BBC, (2021). Available at: www.bbc.co.uk/news/health-57384096 The Guardian, (2021). Available at: www.theguardian.com/society/2021/jul/08/contraceptive-pill-will-be-available-over-the-counter-for-the-first-time The Lowdown, (2021). UK Government, (2021). Available at: www.gov.uk/government/news/first-progesterone-only-contraceptive-pills-to-be-available-to-purchase-from-pharmacies

TOPIC

The progestogen-only pill is being made available over the counter: your questions answered

by The Lowdown · July 9, 2021

by Dr Melanie Davis-Hall · July 9, 2021

The UK’s drug regulatory body has announced that the progestogen-only pill is to be made available without a prescription for a small fee.

This is a huge step in the right direction. The progestogen-only pill is incredibly safe and effective – it can be used by most women irrespective of age, smoking status and many medical conditions. Getting your blood pressure and BMI checked is not necessary.

We have long advocated for this change and welcome any move from the UK Government to remove barriers to contraceptive access.

What we think

The Lowdown wholeheartedly supports the change in legislation which will make the progestogen-only pill available over the counter, without a prescription.

However, in making this change pharmacists and medical professionals need to be better trained to counsel women and help them recognise, understand and address their contraceptive side effects

We were shocked to find that in the Lovima Pharmacy Consultation Checklist for pharmacists, there was only mention of two side effects; bleeding and allergic reactions – and mention of very rare side effects thrombosis, liver problems and ectopic pregnancy.

Side effects are the number one reason that women discontinue contraception, or take it incorrectly – and The Lowdown strongly believes that not forewarning women about these, and helping them manage them, is a huge mistake.

The Lowdown proposes that the pharmacist discusses the possible side effects and explains that a woman may experience them – ensures she understands this, and advises her to come back to the pharmacist if they need further help or the side effects become intolerable.

Why is this change happening?

This decision comes on the back of a lengthy consultation period from the Medicine & Healthcare products Regulatory Agency (MHRA) on the proposal to make progestogen-only pills available from pharmacies.

The MHRA sought views from patients, pharmacists, prescribers, and a wide range of organisations including the Royal College of Gynaecologists, Royal Pharmaceutical Society, Faculty of Sexual and Reproductive Healthcare, and British Pregnancy Advisory Service.

The public consultation received almost 500 responses, with over 80% being in favour of the reclassification.

Why can’t women just get it from their GP?

Over the past few years, budget cuts to sexual health services have meant that women are finding it increasingly difficult to access their contraceptive of choice.

According to the Faculty of Sexual and Reproductive Healthcare, more than 8 million women of reproductive age are now living in an area where their local councils have reduced funding for these services.

This means that women are facing clinic closures, or longer waiting times, fewer appointments, and reduced staff or opening hours. This, combined with the backlog created from the pandemic has meant that women are increasingly losing their reproductive autonomy.

British Pregnancy Advisory Service, the UK’s largest abortion provider, told The Independent they provided the progestogen-only contraceptive pill to almost 10,000 women undergoing an abortion between May and October last year.

All Party Parliamentary Group on Sexual and Reproductive Health in the UK – Report:

Almost half of councils have reduced the number of sites delivering contraceptive services in at least one year since 2015, whilst 13% of councils have reduced the number of sites over multiple years.16
11% of councils reduced the number of contracts with GPs to fit LARC in 2018/19.17
SRH contraceptive services are being commissioned with a reduced service offer. This can lead to reduced access to different methods of contraception or discrepancies based on age, or residency
41% of GPs in England reported an increased number of appointments for contraceptive advice.18

Is this just in England?

Although healthcare is a devolved matter across the UK, this legislation will enable all British pharmacies to sell progestogen-only pills without a prescription. This means that it should be available in England, Wales, Scotland, and Northern Ireland.

What pill is it?

The progestogen-only contraceptive pills that will be sold over the counter are Lovima 75 microgram film-coated tablets, and Hana 75 microgram film-coated tablets. You can buy Hana online as well as Lovima here at The Lowdown.

These pills contain exactly the same ingredients as Cerazette, Cerelle, Zelleta, Desogestrel, Aizea, Desomono and Desorex. More information on brands available can be found on The Lowdown’s website here.

Both of these contain desogestrel and can be taken without having your blood pressure or BMI checked – irrespective of age, smoking status, and many other medical conditions that may need to be considered when prescribing different types of pill, such as the combined pill.

Why is it paid?

The UK Government provides free access to prescribed contraception through NHS prescriptions. As this pill is not prescribed, a small fee is incurred for the user.

It’s just like choosing to buy emergency contraception from the pharmacy. You can get it for free via your GP or for a small fee at a pharmacy.

How much does it cost?

The progestogen-only pills Lovima and Hana will be available for as little as £7.50 for a one month supply.

The Lowdown will start providing Lovima and Hana through our online ordering service in due course, and in the meantime you can buy other brands of the same pill through us.