Since Hana® and another progestogen-only pill became available to buy over the pharmacy counter without prescription, people have had a lot of things to say about it.
Some people are concerned that the pharmacist’s consultation won’t be as robust as a doctor’s, others question our use of the words ‘women and people with uteruses’, and many want more contraceptive options for men and people with penises.
In this article, we’re going to directly address and discuss some of the questions and concerns that people have been raising on our social media channels.
How can it be safe to buy a contraceptive pill from a pharmacist?
As you may know, there are different types of contraceptive pills. The combined contraceptive pill contains synthetic versions of the naturally occurring hormones oestrogen and progesterone, whereas the progestogen-only pill contains – you guessed it! – a synthetic version of the naturally occurring hormone progesterone.
The progestogen-only pill does not contain oestrogen, which means it is suitable for some people who cannot take oestrogen, such as women and people with uteruses over the age of 35 who smoke and people who are on certain medications or who have specific health conditions.
As Hana® and other progestogen-only pills only contain progestogen, blood pressure checks are not required to use them.
The progestogen-only pill is available over the pharmacy counter, but that doesn’t mean you just ask for it and buy it. You will need to have a consultation with a pharmacist – either in person or by completing an online questionnaire – which is then checked by a qualified pharmacist before proceeding.
Pharmacists complete a five year degree and undergo regular training, so are fully qualified to dispense contraception. Your pharmacist will ask all the questions a doctor would ask you, and are available to answer any questions you may have about your contraception.
Does tracking your menstrual cycle work as a contraceptive method?
There are a lot of different ways people choose to help them prevent pregnancy. Some people use fertility tracking – tracking their menstrual cycle and ovulation, often with the help of an app – and using contraception around their most fertile days, whilst having unprotected sex on ‘safe’ days.
This method requires really accurate calculations. Ovulation typically occurs in the middle of your cycle, but it varies from person to person – and sometimes from month to month.
Ovulation typically lasts from 12-24 hours, after which the egg dissolves and can no longer be fertilised, but sperm can live inside the body for up to 5 days after unprotected sex. Some people have irregular cycles, and your cycle can be affected by things like stress, sleep and weight loss or gain.
It can be hard to be accurate enough to reliably prevent pregnancy using this method. If you’re interested in trying this method, make sure you’re comfortable with and able to regularly take your body temperature and track your cervical mucus as well as keep a close eye on your menstrual cycle.
Is making the progestogen-only pill available to buy over the pharmacy counter going to make it unavailable for free on the NHS?
When Hana® and some other progestogen-only pills was made available to buy over the pharmacy counter without prescription, it was never designed to replace the contraceptive services you can get from your doctor. If you want to see your doctor about your contraception, that’s entirely up to you and that option will and should always be there for you.
This move was designed to make the contraceptive pill easier to access for people who, for whatever reason, can’t or don’t want to wait for a doctor’s appointment. Maybe they find it hard to schedule appointments around work or other commitments, perhaps they have to wait for ages before they can schedule an appointment, or maybe they’d just rather get the pill in a pharmacy. Accessibility is important, so that people can choose the right option for them.
What’s with ‘women and people with uteruses’?
We use the words ‘women and people with uteruses’ because women are not the only people who may want to use the progestogen-only pill. Some trans men and non-binary people who have not had a hysterectomy and do not identify as female will still have the ability to become pregnant and may wish to use the contraceptive pill (or another form of contraception) to prevent pregnancy. You can find out more about inclusive language at Hana® here.
Contrary to what some people think, taking testosterone does not prevent pregnancy. The combined pill is not usually recommended for people taking testosterone, because oestrogen can counteract its effects, so the progestogen-only pill can be a good choice for some trans men and non-binary folk.
It’s also important to remember that being trans or non-binary does not mean someone is necessarily taking hormones or has had or wants to have surgery. The way people express their gender identity is unique to them and is their choice. We want to ensure that everyone knows what their contraceptive options are.
What about the male contraceptive pill?
We recently conducted a survey with over 1,000 women, trans men and non binary people. We found that nearly 90% (88% to be exact) would like their male partner to use a contraceptive pill or a form of long term contraception if such a thing existed, and 50% said this was because it would be good to feel like the responsibility of contraception was equally shared.
It would be good for there to be more contraceptive options for men. Men and people with penises are fertile for longer in their lives (there is no male equivalent of menopause), they are fertile every day of the month and the fact they don’t get pregnant means that statistically, they can have a lot more children than women. Unfortunately, trials on the male pill are still ongoing. Read more about the male pill on ellaOne.co.uk, our sister site.
In the meantime, there are a lot of contraceptive options to choose from – including condoms – which do rely on the partner with a penis. There are also reasons that women and people with uteruses may want to continue to take the pill even if these options existed.
Our survey also showed that 39% of the people who wouldn’t want their partner to use a contraceptive pill or other option said it was because they – the person with the uterus – was the one who could get pregnant and so wanted to feel in control of their contraception.
We hope that in the future there will be more contraceptive options for everyone, so you can find something that works for you.