The FDA announced yesterday that it had approved the first daily oral contraceptive pill for over-the-counter sales. That’s a big change. When the product, called Opill, hits the market (which could be as early as early 2024), Americans will be able to purchase hormonal contraceptives daily without a prescription. This is historic news, but it hides another first. In the coming months, Americans will also have access to over-the-counter medications for heavy cramps, cramps, headaches and even migraines. They will have access to prescription-free drugs for endometriosis and polycystic ovary syndrome. You will then be able to purchase medications that reduce the symptoms of menopause. It’s all in the same, progestin-based pill.
FDA approval cover only Opil is used as a form of birth control, but doctors have been prescribing progestin-containing pills for non-contraceptive needs for years. In most cases, interventions work more effectively when the pill contains both progestin and estrogen. Adding this second hormone of hers to the mix amplifies all the beneficial effects of a progestin, plus it helps control hormonal acne. It also gives you more flexibility with regards to timing. Progestin-only tablets (also called mini-pills) have a much shorter half-life in the body and must be taken within the same three hours each day, says Ann-Marie Amys, director of Pediatric and Adolescent Gynecology at Seattle Children’s. Erschlager says it’s far less reliable when it comes to preventing pregnancy. (Some women are prescribed progestin-only tablets because they are particularly sensitive to certain risks associated with estrogen.)
As a result, experts have told me that over-the-counter progestin-only tablets are far from the best way to treat these symptoms. “I think it can be used off-label, but I would be hesitant to use it off-label if a prescription for combined oral contraceptives is available through other means,” says Erin Fleurant, a family planning researcher at Northwestern Medicine. said Mr. . And if progestins themselves are really the right approach, an IUD, implant, or injection could be a more effective way of delivering the drug.
Despite the fact that progestins themselves aren’t usually a doctor’s first choice, “I don’t usually prescribe progestins,” said Veronica Adès, associate director of obstetrics and gynecology at Jacobi Medical Center. can It has significant benefits when taken alone. Amies Erschlager said he prescribed it to his patients to keep their periods down, especially if they were in pain or had heavy bleeding. Even low-dose pills (such as Opil) may help with control associated with menstruation and perimenopause. Migraineas well as mood swings due to premenstrual syndrome and premenstrual dysphoric disorder.
Progestin tablets can also be used for treatment endometrial hyperplasia, is an abnormal thickening of the endometrium (also known as the endometrium) that can develop into cancer.same endometriosisthe conditions that can affect the maximum 11 percent A condition in American women in which endometrial tissue grows outside the uterus. Ades said PCOS patients produce abnormally high levels of male hormones and typically have too much estrogen in their bodies compared to progesterone, the natural analogue of progestin. Progestin tablets can help you maintain a healthier balance.
At this time, there are few options for patients to alleviate these symptoms without medical help. Until Opill hits the market, the best non-prescription way to treat PCOS is a healthy diet and exercise, Amies Erschlager told me. If you have a heavy period, the best non-prescription option a patient can buy is an NSAID like ibuprofen. “For an over-the-counter daily hormone, this is the first in the United States,” she said.
Perhaps the best situation for using Opill off-label is as a stopgap. If you have started bleeding or cramps but are unable to schedule a doctor’s appointment or visit a doctor for several weeks, you can buy yourself a progestin-only tablet for the time being. Opill can also be a backup plan for patients who are already taking birth control pills for purposes other than birth control but can’t go to their doctor to renew their prescription or have a prescription filled out at a pharmacy. There is a possibility. .
Still, Adès warned that even a stopgap use might not be wise for endometriosis patients. For those with endometriosis, switching medications can cause a delicate hormonal imbalance and “create a series of problems.” Fleurand warned that some of the conditions that progestin pills may help alleviate may be related to very serious conditions that require a separate treatment regimen. “If you’re 45 and have bleeding and have a lot of other risk factors for uterine cancer, you don’t want them to pick up this drug and think it’s going to fix everything. she said. Instead, you should see a healthcare provider.
For most women who need contraception, single-hormonal agents like Opir are not the most reliable option. But starting next year, this could be the most convenient. The same trade-off between efficacy and access affects other uses of progestins.
