Over-the-counter hormonal birth control is now available in California and Oregon. Other states are hoping to follow their lead, and Presidential hopeful, Donald Trump has also declared his support for over-the-counter birth control. Considering that birth control has become synonymous with women’s health, this is not surprising. What seems to be missing from this discussion is the fact that oral contraceptive pills (OCP) are not vitamins or supplements; they are pharmaceuticals which come with long list of side effects and risks, as well as lifestyle and drug interactions.
When a woman obtains her prescriptions through her doctor’s office, the impetus is on the doctor to monitor her health and drug interaction concerns (whether they take this role seriously when it comes to birth control, is discussion for another day). But if OCP’s become available over-the-counter, only the pharmacist will be there to ensure her safety. The pharmacist, unlike the physician, has little idea who this woman is, what other medications she is on, or what lifestyle choices she may be making. Who then, will be left to will inform her or to monitor how these powerful pharmaceuticals (designed to disrupt a naturally, well-functioning endocrine system) are affecting her health.
We’ve previously examined the side effects and risks associated with OCP’s, and won’t address them here today. Rather, let’s look at lifestyle and drug interactions are even more ambiguous to the average pill user. Our unquestioning trust in OCP’s has blinded us to these concerns to the point that women believe these cross checks are irrelevant and unnecessary. On the contrary, information on these interactions is a serious concern for women’s health. If proponents get their way, and OCP’s become available over-the counter, there will be little to no regulation of what pill is taken by what women, and no regard for what her personal health needs are.
Lifestyle Interactions with Oral Contraceptives:
The most well-known lifestyle choice that significantly interacts with OCP’s is smoking tobacco. A wave of research in the late nineties researched the effect of smoking while taking OCPs and found that risk of blood clots, venous thromboembolism and stroke are significantly higher, specifically in women over the age of 35. The fight to make the public aware of the dangers of tobacco use has brought this dangerous interaction to light.
Smoking marijuana may also interact with oral contraceptives, although research is limited considering the very recent legalization of recreational marijuana in certain states. Nevertheless, health care providers are able to theorize that “Marijuana may have effects that counteract estrogen. Taking marijuana along with birth control pills might decrease the effectiveness of birth control pills.” Furthermore, marijuana has been found to have an adverse effect on the circulatory system by increasing heart rate and blood pressure. These symptoms are compounded when alcohol is used in conjunction with the drug. Combine this with the pill’s known association with a higher risk of blood clots and venous thrombosis, and the risks of this combination are easy to see.
Interactions of alcohol and caffeine use with hormonal contraceptives are limited, but worth noting. Alcohol consumption in women using OCPs has been seen to increase the central nervous system effects and blood levels of the alcohol. In other words, while taking OCP’s it may not take as many drinks for a woman to become tipsy. Oral Contraceptives are also seen to decrease the metabolism of caffeine, causing it to linger in your system longer. This may seem like a benefit to some, but according to the University of Illinois Health Center, the effects of the combination are significant enough to encourage women to know and look for the signs of caffeine overdose.
In addition to lifestyle interactions, a popular formulation of the pill (ethinyl estradoil/levenorgestrel) has 533 drug interactions to keep track of as well. Check out this helpful list compiled by the University of Illinois that takes a closer look at a few of those interactions including corticosteroids, over-the-counter pain killers, anti-seizure medications, anti-depressants and more.
Risks associated with hormonal contraception have been ignored to the point that most women do not believe there are any risks at all. The move to make contraception available over-the-counter will only worsen this information gap. The political term “Women’s Health” again overshadows the much more important health of a woman.
Women deserve better!
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Rachel Held Evans (a self professed pro-life, woman of faith, Christian feminist) recently wrote a blog entitled “Privilege and the Pill.” She wished to express her opinion, “as a pro-life woman of faith who supports affordable access to birth control.” Denny Burke and Andrew Walker wrote a response here 1 addressing the political concerns which prompted her blog. However, there were many additional points in Mrs. Evan’s piece that needed to be addressed. Continue reading