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FDA approves first nonprescription daily oral contraceptive

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Re: FDA approves first nonprescription daily oral contraceptive

#301

Earlier quoted context omitted.

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, mentall…

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…

>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.

Re: FDA approves first nonprescription daily oral contraceptive

#302
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.

Re: FDA approves first nonprescription daily oral contraceptive

#303
post #76

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-rese... Apparently a company's moving forward with an attempt to productize it: https://www.planaformen.com/ With an opt…

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.

Are you talking about condoms or hormonal birth control? Are there results on a study I can read somewhere about how often people lie about contraceptive use? Can't find anything.

Re: FDA approves first nonprescription daily oral contraceptive

#304

Earlier quoted context omitted.

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.

I agree, and I see a lot of false equivalence comparing BC to the dangers of Tylenol/acetaminophen/paracetamol in this thread. Yes, both are drugs and can be misused with disastrous or even fatal consequences. The important distinction is that you can use oral contraceptives correctly and still have seriously negative, life-altering side effects. There are alternatives which may be preferable and ideally every woman…

I think that it's really shitty that one can take hormonal birth control with perfect responsibility and encounter negative side effects. I also think it's really shitty that the US has the highest infant and maternal mortality rates in the developed world. I've had to deal with both sides (taking hormonal birth control, with some side effects; having a "high risk" pregnancy and being confronted with forced surgery that would increase my mortality burden, against empirical medical evidence but for insurance reasons). My philosophy is consistent: given that the hand of cards is shitty, I want to choose how I play the cards.

Ideally, as you say, folks should have full access to knowledgeable medical experts who can help guide them. Again, our mechanisms for delivery of care in the US don't allow that, and unfortunately our physician and nurse training doesn't facilitate that either. A lot of medical professionals insist that hormonal BC doesn't have side effects, many insurance companies don't cover experimentation to find the best method for a particular person, non-hormonal woman-controlled methods are underused in the US. Since medicine in the US is built around making money & defending against lawsuits, care gets lost.

Re: FDA approves first nonprescription daily oral contraceptive

#305
post #82

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 m…

Women talk about this a lot, you probably just don't have the sort of relationship where it would come up with very many women besides your wife. Most women I've spoken to about it have had bad experiences with at least one hormonal birth control, especially in mood, appetite, sex drive, energy levels, depression & anxiety, fitness, bleeding. The range of things hormones can affect is wide and sometimes subtle. There…

More popular globally actually. not in US.

Re: FDA approves first nonprescription daily oral contraceptive

#306

Earlier quoted context omitted.

I'm not sure the point you're making here. The potential danger of forgetting to use a condom or misusing one (like a condom that's too old) is also a child. Condoms are currently sold in truck stop bathrooms. I really see no distinction between a condom and a birth control pill. Even with misuse, making the pill more widely available will almost certainly be a social good. It will prevent more unwanted children.

Well you should, hormonal pills and latex are entirely different.

They are absolutely different, so we should discuss the actual risks of the pill and not the risks of misusing a contraceptive in general.

Which is why I don't get the point I responded to. "You might get pregnant if you misuse this" isn't something to consider when talking about OTC contraceptives. It's practically a tautological statement "If you misuse a contraceptive, you might get pregnant"

Re: FDA approves first nonprescription daily oral contraceptive

#307
post #299
post #62

Earlier quoted context omitted.

I'd like see the data that supports that. If true, we would do away with the prescription process altogether for most drugs.

> If true, we would do away with the prescription process altogether for most drugs. That might not be a bad idea. In theory, a prescription means that a doctor who has an intimate knowledge of the patient's health works with the patient to make a carefully-considered mutual decision about medication. In practice, much of the time the process is just a formality which imposes a huge time and financial cost on some pa…

I agree. Most of the "flow charts" systems already exist and are used today by the doctors and pharmacists. The only real barrier to opening these up to the public is they would need to be translated to layman terms and provided detailed definitions. WebMD and Drugs.com do this, but perhaps not well. We would also need some sort of guidance or check by the pharmacy just a to rule out the classic "WebMD says I'm dying" panick, or to order/interpret diagnostic tests.

Re: FDA approves first nonprescription daily oral contraceptive

#308

Earlier quoted context omitted.

Women talk about this a lot, you probably just don't have the sort of relationship where it would come up with very many women besides your wife. Most women I've spoken to about it have had bad experiences with at least one hormonal birth control, especially in mood, appetite, sex drive, energy levels, depression & anxiety, fitness, bleeding. The range of things hormones can affect is wide and sometimes subtle. There…

More popular globally actually. not in US.

Interesting, thanks. I didn't know that.

Re: FDA approves first nonprescription daily oral contraceptive

#309

Earlier quoted context omitted.

I would expect someone to explain it; if not technically a doctor then a nurse or such, which is consistent with my experience of medical appointments.

Sure, it should be explained, but the point is that there's no value in only enabling a scarce resource (doctors) to explain something that doesn't require any medical training (take this once a day at the same time). The pharmacist can explain it. You can put it in huge text on the packaging. You can text or email people. You could literally make someone DocuSign a single page PDF that just says "THIS ONLY WORKS COR…

"All of these options get the exact same message across without being inconvenient and causing people to miss taking their birth control because they couldn't get a doctor's appointment, etc. There are costs to making people go into a medical office that you can't ignore here."

I mean, the alternative already exists - online appointments. You can even get auto renewing prescriptions through the mail.

Re: FDA approves first nonprescription daily oral contraceptive

#310

Earlier quoted context omitted.

> It's that this exact moment is the first time in human history that women are capable of understanding "once daily". Contraceptives have a long-standing problem of people being unable or unwilling to follow the instructions, or not catching little nuances like "this pill lasts for 22 hours, so you really need to take it every day at the same time ". For a decent-looking summary, see ex. https://www.ncbi.nlm.nih.gov…

Empirically, how much does visiting a doctor change people’s understanding of “once daily”? Measured in percentage terms. Because that’s the important question here.

They have some data in the links in the article. There could be some bias there (pharma likes to guide subject answers, and they dont provide the methodology details), so we would probably need real world data. But based on that limited data it appears to be no different. In theory, the longer the pill is in use and the more people who use it, then the more likely it is that people in society understand that it's one's a day at the same time of day etc.
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