Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Scientific reasons against over the counter emergergency progestogens
- Ellen C G Grant (14 October 2005)
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Re: Scientific reasons against over the counter emergergency progestogens
- Jonathan A Barker (18 October 2005)
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Scientific reasons against OTC progestogens
- Ellen C G Grant (20 October 2005)
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Ellen C G Grant, physician and medical gynaecologist Kingston-upon-Thames, KT2 7JU, UK
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The FDA’s refusal to make progestogen emergency contraception available over the counter is being seen as due to political influences.1 Why is there not concern that progestagen exposures are an important cause of breast and other cancers? There is also a warning of the powerful immunosuppressive effects of repeated doses of progestogens in emergency contraceptives in the UK GP data base. For women who had used emergency hormonal contraceptives on two or more occasions the increased risk of multiple sclerosis was nearly three fold (Odds Ratio 2.8; 95% CI, 0.8-10.6).2 This preliminary result in UK women warns of possible further increases in serious illnesses. Over 60 conditions were increased in the Royal College of General Practitioners Oral Contraception Study including an increased risk of multiple sclerosis.3 A recent study by Susan Carmichael and colleagues in the October 2005 issue of Archives of Pediatrics and Adolescent Medicine also warns of the possible dangers to the fetus with progesterone use in early pregnancy of an increased risk of hypospadias. Any pregnancy-related progestin intake from four weeks before through 14 weeks after conception yielded an odds ratio of 3.7 (95% confidence interval [CI], 2.3 - 6.0), in 42 case mothers (8.4%) and 31 control mothers (2.4%). Over the counter emergency hormonal contraceptive use risks very large dose progestogen exposures in any undiagnosed early pregnancies. 1 Tanne J H.Another FDA expert resigns over emergency contraception delay. BMJ 2005; 331: 861-a 2 Alonso A, Jick SS, Olek MJ, et al. Recent use of oral contraceptives and the risk of multiple sclerosis. Arch Neurol 2005;62:1362-65. 3 Thorogood M, Hannaford PC. The influence of oral contraceptives on the risk of multiple sclerosis. Br J Obstet Gynaecol 1998:105:1296-99. Competing interests: None declared |
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Jonathan A Barker, Post-doctoral Research Assistant (Bioinformatics) EMBL-EBI, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SD
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Whether or not there are good scientific reasons against OTC sale of emergency contraception seems to miss the point. It seems pretty clear from the article that FDA decisions are being influenced rather seriously by a political agenda. This is undesirable, and quite worrying given the views on religion, politics and science prevalent in the current US administration. Competing interests: None declared |
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Ellen C G Grant, physician and medical gynaecologists Kingston-upon-Thames, KT27JU
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Mentioning the possible dire effects of exogenous progestogens on women and their children (as I have been investigating in my patients for 45 years) is only missing the point if you think that the aim of Emergency Contraception is political and not medical. I don't think politics, ethics and health are so easily separated. World overpopulation and harms from hormones cause huge medical and political problems which need to be faced whoever is in power in the USA. Competing interests: None declared |
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