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Birth Control Health Center

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Going Over the Counter? Legislators to Debate Future of the Pill


Kate Curtis, PhD, is an epidemiologist at the CDC, where investigators are looking into the pill's relationship to breast cancer. The results will not be out for another year, she tells WebMD. But there is a chance that the CDC-sponsored study of 10,000 women will find a relationship between the pill and breast cancer in certain groups of women, she says.

Still, none of the several experts contacted by WebMD would go on record with reasons the pill should not be available over the counter.

The supporters have medical support for wanting to change the status of the pill to over the counter. When initially approved in 1960, the pill was linked to an increased chance of heart attack, stroke, and blood clots. But in the 1970s, the FDA approved several new versions containing much lower doses of hormones, decreasing the likelihood of any of these side effects. But the controversy over the new generation of birth control pills is still a focus of concern. For example, a study coming out tomorrow in a major medical journal will further report on the association between the pill and blood clots in the lung.

However, there are significant social advantages to offering the pill over the counter, Hatcher tells WebMD. For example, the costs would go down for a large number of women, eliminating perhaps one of the "greatest barriers to women obtaining contraceptives," he says. But the cost may actually go up for women whose insurance used to foot some of the bill, because insurance companies typically do not pay for over-the-counter drugs.

Moreover, women would be able to obtain the pill on a Sunday, when many women are scheduled to take their first pill in a 21-day regimen that includes one week off, Hatcher says. "It is one of the most important pills not to miss," he adds, while noting that in combination, these changes also could make the pill far more effective. The greatest barrier to its effectiveness is compliance, he tells WebMD.

Perhaps the greatest advantage of an over-the-counter oral contraceptive, according to both Grimes and Hatcher, is that the conversion of the pill to over-the-counter status would make it available for emergency contraception.

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