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Govt oversight increases risk of serious side–effects, ranging from migraines to liver problems

In a country that has been pushing oral contraceptive pills (OCPs) under its zealous family planning programme since the 1960s, the level of awareness about the sideeffects of such drugs is appalling. The Indian government, in it ardour to control population, even forgot to implement any guideline on the usage of such drugs.

An RTI query has revealed that the Union Ministry of Health has no clue about guidelines set by the World Health Organisation, nor has it bothered to research or collate any data on the impact of long–term indiscriminate use of the drug. Worse, its own family planning programme has failed to prescribe the drugs according to health profiles of the consumers.

This blinkered approach is teetering on dangerous lines, given that OCPs are known to have side–effects ranging from nausea, to aggravating problems such as migraine and liverfunction issues to deep vein thrombosis (DVT). "The government’s long running family programme, increasing awareness among people and the more recent crack–downs on medical termination centres have fuelled the use of birth control pills among women," said Vihar Durve, a citybased RTI activist (a chartered accountant by training), who sought the information from the Union government. "Every chemist sells about 15 packs of OCPs every month," added Vijay Changedia, secretary of Chemists’ Association, Pune division.

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The pills come in variant combinations of estrogen and progestin or are purely progestin. Accordingly, they are classified as monophasic, biphasic or triphasic, which differ in their methodology for stalling pregnancy and have to be consumed in variant dosages. Wrong dosage or overdose can lead to uterine bleeding, severe headache, nausea, weight gain and other side–effects. In extreme cases, if a person has an existing condition it could lead to DVT, with clotting in veins deep in the body.

"Most often, doctors are not consulted and the drugs are picked up over the counter based on the recommendations of another user," Dr Sanjay Gupte, the former president of Federation of Obstetrics and Gynecological Society of India (FOGSI). "This is where the problem starts, as the efficacy and effects of the drugs differ person to person. Family history, preexisting conditions such as thyroid, obesity etc are taken into account while prescribing pills," he explained.

He also faults the government on this count. "The State–run family planning programme has also been prescribing the same type of drug for all without considering their medical history. This is wrong," Gupte said, insisting that otherwise OCPs are the safest bet for birth control.

Dr Rishma Pai, consulting gynaecologist at Lilavati Hospital in Mumbai, also insists on easy access to OCPs over termination of unwanted pregnancies. "Consultating a doctor is necessary. However, not everybody can access a doctor before starting the pills. For them, there should be ultra low dose contraceptives packaged with clear warnings and instruction in local languages," she suggested.

Times of India
11 Sep 2013

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