comes down to patriarchy. When I hear certain wealthy people and billionaires worrying about population collapse due to low birth rates, it reeks of that same male-dominated worldview. The same good ol' boy power structure which went to such great lengths in 2016 to block the first woman president and capture the Supreme Court to overturn Roe v. Wade. It's amazing to me that in 2023, women still had to get permission from their doctor to not get pregnant. And that the thousand whatabouts in the details of that are still discussed online and in otherwise polite conversation, as if that's anyone else's business.

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regus 3y ago
From the article: 'The Pill, Humanae Vitae declared, "... Man, growing used to contraceptive practices, may lose respect for the woman and come to the point of considering her as a mere instrument of selfish enjoyment, and no longer as his respected and beloved companion."' This statement seems pretty prophetic when you take a look at the dating scene today.
- triceratops 3y ago
  > Man...may...come to the point of considering her as a mere instrument of selfish enjoyment And you think this never, ever happened pre-Pill? At least in today's dating scene, women are free to do the same thing. I personally think respect for women has never been higher than today - though there's still a long way to go. Because women have been able to achieve much more, now they have more choice over if or when to become a mother.
3y ago

stuckinhell 3y ago

As a woman, I fear most people don't understand how much hormonal birth control can increase blood clots, cancer risk, mood changes, and all sorts of side effects. There doesn't seem to be a free lunch when it comes to biological modifications. :(

mberning 3y ago
I agree. What are the chances that a young person taking this for the first time will recognize the side effects and know that it is from this vs something else. I guess they can always go to the doctor after the fact, but in some cases the harm will have already been done.
lotsofpulp 3y ago
Vasectomies are pretty close to a free lunch.
- bamfly 3y ago
  Big advocate. They're awesome. Main downside is reversals are 1) another surgery—and maybe not covered by insurance—and 2) often fail. Not a great option if you do want kids, just not right now. I guess that's the not-a-free-lunch part. Excellent option if you are certain you're forever-done with having kids, though.
- nodogoto 3y ago
  Chronic post-vasectomy pain syndrome negatively impacts quality of life in 1-2% of cases. Even a small chance of chronic pain should be weighed carefully against the benefits and alternatives.
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jjkeddo199 3y ago

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38 3y ago
This is the biggest red herring. Global population is at an all time high. We could lose 2 billion and be totally fine.
- jjkeddo199 3y ago
  I am under 30. At current trajectory, my government (USA) will be unable to fund social security, medicaid, and medicare to care for me in my old age due to worsening working-youth:retired-elderly population ratio. I am concerned about unsustainable tax burden on the next generation youth. This problem will be worse in countries which don't attract immigrants.
  - ssnistfajen 3y ago
    Why are you suggesting that problem is caused by contraceptives? Birth rates in industrialized nations are cratering because the social and economic conditions in these countries have evolved to be fundamentally hostile to those who choose to have children. Pregnant women are almost universally punished by their employers especially in the private sector, childcare costs have gone through the roof, while the "career above all" koolaid is being shoved down our throats every single day. If people take contraceptives, it's because they don't want to have kids at that moment. Forcing these people to have kids will create broken parents and broken kids, who go on to become broken parents themselves and perpetuate the cycle. Most of modern society's problems can be traced to parents who should not have been parents in the first place. We don't need more of that.
    - jjkeddo199 3y ago
      The problems you mentioned are real, but I am not convinced they are the root cause for low birthrates. Do you think that Sweden, Norway, and Finland are hostile to parenthood?

gadflyinyoureye 3y ago

Good time to invest in a Burke for all your potable water needs. So many more hormone disrupting chemicals will be in traditional tap water.

prepend 3y ago

What will the cost be? It’s great that the medicine will be easier to get, but generic prescriptions are only $5. I pay $5 for a month of oral contraceptives, prescribed by doctor, and $10 for 90 days. My fear is that will be $40 at CVS and will actually be harder for people to use. For comparison, my 16g nasal spray (120 sprays) is $5 by prescription but much more over the counter.

xenospn 3y ago
Less than one child.

zapdrive 3y ago

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zarathustreal 3y ago

Endocrine-disrupting substances being sold over the counter.. I hope this doesn’t come back to haunt us

nemo44x 3y ago
Yeah, more estrogen will be added to the water supply unfortunately. 90% of birth control isn't metabolized and comes out in the urine. This can have effects for wildlife and possibly humans.

JamesAdir 3y ago

Writing this entire message without using the word "woman" once is just amazing. As someone living outside the US, I can't understand this mindset.

reocha 3y ago
Trans men and nonbinary people can take norgestrel, the language used is just following standard medical language.
- nsxwolf 3y ago
  That language has been "standard" for what, about a year or two? Forgive people for being confused.
  - reocha 3y ago
    It's okay to be confused, I was just stating the reason.
egoisticalgoat 3y ago
Not sure why tho? A) It's not just women who take these contraceptives, and B) "Consumers" is no less accurate of a description

branon 3y ago

When will they come up with one that men can take? Burden has always been on the women to take the contraceptives. Aren't their reproductive systems more complicated than men's anyway? Will there ever be a pill that can make me shoot blanks for a while?

thinkingemote 3y ago

There's some evidence that oral contraceptives increase the risk of depression. Might be the old style "pill" than any new chemical however.

dayvid 3y ago

I'm amazed that with the level of technology we have, the main form of birth control outside of condoms are adjusting hormones. There has to be some other methods of birth control available that will easily allow couples to effectively manage pregnancy without weird side effects. I always though Vasagel was an interesting form of contraception (easily reversible procedure for men), but I haven't seen much progress.

quags 3y ago

This is great. My own experience with my wife and birth control have included * depo shot - which she did not have great experience with * the pill - which had barriers going to the doctor, to continue getting the prescription. This included a mix of planned parenthood, before we had insurance to get the prescription, and finally getting insurance and finding a doctor. * Finally an IUD For the pill, a once daily med all the information to know is given with the prescription. Having a pharmacist give this OTC, like say pseudoephedrine, giving the basic instructions for it is enough.

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tohnjitor 3y ago

Hormonal birth control and its consequences have been a disaster for the human race. Typical testosterone levels (perhaps not just humans either but in other mammals as well) have been dropping significantly since approximately the time hormonal birth control became widely available. The drugs pro Before you snicker and make jokes, reduced testosterone in men has a strong correlation with depression, which leads to increased use of antidepressants which ALSO get into water supplies. I wonder what effects 50 years of microdosing an entire population with those will have. I believe it is possible that these drugs will someday become illegal or significantly restricted.

Balgair 3y ago
Before everyone goes asking : Source?, I want to caution one thing. Smoking increases testosterone levels[0]. Like any drug, nicotine has a variety of side effects, and one of them seems to be increasing testosterone levels (the exact measures here are complicated, read the article for more info). So, trying to untie the decease in smoking to a total decrease in male testosterone seems to be an active area of research and one that the literature is still working on. Maybe there is a falling amount that is not due to less smoking, maybe there isn't. [0] https://pubmed.ncbi.nlm.nih.gov/17163954/ https://pubmed.ncbi.nlm.nih.gov/17163954/
- tohnjitor 3y ago
  I wasn't familiar with that but very interesting. The other factor besides pharmaceuticals and apparently decrease in tobacco use seems to be increased use of plastics.

jake_morrison 3y ago

I wish that everyone in the US had affordable, convenient, and private access to a doctor who could help them choose contraceptives and ensure no side effects. Unfortunately, that's not the case, so getting them over the counter is an improvement.

ironcurtain 3y ago

Good bye, USA. In 20-30 years all those celebrating this decision will be sitting in the assisted living facilities wondering who will be repairing the robots that are taking care of their parents. Demography is destiny.