It was a bit of a shock to see an ad on Toronto transit to buy “birth control” online. People often use this general term to mean hormonal contraception. In this case, that is exactly what was meant. While they were not advertising over the counter (OTC) medication, it did raise some red flags.
Let’s start with OTC hormonal contraception. Some have been advocating for decades to include this option as it became increasingly common around the world. While I appreciate the difficulties some people have in accessing these medications, there are health concerns I cannot ignore.
Working in a sexual health clinic for three decades until 2012, I was always opposed. As sexual health counsellors, we did a full assessment of the client in terms of potential contraindications before sending them on to the doctor or Nurse Practitioner. We advised them to return in three months for their one year prescription.
At that time, we checked their blood pressure and asked the relevant questions about side effects. In some cases, they needed a different prescription. In other rarer cases, they needed to stop taking the medication.
I wrote an article on hormonal contraception in 2014 and another in 2016 outlining some of these issues. Venous thromboembolism (VTE) is a case in point. A blood clot can be deadly. Written in 2014, this study is still worth reading. Some hormonal contraceptives, like the third generation hormones in The Pill as well as the hormones in the birth control patch, have been implicated in increased VTE risk.
Lifestyle meds
The company advertising on Toronto transit calls their products “lifestyle meds”. (They also offer medication for erectile dysfunction.) Granted, the client must connect with a health care practitioner; but how do they assess blood pressure, for example?
In their FAQs, the answer to the question, “is this legal” states:
“Yes! In Canada, only a licensed healthcare practitioner can write a prescription, and only a registered pharmacist can fill that prescription. We are supported by leaders in the Canadian pharmacology and specialized medical fields. …adheres strictly to all the regulations set forth by all applicable Colleges of Pharmacists and Colleges of Physicians and Surgeons in which we operate.”
Who are these leaders? Which colleges of physicians and surgeons?
In Canada there is another issue worth mentioning: the loophole Big Pharma squeezes through to avoid the law on Direct to Consumer Advertising (DTCA). Women’s health advocates first noticed the trend with Pfizer and Wyeth’s Alesse, and then watched as other drug companies followed suit.
Online companies have taken the next step: publicly advertising online access to hormonal contraception for a price. The company advertising on Toronto transit charges $40.00 for this service in a country where universal access to health care, albeit with some essential omissions like pharma care and dental care, is one of the hallmarks of our society.
I am wondering about my next step: Toronto Transit management or the Society of Obstetricians and Gynecologists of Ontario. I am working up a head of steam.
Spring Talks Sex 