Anonymous  Posted: 23/06/2008 11:56

Any logic to support your argument there Anonymous?

Anonymous  Posted: 22/06/2008 05:45

No

Anon  Posted: 12/12/2007 14:26

There are progesterone only pills also so your argument does not stand.

Siobhan (PKI66980)  Posted: 05/12/2007 10:44

yes they should

Anonymous  Posted: 04/10/2007 14:24

The coil ois suitable for use up to fie days after unprotected sex so of course the later it is fitted, the more ineffective it is.

Anonymous  Posted: 04/10/2007 13:14

The MAP is not the same as the pill. It contains only progestogen. The pill contains oestrogen also, which is the component which causes problems for most people. The coil is actually more effective than the MAP but, as you say, a lot less comfortable to take.

Anonymous  Posted: 04/10/2007 12:29

Untrue Anon, I can't take the pill on a long term basis but I have been perscribed the MAP as a one off with no problems. It's more effective than the morning after coil and involves far far less discomfort

Anon  Posted: 03/10/2007 23:11

Anonymous, If you can't take the pill, then you can't take the MAP either because they are both made up of the same substance ie hormones! I find it rather amusing that people say they can't take the pill but they can take the morning after pill. It just doesn't make any logical sense to me.

Anonymous  Posted: 11/09/2007 12:39

Of course it should be. Accidents happen, it's not about teens being given a bad impression. I'm in my mid 20's. In a stable relationship. Can't take pill in general. Accidents happen, I'm not ready for a child so morning after pill is my only option.It could be monitered to how often someone gets it, so they aren't getting it too often.

Olivia  Posted: 20/07/2007 00:53

Aquarius, How much did it cost you to get the MAP over the counter in Enniskillen? Did the pharmacist take your daughters blood pressure or do any other medical checks to ensure she was suitable to take the MAP? (Some people aren't). In the UK the MAP costs approx £30 (sterling) to buy. Here, if you go to your local G.P. (I went to mine, out of hours service). I paid 50 euros, (my friend didn't have to pay a penny as she had a medical card) and got the MAP given to us there and then, along with the advice slip that came with it re. side effects etc so that I was prepared for any side effects that I might have. I also got a screening from the Doctor. So, I feel I got a better service and I didn't have to travel anywhere other than my local out of hours G.P. service. All in all, I think that was a much better service, much better value for money, (no prescription)much better health care and no judgement whatsoever. In fact, the nurse who spoke to me before I seen the Doctor was very informative, friendly and very helpful all in all.

Anonymous  Posted: 19/07/2007 17:39

Well, let me tell you this. For the first time ever I had to request the MAP. I am in my 30's and am unable to take the contraceptive pill due to it making me quite ill. So, I required the MAP. I rang my Dr who basically told me he'd leave a perscription out for me. I collected it and went to my local chemist. The pharmacist came out to me and she was so lovely. Explained that the old pill used to make people sick, but that this one doesn't. However, if by some fluke I did vomit within 3 hours of taking it, to come back to them straight away and they would replace it FOC. She said the main thing to do is take it immediately. Basically, what I am saying, is that she was more informative than the Dr. He told me none of this !

Aquarius  Posted: 19/07/2007 10:28

A very definite YES. While pro active contraception is the ideal we do not live in a utopia and must face up to the facts."Accidents" and unplanned sexual encounters happen. I brought my daughter for the MAP in Enniskillen . The pharmacist did a full comprhensive interview with her in private before giving her the MAP. excellent service and very non - judgemental.

Anonymous  Posted: 24/05/2007 12:32

So, a woman who is vomiting three hours after taking the tablet is supposed to make her way back to the clinic / doctor to take an anti-emetic. - like I said, ludicrous.

Emma  Posted: 24/05/2007 12:22

Anonymous, you obviously did not even read what I said. The most common MAP now given consists of 1 tablet and 1 tablet ONLY. The advice given with the tablet is that if you get sick within a 3 hour period you need to take the tablet again BUT whilst it makes some women nauseous it very rarely if ever, actually makes them sick so they do not need to go back. IF the rare occurrence is sickness and they need to take it again, they are not charged a 2nd time. Because the side effect of actual vomiting within the 3 hours is so rare, the need for anti-emetics is not there for the obvious reason that there is no need to give an anti-emetic if there is no reason to do so. What do you not understand? I never said that Pharmacists were not educated to give advice but a busy Pharmacist is not always in a position to check out the necessary medical contra indications and usually just refer to the leaflet that is issued with the medication. Just the same as a Pharmacist is not in a position to tell me if the OC is right for me or not. They dispense using their knowledge but they are not there to prescribe meds that can have serious (in some cases) contra indications.

Anonymous  Posted: 24/05/2007 10:19

So, now you think pharmacists have no medical / perscribing knowledge whatsoever? Emma, you're saying that a women should take one tablet , go about her daily busienss and have to return from wherever she is, three hours later, probably in the middle of the day and pay another €50 to get the second tablet, which she should have gotten in the first place anyway?? Ludicrous.

Emma  Posted: 23/05/2007 19:30

Anonymous, The most up-to-date MAP is only 1 tablet. Anti-emetics are not normally prescribed BUT anyone talking the MAP is, or should be told, about the fact that they may become nauseous. If they are sick within 3 hours, they have to return for a 2nd tablet. The average cost of the MAP in the UK is 30+ euros and that is without any medical assessment whatsoever so for the sake of a few extra bob I would rather err on the side of safety and have myself checked out before taking it rather than no medical supervision whatsoever. It is not a money issue, it is a health issue.

Anonymous  Posted: 22/05/2007 21:25

The MAP contains 750mcg per tablet. The full dose of 2 tablets amounts to 1500mcg.

Anonymous  Posted: 22/05/2007 21:23

"both the OCP and the MAP contain levonrgestrel. POINT PROVEN". What point is proven, exactly? The OCP also contains oestrogen which has more side effects than progestogens, such as increasing the risk of thrombosis and certain cancers. Just because anti-emetics are prescribed for certain conditions, doesn't mean they are side effect free. They can cause neurological disturbances, particularly in young adults. They are certainly not needed by the majority of women taking the MAP. You are surely not suggesting they should be routinely taken, regardless?

Emma  Posted: 22/05/2007 17:42

No Anonymous, that is clearly not what I said or implied. Lots of meds can be sold OTC but the health of the patient/client/woman is THE most important angle and some meds need to be prescribed under medical supervision due to the make up of those meds, their interaction with other meds and also because of the side effects and contra indications. HRT is not sold OTC either is the OC so why should the MAP? Anyone taking any of these hormone based meds need to have some sort of medical supervision first to make sure they are suited to that med. I think that is sensible and is the right procedure for the patient/client/woman so why do you see it as a problem?

Anonymous  Posted: 22/05/2007 08:37

So using the reasoning of the MAP being certified as safe is pointless?? So was Aulin/Mesulid and indeed HRT and now we all know what happened with them? So what do you propose - that no one ever take any medication at all when they need it and just throw out all medical research and advice done over the last 50 years?? Best of luck to you with that endeavour.

Emma  Posted: 21/05/2007 17:05

To Anonymous Posted: 21/05/2007 08:49 Actually, The most common MAP is only 1 tablet and is NOT given with an anti-emetic. As Anonymous 13:00 & 13:09 stated, you don't actually seem to know anything at all about the MAP. I am in full agreement of the MAP but nevertheless I don't think it should be freely available without medical advice. By the way, using the reasoning of the MAP being certified as safe is pointless. So was Aulin/Mesulid and indeed HRT and now we all know what happened with them?

Anonymous  Posted: 21/05/2007 14:10

If the woman needs anti nausea meds (or meds for cramping) they should be perscribed. As for anti nausea meds - which are perscribed for everything from morning sickness to those undergoing chemo - having more side effects than the MAP??? You cannot be serious. Both the MAP and the OCP conain levonorgestrel - POINT PROVEN. If the MAP has 500mcg of levonorgestrel only - then why are two tablets needed????? Homer, taking the MAP is a form of taking responsibility when a contraceptive fails. A heck of a sight more responsible than an unanted pregnancy or indeed an abortion.

Anonymous  Posted: 21/05/2007 13:09

Oh and anonymous: I've just read your previous posts and should point out that the modern MAP does not contain exactly the same ingredients as the ordinary contraceptive pill. Your average contraceptive pill has oestrogen in it and about 150mcg of the progestogen levonorgestrel. The MAP has l500mcg of levonorgestrel only.

Anonymous  Posted: 21/05/2007 13:00

I don't know where you got your information, anonymous, but the MAP nowadays is 2 tablets that you take together, at the same time and often in view of the doctor. It used to be 2 tablets taken 12 hours apart, but never a "series". An antiemetic is not routinely prescribed with it as the incidence of nausea and vomiting is low. 1 in 5 women may experience nausea to some degree and 1 or 2 in a hundred may vomit. It makes no sense for the other 98 to take drugs they don't need. The anti-nausea tablets probably have more side effects than the MAP! Could this be yet another expamle of someone holding forth on a subject they really don't know that much about?

Homer  Posted: 21/05/2007 12:39

Hello NO I do not agree. Responsibility should be taken on board between couples / partners.

timmy  Posted: 21/05/2007 11:41

i always thought it was freeably available in pharmacies..didnt realise one has to go to a doctor..shows wat i know!!

Anonymous  Posted: 21/05/2007 08:49

What level of hormones (over and above the natural level within the body) do you think is safe to pump into young girls/women? The same levels of homone that are in the pill/ map have been vcertified as safe for use - which incidentally are way way Way lower than the amount of hormones flooding through a womens body when she is pregnant. As for the GP who has the girl take the tablet in from of them - this is a nonsnse because as anyone kinows it is npot one tablet but a series of them which needs to be taken along with anti-nausea meds which any dr. should be perscribing aloing wiht the MAP.

Emma  Posted: 20/05/2007 23:23

To Anonymous 12:06 - What level of hormones (over and above the natural level within the body) do you think is safe to pump into young girls/women? To Anonymous 16:31 - Do you think that you are going to get the MAP free OTC? Also, young girls and students are on no or little income and therefore are entitled to medical cards, therefore the MAP actually does not cost them anything so being able to buy it OTC is of no benefit to someone on a medical card because without a prescription from a doctor they would have to pay for something that otherwise would be free! Most G.P.'s that I know will not prescribe the MAP but will insist that (after checking the patient/client/woman/girl) they take the table there and then in front of them. So they might pay the Doctors fee but they do not pay extra or seperately for the MAP.

Anonymous  Posted: 20/05/2007 16:31

Yes definitely it should. besides anything else the cost of drs fees is a disgrace especially 4 younger girls and students who might not have any way to get the cash.

Emma  Posted: 13/05/2007 20:05

Exactly, Anonymous, so what is the point in having the MAP sold OTC when the real issue is contraception? A high percentage of girls taking the MAP don't bother with any contraception because they know they can get the MAP. All a bit pointless don't you think?

Anonymous  Posted: 11/05/2007 12:06

Emma the MAP has the same constituents as athe pill in higher doses. iIt is suitable for one use per cycle and speculation on what if's and might have's is useless. If a woman needs it every month then it is obvious that what she needs is contraceptive advice and the use of a suitable relaible contraceptive.

Emma  Posted: 10/05/2007 19:48

Anonymous, I don't think that was what Plum meant. I think she was saying that because girls know the MAP is available (and more so, if it was OTC) they don't think about contraception AT ALL and then run the much higher risk of STD's. Maybe I am wrong, if so I'm sure she will correct me but that is what I read from her posting. I would agree with her. It would be a backward step to have the MAP sold OTC for a variety of reasons. There was an article in the London Times about the MAP recently and if you seen what it is made of, you wouldn't touch it with a bargepole. Doctors have a duty to explain the MAP to girls who want it, pharmacist, with all the best will in the world, would not be taken seriously. I too, believe that the MAP will have some very serious consequences down the road for the health of us women. Yes, by all means, it is great for those that are caught out once in a blue moon but there are vast amounts of girls who are using it as a form of contraception. Paying the GP/locum Doc doesn't hinder them whatsoever so money is not the problem here, as far as I'm concerned. My only issue is the overuse of heavy duty hormones mixed with steroids on a regular basis.

Anonymous  Posted: 09/05/2007 15:46

I have mixed feelings about this. I myself have taken it once and luckily had the finances to attend a clinic to do so. I worry that if it is brought in over the counter that many people will be too casual in using contraceptive, also isn;t there a limit to the number of times that one can take it?? personally i think it would be more beneficial if they reduced the cost of condoms, how any teenager can afford a box these days is beyond me, its not exactly encouraging safe sex.

Anonymous  Posted: 08/05/2007 08:31

Plum, making the MAP available in pharmacies would not mean these women would somehow be more prone to STDs

Plum  Posted: 04/05/2007 16:21

NO, NO, NO I work in a STD clinic and the amount of women who have careless sex esp on the weekends and pop the morning after pill is UNREAL and think its A TREAT. If you came and seen the amount of women who have a STD because of the MAP so called TREAT you would change your mind. Oh and by the way most of the women are in their late 20s early 30s.

Jenny  Posted: 02/05/2007 22:35

Sarah, there is a doctor on call in every rural area. Just because pharmacists give it out in the UK does not necessarily mean it is the right thing to do. How can a busy city centre pharmacist ask the questions or be expected to do a health screening? If, as suggested above, the tax payer would have to subsidise the pharmacist then what is the point? The client would get better value for money by going to her Doctor and getting a proper screening. Wait and see. There will be some very nasty side effects raising their ugly heads in the next 30 years in the same way as we were all force fed HRT for years and now, no decent G.P. will prescribe it without telling you all the negatives. Homer, just an afterthought. How can you be serious in that post you wrote last? The logic of it defies understanding.

Anonymous  Posted: 30/04/2007 12:37

Homer, what has your view that foetus is a life got to do with disagreeing with the MAP - which prevents an unwanted pregnancy? Totally illogical.

Homer  Posted: 29/04/2007 18:55

Hello A definite no. Why Doctors should know who are in need of the morning after pill. It might not suit some health. I am also against the pil as it is & I have arued this point from the start a Foetus IS A PERSON a gift of life. I will say no more on this matter.

Sarah  Posted: 29/04/2007 13:15

I definitely think it should be available in pharmacies. As said before all young people are not the same but accidents do happen. I had to get the MAP recently because my OCP was affected by antibiotics and then the condom broke. I was lucky that I could get to a doctor early on a saturday morning but for some girls out in the country it may be a lot harder or impossible to get a doctor at the weekends. Other countries sell it over the counter so why not here? When are we going to move into the new millenium?!

Blath  Posted: 26/04/2007 17:33

Let's take our heads out of the sand and make the MAP available OTC in pharmacies. I think that a good pharmacist would be well qualified to advise girls and women buying it and take the pressure off GP surgeries and A&E depts. I also think that the pharmacist should be reimbursed for providing the MAP and giving advice.

Anonymous  Posted: 25/04/2007 11:27

Pharmacists in Britain are able to do it successfully every day of the week, it is part of their role For those for whom the MAP is not medially suitable, I presume a possibility of an unwanted pregnancy or abortion would be even more unsuitable and the morning after coil is considerable more truamatic espcially for younger girls.

Angela  Posted: 24/04/2007 18:24

I work in a clinic that deals with women all the time who are looking for the MAP. Most of them (in fact 99%) are girls in their late teens and early 20's. I agree with Anonymous who posted on the 17/4, the level of ignorance is frightening. In the clinic I work in, nobody is dealt with harshly. Each girl is given total privacy and as long as they like to talk. The same procedure is adhered to as Anonymous employs. They are charged 50 euros but for that 50 euros they get the MAP whilst in the clinic. Do you think the Pharmacist will do it free? Of course not, so if you are going to spend the money isn't it better to get a medical assessment also for your money. There are risks and side effects (some of them very unpleasant) and on top of that, there are some for whom the MAP is just not suitable on medical grounds. Isn't it better that a Doctor sees them rather than have them going off with the MAP and running other health risks? Pharmacists just do not have the time or space to give people their full, private attention. It is not part of their role.

Anonymous  Posted: 24/04/2007 10:46

In relation to the point about the ID and the girls being too young etc and having to deal with a crisis pregnancy - I don't know if the ID thing would work but it is a useful guide or idea! I know there are younger girls who are so much younger than the age of consent having sex but guys there has to be a limit right? I think if a really young girl goes to the pharmacy and is told she is too young - perhaps she should be advised as to what help/options are there for her. I'm all for the MAP to be given out by pharmacies but there has to be a legal limit surely. At the same time I'm morally concered for the really young teenagers out there having unprotected sex and extremly worried that they would have unwanted pregancies, that would be terrible and I understand peoples points but I presumed it could only be given to girls of the age of consent because of legal stuff - but hey - I'm not a politician, a doctor or a solicitor - isn't it really scary and sad that there are really really young girls and boys for that matter having sex at such a young age?? - I think this subject has a lot of pros and cons but I'm still for the MAP being given to girls and women who need it and want it!

Anonymous  Posted: 23/04/2007 22:46

OF COURSE IT SHOULD. Its hard to believe that it still is not.

Maire (mairemor)  Posted: 20/04/2007 08:15

definately - think of the statistics of unmarried mothers in Limerick on the radio yesterday - above 50% - shocking and not necessary at all. We are not a third world country - it is totally unavoidable by easy availability of the pill in general to all young girls and the morning after pill also. M

Anonymous  Posted: 19/04/2007 19:11

yes it should be . why should a person have to go to a doctor lets get real in this country

Anonymous  Posted: 19/04/2007 16:51

And if ID shows thatthe girls is underage . . what then? Will a pharmacist refuse the provide the MAP? If the girls does not go to her family doctor you will have the most vulnerable facing a crisis pregnancy.

Anonymous  Posted: 19/04/2007 16:39

In my opinion I think that the MAP should definitely be available through a pharmacist, however it is important that there should be some sort of a questionnaire and id required especially if the girl is under the age of consent. I know a lot of people are saying that giving the MAP to girls through a pharmacy is just telling them to go have sex, well open your eyes people, there are young people out there having it anyway and most young girls would be scared or embarrassed going to the family doctor. At least through the pharmacy there is some type of privacy and at least there would be some hope that these girls lives won't be disruped by having to deal with an unplanned pregnancy and perhaps who knows, maybe the younger girls of today will realise the importance of taking the pill or other contraceptive if they are having intercourse. There is of course advantages and disadvantages but even as an older woman in my late 20's but this effects all women of all ages - its not just about young girls- I think thats unfair - I know If I wasn't on the pill and found myself in a situation where I had to use the MAP - Id like to know I could go to a pharmacy without having to pay a dr a fortune to write the prescription!!

Anonymous  Posted: 17/04/2007 14:10

I prescribe the MAP on a regular basis and spend a minimum of 10 minutes ascertaining whether it is necessary and suitable. As is surprisingly necessary, I explain how the reproductive cycle works, how the MAP works and what to expect after taking it. A women often comes in in a state of embarrassment and anxiety and leaves feeling reassured that she has done the right thing and with a full understanding of her situation. She is also offered a free follow-up appointment after 3 weeks. This allows more time, under calmer circumstances, to discuss her future contraceptive needs or to do a pregnancy test if required. I think 50 euro for this service is money well spent. I do appreciate, however, that not all clinics are as thorough. The level of ignorance amongst young women in this area is staggering and a visit for the MAP is a great opportunity to educate and perhaps reduce the need for the MAP in the future.

Mary  Posted: 16/04/2007 09:03

Well said Alex. Jane, if a girl is taking it month after month, then she needs to be on the pill or some other reliable contraceptive suitable for long term use rather than using condoms. In addition to the MAP, she needs contraceptive advice.

Jane  Posted: 14/04/2007 11:48

Unfortunately most young girls are not mature enough to understand that is has serious side effects and they most certainly do abuse it. I work in the field and see dozens of girls every week. 11 out of the 12 I see have taken it before. Some of them only a month previously. Some take it more often than that but won't tell you openly because they treat it like a panadol! I worry about their health when they get older in regard to overload of hormones which was suggested on here by another poster. I see nothing wrong with it being sold over the counter except from the health/abuse angle. The normal excuse (12 out of 12) is "the condom split". Now if condoms are that unreliable then the condom manufacturers should be taken to task but somehow I feel, its nothing to do with condoms. It is most certainly being used as a normal back up and that is not a good policy in the long term. Personally I think it should not require a script or a 50 euro fee but then again, most girls do not baulk at this.

Alex  Posted: 14/04/2007 11:32

I think accidents happen we are not all perfect, access to this medication should be immediate. I think the comment previously on how it will do the little slut good to sit and stew for 10 hours is a disgusting attitude. I am a firm believer in the individuals right, in particular the womans right to have control of her own body. If she does not want to be a human incubater for 9 months then that is her choice. I do not think she should be denied to intamacy of making love to her partner to be free from that burden. I have met a doctor who refused to prescribe me the OCP on moral grounds, so this is the attitude we are faced with- this was ment to be an educated man, what if last night the condom slipped and this was who I was asking to save my life the next morning? At least if the MOP is available in pharmacies then I could move on to the next one. How long would it take to reschedule a doc's apt?

Anonymous  Posted: 08/04/2007 22:44

Yes, the morning after pill should be available from any pharmacy. It's a disgrace that you have to pay 50 + euro to get a doctor to write a script for this.

eil  Posted: 05/04/2007 17:01

Yes most people would t be abusing it it is for emergencies and i think most women are mature enough to realize that

Anonymous  Posted: 02/04/2007 23:15

Save us from holy joes !!

momof2  Posted: 02/04/2007 16:21

u can get it in d chemist i had to drive miles one bank holiday morn to buy them and guess what they didn't even work. you should always be protected and not need it. i am married and my oldest child was only two months girls so get injection

Mary  Posted: 28/02/2007 12:27

Again like Michelle's experience Anonymous Posted: 28/02/2007 10:39, a Dr. cannot refuse to treat and must refer if he cannot treat. A pregnancy test is completley useless and unneccessary in those circumstances as it will not show up as postive wihtin 24 hours of unprotected intercourse. A person doesn't have to be a nurse to know that.

Anonymous  Posted: 28/02/2007 10:39

I had an experience very similar to michelle's when i went to my college doctor. again, i had to see the nurse first, who LAUGHED at me and told me the doctor didn't have to give it to me. she did a pregnancy test and was very unpleasant. i was then sent to the doctor who lectured me and told me i was a chancer. Like michelle, i was left feeling a whole lot worse about the entire experience, which was stressful enough as it was.

Mary  Posted: 21/02/2007 10:43

Anonymous, I have never taken the MAP, fortunately, therefore I have never read the instructions/leaflet that comes with the MAP. I know that like the pill it has unpleasant side effects for some and serious side effects for a small minority of women. Aspirin indeed also has serious side effects for a small minority of people. In the last two years I have used an IUD, thyroid medication and an antibiotic and yes, I have read the insert that came with all three. When I was on the pil, many years ago, I read the insert that came with that. Don't you read the insert which comes with any meds you take?

Anonymous  Posted: 20/02/2007 23:08

Michelle, What happened to you is totally out of order. That nurse had absolutely no right whatsoever to treat you like that. You were treated badly by her and that is that. There is no arguement about that. She was in the wrong. You were just being responsible. Mary, when was the last time you read the instructions/leaflet that comes with the MAP? Of course, it has side effects, some of them extremely unpleasant for some women and it also talks about hormone overload. The hormone overload is what I would worry about in the long run especially with girls who mis-use the MAP. We as a society cannot stop people misusing any drug but we can certainly try to reduce the chances whenever possible. You talk about the MAP as if it was akin to taking an aspirin. It has, in fact, more serious side effects than a mere aspirin for some women usually the most vulnerable.

Lou  Posted: 20/02/2007 15:17

Yes!!!! In this day and age of course it should be available over the counter. I am sure if men were capable of giving birth it would have been available over the counter donkeys years ago.

Mary  Posted: 02/02/2007 08:49

Michelle, the nurse had absolutely no right whatsoever to to upset you or any woman like that. If anything her attitude requires a reprimand. As for a pregnancy test, that is completely irrelevant because it won't show as positive until they day your period is due, which by then of course would be too late for the MAP. As a patient you have rights. The doctor absolutely must treat you and cannot refuse unless s/he has a very good medical reason. If a doctor feels they cannot provide treatment on 'personal' grounds then they absolutely must refer you (patients charter 1994). My uni (not UCD) and quite some time ago admittedly had the same policy where the patient had to see the nurse first but in your case the nurses attitude was unprofessional and downright appalling. If you had fallen of a bike and broken your arm would she have given you the same lecture about how silly you were and told you that the doctor doesn't have to treat you? I doubt it. Your country GP should be completely and utterly professional is his /her treatment but if this was the attitude of a nurse at a large uni healthcare practice, I can see what you mean. May I suggest that you find a large healthare clinic which is used to treating women patients in the sexual / reproductive medecine area. The wellwoman / ifp / everywoman clinics many people have found to have professional, helpful staff who provie advice in a competent manner without lecturing or being rude. But of course in a situation where you need the MAP, time is of the essense and the last thing you need to do, is have to take a couple of buses and trek accross town. Interestingly, I spoke to a friend about this last night and she too (and this is goig back a decade or more) needed the MAP and was automatically given anti-nausea medication and ibprofen for any cramps may resulted - as standard.

Michelle (WAJ57976)  Posted: 01/02/2007 17:13

The MAP should definitely be available OTC. I'm a college student who unfortunately had to go to the doctor to get it at our college health service. As it was short notice, I coudn't see the doctor straight away, and had to have a consultation with a nurse - this is (a ridiulous) standard practice in our health centre. She made me do a pregnancy test, lectured me about how 'silly' I was, and actually made me cry - she kept telling me 'the doctor doesn't HAVE to give you the pill, you know' - as if I might not get the MAP at all. Then I went in to see the doctor, who gave me a further lecture, gave me the pill and sent me on my way, feeling even worse and even more stupid than I had when I went in. An isolated incident, I know, but ask yourself - if this is the attitude of a doctor and nurse in UCD, the biggest uni in the country, who see more sexually-related cases than anything else - imagine having to go to your regular country GP who you've known all your life, and see at Mass every Sunday? I'm from the country, and I wouldn't do it. The MAP needs to be available in pharmacies.

Mary  Posted: 01/02/2007 08:56

Similarly, why isn't every drug on prscription only? This would give doctors far more work to do and put them under more pressure. Because certain drugs have extremely serious side-effects in many people. Some can often kill - and do. The MAP is not one of those. Because depression athsma and schizophrenia require much wider treatment than a perscription and becuase that along with infection and hypertension require careful diagnosis. Again, the requirement for the MAP does not. It just needs for the woman to have had one episode of unprotected sex. You don't need to tell the counter asisstant your problem, you could speak directly to the pharmacist. People often do. I know of three pharmacies, one in Dublin, which have a room off to the side if you want to speak to the pharmacist without being overheard but no, this is not the norm. However, if you askd to speak to the pharmacist privately, I can't see why that courtesy would not be offered. Yes, you could buy medication over the net but to mind mind, it would need to be an extremely reliable online pharmacy and how can you be sure of that. Oddly enough, I know a GP who referred a patient at one stage to A & E to have a wound stitched. A waste of A & E's time and the patients time.

Anon  Posted: 31/01/2007 17:46

Mary, For the most part in most discussions I agree with you. However, sometimes I think you just play Devil's Advocate for the sake of it. This is one of those times! Why isn't every drug/tablet available OTC? The whole gamut! Why don't we let pharmacists decide when we go into a pharmacy for a medication for eg. depression, asthma, infection, manic depression, schizophrenia, hypertension, etc what we should be taking? Why do we need prescriptions at all? What is the difference between prescription drugs and non prescription drugs? To go a step further, we could go into the Pharmacist, explain our problems to them after first telling the counter assistant, with a line of other customers waiting. (No pharmacies I have ever been in have a seperate, private consulting room). Then the Pharmacist can tell us what he/she thinks we should be taking. Then we can buy or go home and buy the medication over the net, cheaper! We would all be happy then? That would get rid of the Doctor and free up his time to do more mundane things like stitching wounds occasionally and manicuring his nails for the rest of the time.

Mary  Posted: 30/01/2007 16:45

Anon, you could say a similar thing about the database which your doctor has set up. Afterall if it saves adverse reactions from people which do not or feel they cannot tell their pharmacist about existing medication they are taking, it would be a very beneicial exercise. As pharmicists are subject to confidentiality requirements I can't see that it would be an infringement of privacy any more than your doctors database is. Yes, I suppose the could get the same tablets over the internet altho' in the case I know, the woman was in Thailand on holidays. Yes, it does show how little some women know about mixing hormones ad hoc and therefore how much safer it would be if they could get them from theit pharmacist with advice if they needed them. The pregnancy argument is completely relevant and is also introduces those hormones at much higher levels into the body.

Anon  Posted: 30/01/2007 13:40

Mary, With the beleagued health system we have at the moment, I think the money it would cost to set up a central database for Pharmacists is a waste of money. It would make more sense to spend that money on more acute areas. Pharmacists dispense drugs. That is their job. They do not have a legal right to prescribe, as such. A central database would just be yet another infringement of our privacy. I certainly would not want my Pharmacist or his/her staff knowing all about what drugs I may or may not have taken in my lifetime with my G.P. Its none of their business. As for girls bringing tablets from abroad, well, with the internet, unfortunately, there is not much one can do about that. But doesn't that tell you how little some girls know about mixing hormones ad hoc? No point bringing the pregnancy arguement into it, as its not relevant to my point. Pregnancy for the most part is a natural state. The concern is the mixing of a variety of hormones. Lots of people have lots of adverse and unwanted reaction to the contraceptive pill as is even well documented on this site. Adding the MAP into the equation on a REGULAR and over used basis is asking for problems.

Mary  Posted: 30/01/2007 11:31

The same thing could easily apply with pharmacies. One pharmacist could check enquire as to the womans' local pharmacy and check with a central database. The health risks - i.e. side effects from the MAP are similar to those of the OCP and similarly rare, therefore it is a minority of people who would be unaware of thse risks - which would be greatly magnified in pregnancy anyway. Pharmacists are also trained with regard to the risks and dangers of mixing certain medications. Worryingly tho' and this may only be an isolated case but I doubt it, I came across of 19 year old who brought supplies of what she believes to be the MAP back from Thailand (in case of accidents!). Would it not be far better, that should she need it, she can get it at her pharmacy rather than bringing it from somewhere where controls and standards are not the same as here and she cannot be sure of either the safety standards, efficacy or indeed genuiness of it.

Anon  Posted: 29/01/2007 21:37

Mary, you cannot go straight into a pharmacy and get the contraceptive pill OTC or sleeping tablets OTC. Why? Same applies to the MAP. These drugs should rightfully be only supplied alongwith a certain amount of health education/information. The MAP is not meant to be used on a monthly basis so you can deduce that it will not be required by any one person more than an infrequent number of times. So, whats the problem going to a Doctor and getting appropriate advice/information/basis screening? The MAP is not suitable for everyone. Personally though, I think when it is needed, it should be given free of charge.

Bunty  Posted: 29/01/2007 21:33

Mary, If they went to another Doctor, the 1st thing he would ask them is the name of her own G.P. I work in the field, I see young girls getting the MAP all the time. They just DO NOT understand the health risks. At least when they spend whatever little time it might be with a Doctor there is a chance he can get some advice across to them. Believe me, you would be amazed at how blaise some girls are about mixing a variety of hormone based drugs & doing so on a regular basis.

Mary  Posted: 25/01/2007 15:19

Anon, you were referring to your local pharmacist but bear in mind that a woman could go to any doctor (who would not know about other medication she is on) if she was going to be silly or risky about her use of the MAP.

Anon  Posted: 25/01/2007 13:45

Mary, You can go to ANY pharmacist with a prescription so no one pharmacist would necessarily know about any other medication you are on. Yes, if you are sensible you will discuss this but young girls who want the MAP are not quite inclined to discuss such matters and secondly they quite often do not even realise the risks involved in taking the MAP more than once in a cycle so therefore any other risks involving any other drugs they may be on would not be important to them either.

Mary  Posted: 25/01/2007 10:41

In my experience Ann on it IS a rarity. Clearly our experience is different but that does not negate my experience. And in my experience is is not the norm. Actually your pharmacist has a record of what he has dispensed to you so that is aleady available to him or her. Obviously your medical history is not. And pharmacists are unde a confidentiality agreement similar to that of a Dr. Surely a pharmacist in that regard is already involved in your care. If pharmacist records were centralised they way your doctors (but unfortunately not my Doctors' ) records are then they would be privvy to the fact that you may be on a variety of drugs that may be relevant. Altho I would have thought it was common sense to tell your Dr. pharmacist what other medications you are on as well as your doctor.

Anon  Posted: 24/01/2007 21:18

No Mary, its not a rarity. It applies to the patients of any G.P. who partakes in the out of hours system. How do you think the out of hours system works? The overall system is not computerised in all areas but if the Doctor is part of the out of hours service then it is obviously easier for those patient records to be accessed. However, I don't know of any G.P. who is not computerised now. Even my own G.P. in a small rural village is computerised. That is more the norm now than those that are not. Why would you want Pharacists linked in the same way? Pharmacists dispense medication, they do not prescribe it. I would not want my medical history on tap to my local pharmacist or anyone else for that matter that was not directly involved in my care. There is nothing private about a chat in a shop with a pharmacist and no matter what advice a pharmacist can give you regarding a particular medication, that pharmacist is not privvy to the fact that any patient he encounters may well be on a variety of drugs that the patient may not either want to disclose or may feel it is not relevant to disclose.

Lillith  Posted: 21/01/2007 19:32

Yes.

Mary  Posted: 19/01/2007 13:01

Wow Anon, that's an excellent service. Not only are your records on computaer but they are on a central database which can be cross-referenced. I believe that is a rarity. I think many GPs have paper records. They haven't computerized not to mind having their record centraly available, which is a great pity. Would it not be perfectly simply to have pahracists records set up in exactly the same way. Problem solved.

Anon  Posted: 18/01/2007 18:46

Mary, where I live, if you call the on-call service they can tell you from your phone number, your medical history as it is on computer. Yes I agree, accidents do indeed happen but the numbers for the usage of MAP last year alone does not equate with accidents therefore one would be correct in deducing that it is being used as a regular contraceptive by a huge amount of girls. This is WITH the prescribing situation being as it is so it would be equally logical to deduce that this number would increase greatly if the MAP was sold otc. There are other forms of contraception so it is not as if we are all relying solely on the MAP as protection (which of course it was never intended to be used for).

Tara  Posted: 18/01/2007 17:36

Yes definetly especially with waiting rates to see gp's etc.

Mary  Posted: 18/01/2007 16:08

If you need the MAP at the moment, you can also get it from any DR. If it were available OTC, more women could get it In Time. If a pharmacist does not give advice, then they are acting not only unprofessionally, but perhaps illegally. If you go to the GP on call it is perfectly obvious that your own GP is not available and thus your records will not be available either. As for a mature prson not putting themselves at risk (and remember maturity does not always equate with age) of course they won't, that's obvious. But accidents happen, condoms split, stomach upset occur, coils slip out, diaphragms come off. And this is where the MAP is needed.

Anon  Posted: 17/01/2007 18:36

Mary, You are completely missing the point. If you need the MAP and can get it from a pharmacy, you can get it from ANY pharmacy. No amount of advice will make any difference if a young girl is using it unwisely. A lot of pharmacists wouldn't even bother giving any advice about it. If you have to go to a G.P. on call or otherwise and if that is not your normal G.P. 1 of the 1st questions that will be asked is who is your normal G.P. There will be a record of it having been prescribed. This at least, will encourage a G.P. to give the appropriate advice to the girl. A mature (er) person will know that you cannot take it more than once per cycle and won't necessarily put themselves at risk but young girls don't even think about the risks. Some young girls ARE taking it more than once per cycle and if they did not have to get it from a Medical Professional they would do it even more often. At least, having to go to a Doctor will give SOME level of advice.

Mary  Posted: 17/01/2007 11:24

Anon, a 16, 26, 36 or 46 years old can go into a different Dr. every time she likes, to obtain hormone meds if she wants to and simply has the money to do so. It is ill-advised and rather silly but remember the MAP is suitable for use only once during each cycle and a pharmacist is perfectly capable of providing advice on any medication. What, not having it available in pharmaciies is simply doing, is preventing those who need it accessing it on time. Needing to go to a Dr. to get it won't prevent those who are being silly about it from continuing to be silly about it. That is a lifestyle problem not just a medical one. The dangers of pregnancy are far from irrelevant as it too involves huge levels of homones being introduced into the body. And it is precisely the dangers of pregnancy which will result if the MAP is not accessed on time - which it quite patently cannot be, for some as it is very obviously NOT available on time to be effective, at the moment to whoever wants it. The MAP most certainly CAN be taken for one episode of unprotected sex in any cycle regardless of whether the woman has missed her pill, taken it late, had a stomach upset or whatever else to make it ineffective. Any gynacologist will confirm this - including my own. We ALL make mistakes - miss the pill once, have a split condom or whatever. That is part of being HUMAN. Yes, women who miss their pill on a regualr basis DO need advice and it may be something as simple keeping it beside their toothbrush so that they remember every morning or night. But not so easy to do if you are trying to conceal your contraceptive needs from inquisitive parents (due to their religious or other superstitions in some cases) and yes this DOES happen, even in this day and age. This fact as brought home to me just recently. The side effects from the MAP (which is similar to a large does of the ocp) are nausea and cramping - PERIOD (pun intended). Again, any GP will confirm this. Sure, there are other very rare side effects but these will have been mirrored in the pill and would be magnified in pregnanacy anyway. As I have said already, a pharmacist is more than capable of giving advice on the side effects of any medication. That is reality.

Anon  Posted: 16/01/2007 19:34

Mary, The fact that the MAP is not yet sold otc in this country has absolutely nothing to do with religion or the constitution AT ALL. Just because the MAP is available OTC in the UK doesn't necessarily mean it is right to have it OTC. Anyone who has posted on this discussion and is not in agreement with the MAP being sold OTC is not doing so on constitutional or religious grounds whatsoever, ONLY on medical grounds. It is not good health care for a 16 year old girl to be able to go to a pharmacy and obtain a hormone based medication OTC without any advice whatsoever from anyone, and do so whenever she likes. It is dangerous in the extreme. Don't come back at me about the risks of pregnancy as I am not talking about a pregnancy. Its irrelevant because the MAP IS available at the moment to whoever wants it. Taking the pill and then taking the MAP as I have only seen as late as last weekend in my role as a health professional is dangerous and girls are doing this all the time. They are on the pill, miss 1, take it as soon as they realise they have missed it, then on top of that take the MAP because they want to be sure, to be sure. This is going on all the time. I can guarantee you that there will be repercussions for that in the long term. These girls need good medical advice. They regard these drugs akin to smarties and do not understand the side effects. It is important that they are given some guidance and if the MAP is available OTC, they will not get any guidance. That is the reality of it.

Anonymous  Posted: 16/01/2007 09:01

Anon, if you don't understand my post and that of Public Servant28, with whom I was agreeing, perhaps you should read it and Public Servants post again. To restate: PublicServant28 is right on certain matters of our constitution which are totally outmoded and irrelevant. Read public servants post again and perhaps you will understand a bit better. The MAP is available in NI and the UK over the counter in pharmacies. What is your problem with having the same service here. Considering that the MAP is being considered for OTC use, it is hardly the "End of Story", now is it.

Anon  Posted: 15/01/2007 15:52

Mary, What sort of drivvel is that re the constitution in particular? The MAP is available in every G.P.'s surgery and in every out of hours, on-call clinic. End of Story.

John (GEI53425)  Posted: 14/01/2007 16:21

Yes yes yes

Mary  Posted: 05/01/2007 15:36

Anon, it is well known tha tthe MAP is less effective when taken later. Even when I went on he pill, the Dr. did not take 40 mins to ask me questions. A pharmacist can always ask your medical history. An A&E r. is equally unlikely to have it. Perhaps Belucciemz has never forgetten how poorly and shabbily she was treated in seekign a medical service. That would certainly stick in my mind. If it has been available at the pharmacy, it would have been quickr, subject to less worry and shoddy treatment and would have cost less. Ads PublicServant28 said it is available in NI and the UK. sADLY PublicServant28 you are right on certain matters of our constitution. Totally outmoded and irrelevant.

Belucciemz  Posted: 05/01/2007 15:16

The doctor i went to see had no details of my previous medical history AND although it may be hard to believe the questions were irrelevant - i discussed them with my own GP after the visit. As much as you do have 72hours, the chances of it not wrking get higher as u pass the 8 hour mark...

PublicServant28  Posted: 04/01/2007 22:37

Yes, of course the MAP should be available over the counter in pharmacies. It is available in NI and the UK and is totally accepted. There are many many religious people in the UK, but in terms of women's health, they have a choice in this matter unlike Ireland, where the religious ideals prevail. The Constitution of Ireland had significant religious influence. The Premable to the Constitution reads almost like a prayer: "In the Name of the Most Holy Trinity ... Humbly acknowledging all our obligations to our Divine Lord, Jesus Christ ... " It is not a secular text and therefore reflects the views of the Church in the 1930s, which, even in the 21st century, does not do much for women's rights. Article 42 still suggests that women should not work outside the home and that the common good would be served best if women worked in the home and looked after the family. It is therefore hardly surprising that we have to debate the issue of the MAP. As previously stated by many in this discussion, this is a health issue which is suffering the same fate as contraception and divorce before it - by virtue of the fact we live in a county which may be becoming more secular and open, but still operates under religious-influenced laws - it is still seen as a moral issue. I have used and been grateful for the MAP in the UK when, having recently moved there, the GP and Pharmacy realised that the pill I was on was not available in the UK. This was completely unexpected as I had signed up with a GP for this purpose the week I arrived and the situation wasn't discovered until I needed my repeat prescription. I was not a teenager, did not have unprotected sex, was not drunk, have been with my partner for years - yes, "normal" people have occasion to use the MAP in emergencies, despite what some people think. I was grateful my situation was resolved by a relatively simple medical prescription. Yes there were side effects but I suspect the nausea was more from stress and worry than the pill. I went through a GP (who advised on use) and then a pharmacy (who also advised on use) but having the MAP available through a Pharmacy gives people a lot more choice and control. There are at least two pharmacies these days in even the smallest town in Ireland if people were afraid of meeting someone they know. In someone's local area there would be significantly more pharmacies than GPs. Having more access, choice and control is very important at such a stressful time. Since I returned from the UK at least the MAP is available from GPs but having it OTC is the next logical step.

Anon  Posted: 04/01/2007 21:53

Belucciemz, Interesting post! The point is, a Doctor has to presribe the MAP to you, in the same way that a Doctor has to prescribe the pill. You did have 72 hours. Also, why didn't the pharmacist just call the on-call Doctor? The pharmacist would have had the correct number. A pharmacist is not privvy to your medical history. The Doctor didn't waste his/her time asking you irrelevant questions. They might have appeared irrelevant to you but to a Medical person they were relevant to your health. I take it the whole episode was something you have obviously never forgotten, even the detail of it, so for that reason I think it is good. Yep, at least you learned but not quite as acute a learning curve as it would have been if you found yourself pregnant. I'm glad you were so sensible. Well done. At least it ended ok for you. 60 euros is a small price to pay for safeguarding against a pregnancy which would have cost you a helluva lot more??

Belucciemz  Posted: 04/01/2007 14:44

I am 18, I had to get the MAP a few years ago. I had had protected sex with someone i knew and the condom broke. I woke up the Sunday morning with quite a hangover only to realise that i had to find somewhere to get this pill. I rang my GP's office and the number on the anwering machine for the Sunday clinic was INCORRECT! I tried directory enquiries with no joy and ended up going to my local pharmacy in quite a state to ask for help. The pharmacist had all the relevant phone numbers to hand and even let me use his phone to make the appointment. I went to the hospital, where i waited 30mins after the time of my scheduled appointment, hours later, only to be met by a very casual doctor in jeans who asked a lot of irrelevant questions and lectured me about the correct way to put on a condom (this took a further 40mins) he then took my blood pressure and handed me the prescription and a bill for €60! The pharmacy provided a glass of water so that i could take the pill then and there so as not to waste any precious time. Luckily it worked. That same doctor told me that the pill should only be considered if one is in a serious relationship and that sondoms should meet my needs! I think a pharamcist could fill this role much more efficiently and that it would benefit us greatly!

Anonymous  Posted: 02/01/2007 14:19

Perhaps for the same reason that you pay to see the doctor before taking other drugs? So that they can make sure that you actually need to take it, that it is safe for you to do so and that you understand fully the risks and consequences of the possible outcomes.

Anonymous  Posted: 31/12/2006 19:10

yes it should be why should u hav to go to the doctor pay him/her then pay for the morning after pill

Julie  Posted: 23/11/2006 13:19

Mary, How many methods of contraception does 1 society actually need and even still with all that is available here, there are still unwanted pregnancies. If you have taken the risk and think you might be pregnant, are standing in a pharmacy, and some pharmacist tells you that you can only take this once this month, do you honestly think that will make any difference to the girl? How many girls do you think will listen to a pharmacist telling them the risks etc? At least, if they have to go to a Doctor they will have to at least listen to something being said to them. I am not against the MAP in any way, far from it. But I am not sure about the safety of OTC medicines that interfere with the reproductive system being available carte blanche. Also, check out the 2 other polls on Irish Health at the moment about people having unprotected sex and 2 our 3 having sex. Whilst these are not scientific polls, they are an interesting insight into reality, My reference to drug adverts on TV was not in connection to the MAP but of course, that will be well advertised if it suits the pharmos.

Mary  Posted: 23/11/2006 12:45

Holly, in this day and age to say to anyone, don't have sex at all unless you want to have a baby, is laughable to say the least and in an ideal world, everyone would use condoms or be on the pill but this is not an ideal world and mistakes and accoidents DO happen. What would you prefer if it were your sister or friend, improved access to the MAP or an abortion?

holly663  Posted: 23/11/2006 10:21

If they are unwanted pregnancies then try using condoms!!! or dont have sex at all. Your saying its ok to have unprotected sex, and then using the morning after pill. You might as well say its ok for everyone to have unprotected sex and to have abortions after.

Mary  Posted: 22/11/2006 16:03

Julie, that the map is only suitable for use as emergency contraception for one incident of unprotected sex per menstrual cycle requires only sufficient understandign to listen to a dr, pharmacist, nurse, health worker, read an informaiton leaflet or website. It is already being used as a back up by some and for those who cannot access it, this only results in unwanted pregnancies. Sure, education is important but so is access. They are not talking about advertising or marketing the MAP, only making it in a pharmacy, over the counter.

Julie  Posted: 22/11/2006 15:05

Mary you say:- Holly, THE map is only suitable for use as emergency contraception for one incident of unprotected sex per menstrual cycle. That implies a certain amount of education & understanding. I agree totally with Holly, it would definately be used by some as a method of contraception (to the long term detriment of their health). It would be used by lots of girls as a back-up in a sub conscious fashion and that is a real danger. It is not a positive thing, in my opinion, to make more and more drugs available otc. In fact, I would go so far as to say, I think its totally irresponsible that Pharmaceutical co's are allowed to advertise ANY drug on tv even panadol. Mass marketing for drugs is dangerous and implies a level of safety where their is none.

Mary  Posted: 22/11/2006 12:55

Holly, THE map is only suitable for use as emergency contraception for one incident of unprotected sex per menstrual cycle. Sure, ideally people people should be mature enough to have safe sex all the time but the fact remains that some arent and they are even more likely to need prompt access to a means of preventing unwanted pregnancy.

holly663  Posted: 22/11/2006 11:43

People would use the morning after pill as a concraceptive if it was that easy to get a hold of. They need to be mature enough to have safe sex, or not have sex at all.

Agnes  Posted: 20/10/2006 00:11

Chana, I never called Aine a liar. Please do not put your own interpretation on my conversation with Aine especially when it is so insulting. Aine, when I said I found it not plausable, it was meant from my own point of view in terms of which situation was the most or least embarrassing. Yes, I agree with you, a note could be handed to the Pharmacist, but I have seen embarrassing situations in pharmacies regularly ie. people asking discreetly for something and they repeat the request at the top of their voices! Secondly, a responsible pharmacist (& there are lots of them) would have given her the MAP and then rang her G.P. to send in the appropriate prescription (this happens a lot). There are lots of ways around any situation and my saying I found your description not plausable was because putting myself in her shoes, if I didn't want another child I would have overcome my embarrassment. If I was genuinely embarrassed about going to a G.P. I would have been even more embarrassed by the alternative ie. telling the family/whole world & then labour! Maybe its your use of the word embarrassment that leaves me doubting. I would think, from what you say, that although she hadn't planned the pregnancy, once she found herself pregnant, she was not unhappy about it. Fair play to her and I hope she is happy. Its just having MAP otc would not have changed that particular eventuality.

hopeful  Posted: 19/10/2006 17:25

With the new advice and prescribing given by Pharmacists now, I think that any medications that are straight forward, with only minor side effects, should be prescribed by the pharmacist. They have the best knowledge for medicines. But this can only be done when a person's medical records are not important as well. It often happens that a patient's past medical records are important in prescribing medications, for whatever reason, including allergies. If these conditions make no difference, the morning after pill can and should then be prescribed by a pharmacist. But not over the counter. We wouldn't want anyone taking them too many mornings after.

Aine  Posted: 19/10/2006 02:15

Sorry Agnes, I forgot to sign my name... Aine.

anne (WEV52065)  Posted: 19/10/2006 02:11

Agnes, You don't find my reasons "plausable"?? I live in a large town. Four times, so far, I've had to call wk/end doc, and they were all local docs. I don't know what H/B you live in, but thats the way it works here. There was a time condoms could only be bought in Family Planning clinics in cities, now they are in every supermarket. I doubt if anyone is embarrassed picking them up anymore. I don't think the MAP should be left out like that, like any medication, it must be treated with respect. Embarassement regarding WHAT doc was going to treat "my" girl was NOT an issue. It was the whole thing of CALLING OUT the Dr. that was the problem. In a chemist, a note could be handed to the pharmacist if you were SHY. Yes Agnes, "my" girl was embarrassed when it was known she was pregnant, and when she started to show. Nine months is a long time, when five minutes in the chemist would have solved everything.

Chana  Posted: 18/10/2006 16:45

So, Agnes, what you are saying is that unless people agree with you, about a situation you know nothing about and they do, then they are automatically Liars??? It is you who are being implausible

Agnes  Posted: 18/10/2006 16:11

Aine, I am not argueing with you but I find the reasons you give just not plausable. I live in a rural area myself & I fully understand the system. The chances of knowing the G.P. that sees you as a locum are far less than are the chances of knowing the pharmacist or indeed in my own locale, having half the parish in the chemist whilst you are there! Far less discrete when you are embarrassed. There is absolutely no privacy when asking for medication in the chemist. And although having MAP otc. It would be just that, OTC. You would still have to ask for it. You couldn't just go in and pick it up off the shelves! Your girl was embarrassed at the situation she found herself in. I fully appreciate that & no way would I condemn her but at the end of the day, you can't hide a pregnancy, so rather than braving the embarrassment of going to the G.P. where only he would have known what she wanted, in the end everyone knew she was pregnant when she started showing and eventually was admitted to give birth. I understand how she felt, totally but I don't see how you think that having MAP OTC would have dissolved that embarrassment.

Aine  Posted: 18/10/2006 12:58

Mary, Agnes didn't take all factors into account. Firstly, there is every possibility that you will know the weekend doc, in our area the local GPs DO that work at the weekend. That would'nt have mattered to "my" girl, she WAS too embarrassed to call one out, so she decided to "take the chance". Secondly, because she already had a child, she felt "very stupid" for letting it happen. It would have made all the difference to her if she could have gone to any chemist for the MAP. She felt no one would have known her business. When her period did not come 4 or 5 days later, she knew she was pregnant. When you do call out wk/end doc, you have to give your details over the phone to a receptionist who will then refer you to a nurse, who will give you an approx. time to meet the doc. You might have to wait only ten minutes, or up to a few hours, depending on how busy the doc is. All this time could be shortened by a simple TRIP TO THE CHEMIST.

Mary  Posted: 18/10/2006 11:33

Agnes, I don't think you've honstly taken all factors into account. It;s not just calling out a locum, it's the fact that family will ask questions or the fear that the Dr. will be juedgemental, which of course they should never be. There is a 72 hour wondow but as has been explained to you time and time again, the earlier it s taken the better.

Agnes  Posted: 17/10/2006 22:10

Mary, I was referring to Ceci's wee niece. To be honest, if I was too embarrassed to go to call out a locum G.P. (who wouldn't know me anyway). I would be far more embarrassed going into a local pharmacy. Nevertheless, there was a 72 hour window Mary so Aine's girl didn't avail then either even with the knowledge of having been pregnant before so you would have to conclude that she preferred the pregnancy to continue. Which is more embarrassing in your mind? Getting a prescription for the MAP or giving birth??

ainebeag  Posted: 17/10/2006 21:49

Agnes, When a young person is sexually active, they should be sat down and the pros and cons explained to them. Contraception is very important, 1) to prevent pregnancy 2) a condom will help prevent contracting an STD. It can be very hard to communicate freely, with a bit of perseverence, they will listen!! They might joke, make cracks and smart comments, but believe me it will get through to them. A girl should be educated about the MAP-that it is for emergency only and can only be taken once during her cycle, after all , if there is an accident she will be left to carry the can. I spoke strongly to my daughter about this, and asked her to tell ME first if she thought she needed it. She was 20 then, she is now 25. Since this debate came up we have discussed it all, and she told me she always felt she could come to ME if needed. She also went to England with two of her friends while they had abortions, a nurse friend also accompanied them. While they were having the "procedure" done, the friends went shopping, the first thing they saw in a chemist was the MAP. One of the girls carries a lot of guilt with her and at the moment is having counselling. Again, all this heartache could have been avoided-MAP-NO PREGNANCY. Thank you.

Mary  Posted: 17/10/2006 10:53

Agnes, I think Aine has confirmed that it was not naieveity or inexperience in this case but the girl was ashamed to call the weekend doc to get the MAP. OTC availability would have solved this. Not of course that any girl regardles of age should be a ashamed to avail of any medical service regardlss of te reason but sadly some are.

Agnes  Posted: 16/10/2006 20:21

Mary, Hindsight is a wonderful thing. If you are young, inexperienced, naive etc the chances are that you do not even realise you are pregnant until you miss a period. That was my point! That sort of situation is not something you can ever stop happening.

Mary  Posted: 16/10/2006 08:47

Of COURSE the MAP would have made a difference in those two cases. If it was available in time it would have prevented pregnancy.

Aine  Posted: 15/10/2006 10:21

Hiya Agnes, I can guarantee you the girl who had my grandchild was not innocent, she already had a child. With my son "it" happened on a Friday night and she was ASHAMED to call weekend doc. They were not even in a relationship together, both had too much to drink. She told me all this herself. BOTH should have taken precautions as neither wanted a baby-she could have had an abortion, we're so glad she did'nt. By the way, neither are teenagers. As I said before, they are both there for their child now. If the MAP was sold otc, an awful lot of heartache could have been avoided.

Agnes  Posted: 13/10/2006 21:00

Well, there ya go. In the last posting Ceci says her niece was young & innocent. I think Aine implied the same thing in her case. The MAP wouldn't have made any difference in either of those cases. There has never been more contraception available as there is now but accidents will still happen. I suppose the onus is on us as parents to educate our children but I guess even with that, there will still always be unplanned pregnancy.

ceci  Posted: 08/10/2006 23:32

Same case than Ainebag. My dearest little niece, innocent, first experience, resulting in an unplanned baby. I cant overcome it, only thinking it´s her destiny and the baby´s.

ainebeag  Posted: 29/09/2006 02:16

Hiya, I'm going back to the MAP discussion,if you dont mind!! I think it should be given over-the counter. I am 55yrs old. If I go out for the night for a few drinks with my hubby or friends, and have not planned in advance, then I will need an open pharmacy in the morning for something for a headache-at my age(and I feel very young)you'd think i would THINK ahead. What happens then to a young girl "the morning after", not just a hangover but maybe a pregnancy too. My one and only grandson was the result of such a night. He was totally unplanned, and if I were to be honest-a mistake. My son is the dad and we all love our grandson to bits. My son and the mam had to grow up overnight, there were a lot of problems and tears, I would not wish it on anyone. Our baby's mam is brilliant and his dad is equal. They are not together now as a couple, I think thats very sad, but this is not a perfect world We are all still a unit...but thats it. We adore our grandson, and he will want for nothing, but thats not the way to start a precious little life. At the end of the day, mam is, and always will be left holding the baby, Anyone understand what I'm trying to say?

enna  Posted: 22/09/2006 12:14

Absolutly

Mary  Posted: 19/09/2006 11:53

I stand corrected Agnes, it would appear from the article that unopposed eostrogen therapy was indeed around since the 60's.

Agnes  Posted: 19/09/2006 00:52

Mary, HRT is around since the 1960's. If you want to confirm same, check this site (if Irish Health will permit the site name to be posted http://patients.uptodate.com/topic.asp?file=endo_hor/10192 I only found this site now in a random search on the history of hrt but its quite informative if you are interested in the subject.

Mary  Posted: 18/09/2006 09:01

The research, which is from Medscape and JAMA most certainly IS peer reviewed and quite recent (withing about 2 months)/ Soya milk is not suitable for everyone - I had pointed this out. But if you need supplementation, there are at least two types of fortified dairy milk on the market. The reason your periods cease is becuase your bdy has stpped producing the hormons it needs. The contacts on both the JAMA and medcape websites are from experts in their field not GPs who may or may not keep up with all the latest research. To return to the original discussion you claim your concern about the MAP is similar to your concern about HRT in temrsof possible future side effects. I pointed out that the MAP has been around since the 70'S but HRT is a lot more recent.

Agnes  Posted: 14/09/2006 23:18

Well, Mary, this is the last I am saying on this subject but wait until you are menopausal and tell me then if phyto estrogens help hot flushes. From experience, I know they do. Every item you posted totally contradicts what my Medical Carers have said and not to offend you, I would rather take their word for it as I know my G.P. would not mislead me, knowingly. If my G.P. had prescribed HRT for me I would have at the very least, tried it but he didn't because he feels its unsafe in light of the latest research. You state, quote From Medscape: "phytoestrogens are not really estrogens at all. If they are not estrogens then that contradicts all the previous 'evidence' that they cause a disruption and cause cancer. I don't know where you got your research but it is not peer reviewed or followed by my G.P. practice. The average age of menopause is 51 here. That is, cessation of periods completely. So, in taking on board the subsequent posters view, if that is the case, there is no point in taking hrt before 50 or 51 as you are not in fact menopausal but in fact, peri-menopausal. Its after 50 that matters when the hormone levels have depleted. Japenese women have less menopausal symptoms because they have soya in their diet and they also have less cases of breast cancer, to name 1. I have done my research Mary but my research was prompted by the fact that I am now facing menopause and not talking about a subject that does not yet affect me. If my G.P. (and many like him) are not happy prescribing HRT I wonder why. He has more to gain financially from me as a patient if he could prescribe hrt than recommending soya products or anything else for me but he feels its unsafe. Your research into HRT is old hat. The facts are now, it is linked in increased heart disease, not the other way around. Soya milk (as an example) is fortified with calcium and C, E, and B vitamins & is a far healthier option than dairy milk in the diet. If your periods have ceased then you do not need excessive amounts of hormones that have no function in the body, for obvious reasons so why try to fool your body into thinking it is in need of these hormones. Also, what do you think happens in the body when it is given hormones it does not need, (for simplicity) it causes an excess and excess of anything can be dangerous as the body struggles to utilise what it doesn't need. If you flood the body with hormones that the body does not have any use for then how can you expect anything else but problems. Again, apologies for this to all you other posters but when challenged I have no other option but to clarify where I am getting my information from and it is not a web site but from my own mature but well educated and clued in Medical Practitioners.

Anonymous  Posted: 14/09/2006 16:57

I thought this was supposed to be about the MAP??? As for HRT, the medical consensus is that anyone undergoing early menopause for whatever reason should be offered HRT. The risks in terms of cardiovascular disease and osteoporosis for anyone under 50 having little or no ovarian oestrogen outweigh the risks of HRT. After that age, opinion remains divided. In terms of breast cancer, the risk for a post-menopausal woman taking oestrogen only HRT or Livial for 5 years is about the same as for a woman of the same age who's still having periods over that time and not taking oestrogen. It's such a low risk that nobody gets too excited about it, in other words. Now can the HRT debate move elsewhere, please?!

Mary  Posted: 14/09/2006 12:47

That's astonishing Agnes - are you tellign myt HRt was around in the 70'S? Where? You believe that there is not 1 single bit of research on the market to say soya is in fact dangerous at all?? I really think you need to do more research on that. Average consumption of soy foods in Japan and China is 10 grams (about 2 teaspoons) per day. Asians consume soy foods in small amounts as a condiment. Most modern soy foods are not fermented to neutralize toxins in soybeans, and are processed in a way that denatures proteins and increases levels of carcinogens. Soy foods can cause deficiencies in calcium and vitamin D, both needed for healthy bones. Calcium from bone broths and vitamin D from seafood, lard and organ meats prevent osteoporosis in Asian countries—not soy foods. Soy isoflavones are phyto-endocrine disrupters. At dietary levels, they can prevent ovulation and stimulate the growth of cancer cells. Eating as little as 30 grams (about 4 tablespoons) of soy per day can result in hypothyroidism. Contrary to popular myths that Soy foods are safe and beneficial for women to use in their postmenopausal years, can stimulate the growth of estrogen-dependent tumors and cause thyroid problems. Low thyroid function is associated with difficulties in menopause. Ultimately much of the literature on this topic is flawed, and it provides little evidence of benefit for these products on menopausal symptoms. To quote the JAMA review: "Hot flush frequency was not reduced when all trials of red clover isoflavone extracts were combined, and results for soy isoflavone extracts were contradictory even among the largest and highest quality trials. These results are consistent with other recent systematic reviews. We also reviewed trials of other forms of soy isoflavones, such as flour, powder, and food items, in another study. However, these trials are difficult to compare because of variability of components and doses. Overall, evidence does not support benefit in relieving hot flushes" The phyto-oestrogens found in soy is a weak plant oestrogen, it does not replace the chemical oestrogen which your body has stopped producing. From Medscape: "phytoestrogens are not really estrogens at all. Mammalian estrogens are derived from cholesterol and share the 4-fused carbon ring structure of the steroids. Phytoestrogens are derived from phenols and lack this 4-fused carbon structure, but their phenolic ring can interact with the 2 recognized estrogen receptors. This interaction results in either activation or inhibition of the receptor." The average age for menopause here is considered to be in the mid 50 bracket as far as I know but of course it varies depending on the woman and her circumstances.

Agnes  Posted: 14/09/2006 01:20

Mary, the risks for HRT are beyond a shadow of a doubt extremely well documented and it is around longer than the MAP, regardless of what you might think. Up until recently HRT was considered to stave off heart disease when now, in fact, they have proven that it actually contributes to heart disease, along with a long list of other serious diseases. If soya has side effects (considering you have to take a huge amount of soya in your diet to equal what is in HRT) then that proves my point but in fact, there is not 1 single bit of research on the market to say soya is in fact dangerous at all. In fact, it is firmly believed that the negative views on soya have been put out there by the Dairy Food industry as they were getting a little worried about people coming off dairy food or excluding it from you diet. Soya milk for a start is just made up of soya beans and water. As for the woman of 40 being prescribed HRT. Peri-menopause can occur for up to 7 years before menopausal symptoms even show themselve to the patient. Usually in the form of niggly symptoms that the women themselves do not realise are associated with the ovaries shutting down. Its only when your periods have stopped for 1 year that you are considered menopausal but in fact, you have already gone through the menopause at this time and are then post menopausal.

Mary  Posted: 13/09/2006 12:49

No, it's not possible to cover every single scenario but it is responsible to attempt to cover the most common ones. Yes, it is worrying, not just that so mny women risked unwanted/unplanned pregnancy but what worries me more is the fact that their whole lifestyle contributes to this. Use of HRT for 9 or 10 years in he UK is uite common without ill-effect in the women concerned. My scenario is quite the opposite, out of all te women I know aroundmenpause age, I only know two who are not on HRT - one of whom it is contraindiated for. For your friend who is on it 10 years, I would say get herself to see an endocrinologist who specialist in menopausal medecine. Altho' 40 seems to me to be very young to be menopausal - 'tho there are of courses cases where women need replacement therapy at a younger age due to medical complications - removal of the ovaries or premature spontaneous ovarian failure. If you believe the the known risks far outweigh the benefits, I would advise more research by your medical care team as there is quite a lot of research out there which suggests evidence to the contrary. The diffeence of course between HRT and the MAP is that HRT is relatively new whereas the MAP has been around, in many European countries since the 70's. Similar to the pill - in he 60's they were telling womne to only stay on it for 10 years (for contraceptive purposes) but now the new 4th generaition pills have been refined the extent that they are suitable for much longer term use, for as long as the women needs. Actually, there IS to the effect that excessive soy is dangerous.

Agnes  Posted: 12/09/2006 19:06

Mary, I'm sure others are getting bored reading this but just to reply to your posting. You are back to the 'what if' scenario again. It is not possible to cover every single scenario out there in every single case. Its a personal decision & somewhere along the line, responsibility has to come into it. Everyone can make a mistake but my point was, I find it worrying that there was 100,000 cases where women left themselves open to unwanted pregnancy whatever, (especially as they knew they would have to get a prescription within the 72 hours) in 1 year & the media implies also that it was more a life style choice where alcohol was concerned rather than a genuine mistake, or 1 off accident! Some girls do use it far too regularly as almost a way of life, in a back up system way without giving it a second thought. As for the HRT, any Doctor I have spoken to about this has suggested that anything even like 9 years is far too long. Believe it or not, I only know 1 woman, in a large group of that age group, that uses HRT & she is on it 10 years, & is now panicking as her new G.P. has told her she has to come off it asap! Thing is, it was precribed when she was 40 & she is genuinely worried about the risks associated with it & the effects of coming off it. She is more frightened being on it than the thoughts of living without it. At this stage, the known risks far outweigh the benefits as far as my Medical Carers are concerned. On the other side of the coin, isn't it frightening that what was once considered the wonderdrug for menopause, is now proven to have a list of serious effects. That was my original point about the MAP. I really do think messing around with hormones is not something to consider lightly but we have been lulled into thinking that hormones in many forms are doing us good. In the next breath you will have people telling you that soya is dangerous because it contains phyto-estrogens! Confusing thinking, don't you agree? Its a huge subject.

Mary  Posted: 12/09/2006 09:45

Agnes, some women are intolerant to HRT - it can cause problems for them. It is also contraindicated for certain categories of women. I'm not sure what you mean by long-term but I know women how have been using it for up to 9 years. Not sure if this fits the category of medium term or long term tho'. I do agree of course that we need to educate ourselves as consumers. "Anyone can get a prescription within 72 hours anywhere". What about if you have a scare on the Friday of a Bank holiday and your Dr. and Pharmacy is closed until the Tuesday morning and your nareast A&E is 50 miles away with no ar available. Sure in theory you have 72 hours but the later it's taken the less effective it is. If it was the case that anyone worried about a pregnancy scare got a prescription withing 72 hours which was effective, whnhe then are there so many unwanted pregnaancies as a result of accidents. Education is of course a huge factor - you're right and I'm if you had a young daughter who had an accident, so to speak, she could come to you and you would make sure she got the neccessary treatment but not every mother is the same as you.

Agnes  Posted: 12/09/2006 00:24

Mary, 2 things. Women are not 'intolerant' to HRT. It is just not safe as a long term treatment, fact! Your Mums Dr was correct in what he told her but as a Doctor said to me recently "I can tell a patient all the side effects and I can tell them I do not think they should take a particular drug but at the end of the day, if thats what they want & if I don't give it, they will go to another Doctor who will". Therefore that puts the emphasis on us as consumers to educate ourselves as to the risks as best we can. (not always easy I know) As for not getting the MAP prescription until its too late. There are 72 hours. Anyone can get a prescription within 72 hours anywhere. Yes, its inconvenient but if you are genuinely worried about a pregnancy you will get a prescription within 72 hours. We can't all live our lives on the 'what if' factor. Just because the MAP is widely available in Ireland nowadays, it doesn't seem to have any impact on the number of unwanted pregnancies so there will always be those that do not have the education to take control of the situation themselves. Its up to the Medical Profession to try to use their time with these women to educate them on the risks they are running by relying on the MAP to solve their problems.

Mary  Posted: 06/09/2006 09:00

Really? The two brands of which I am aware ( I don't think I am permitted to post the names but if so they are premarin and premak, tho' of course they may be others) have been in use since the 70's? I wasn't aware of that. I thought it was early 90's when they were passed by the FDA (U.S.) and BMB (u.k.) alone. As for your GP - well Dr.s differ. My mothers GP has told her that there are substitutes IF she is intolerant to HRT or there are contraindications in her case. But what Agnes in cases where you CAN'T get a perscription for the MAP until its too late? I imagine the side-effects of an unwanted pregnancy when you're young is far greater than the MAP. As I said it's a case of risks versus benefits. In addition of course there needs to be education - in schools, if parents won't take responsibility - on contraception and pregnancy. Any parents out there who still have the stupid hang-ups they carry with them from a bygone era surrounding their bodies and sex need to get rid of them and quickly.

Agnes  Posted: 05/09/2006 16:19

I agree Mary. But HRT is around for even longer & its only in the past few years that the serious side effects are coming to light. As I said, my G.P. says up until a few years ago he prescribed it for every woman but now he won't & will even give guidance on alternatives rather than risk HRT. When your young you don't consider side effects in the longer term as you feel invincible. If you need to get a prescription for MAP at least you will get some medical guidance rather than if you can just buy it otc. Making it tooo readily available to all age groups just gives the impression that it is harmless. There has to be some safe balance that can be reached to suit most women. It is exactly this scenario that caused the banning of St John's Wort because people were taking it with prescribed anti-depressives, thinking it had no side effects.

fifi  Posted: 05/09/2006 13:55

Of course it should for Gods sake!

Mary  Posted: 05/09/2006 13:37

Sure, not all women make their decisions based on proper medical information but you cannot legislate for every possible scenaro. If women are taking it almost as a way of life - drinking more & can't remember what happened the night before and so take it just in case, this is not just a contraceptoive issue but an entire lifestyle issue. In my opinion, they don't just need medical advice and contraceptive care, they need lifestyle advice and guidance. HRT like the OTC, MAP and various over the counter meds has a long list of serious side effects - but not for every simgle person who takes them. Like any drug, I imgaine that it is better to avoid it IF you can, but as you say - when a woman needs it, she needs it. It took years to find out the side effects of HRT as happens with many new drugs but remember the MAP has been around since the 70'S.

Agnes  Posted: 04/09/2006 20:08

Exhausted Doc, I didn't say you were using it as a method of contraception. However, even if you took it every month, it is absolutely none of my business as you are making your own decisions based on medical information. My reference to the 'duty of care' is relevant in terms of the fact that you post under the name of exhausted Doc so for younger women reading your posts, they are doing so in the knowledge that they are reading what a Doctor has said. Not all young women make their decisions on proper medical information. All I was trying to allude to is that taking the MAP too frequently cannot be good for women. When a woman needs it, she needs it but 100,000 last year... it would make you wonder. In yesterdays newspaper there was an article about the MAP which implied that women were taking it almost as a way of life ie. they are drinking more & can't remember what happened the night before so ... just in case! The article implied that this scenario was normal for them rather than an exception. Mary, my point regarding HRT is that regardless of women thinking it is a wonder drug, nobody can take it for long as it does have long lists of serious side effects. Its only a stop gap & the Medical thinking on it is that it is better to avoid it if you can. Look how long it took to find out the side effects of HRT. The same thing could just as easily happen with the MAPS. Its not the sort of drug to mess with by taking it too often.

Mary  Posted: 04/09/2006 11:58

The MAP was available in the 1970'S in France, Belgium and Holland. I'm not sure about the UK. As a side note, I know several women who are on HRT from their 50'S for a number of yearsand for them it is the wonder drug as it replaces what their bodis can't produce anymore. But like the OCP - it's not for everyone.

ExhaustedDoc  Posted: 03/09/2006 21:56

Agnes, I AM recommending it to young women who find themselves in a worrisome situation. However, when I recommend it, I will say that is what I am doing, not leave cryptic hidden clues that I may be recommending a particular course of action by stating that I have done it before. If people do that then it is no wonder there are a lot of misunderstood healthcare providers out there. I am and have been stating that it is "alright" for young women who are fully informed and who feel they want it to go ahead and take it,ie, that the benefit outweighs the risk in my and their opinion, however I am not and have not been advocating it as a regular means of contraception, I'm not entirely sure which one of my posts you managed to read that into. I have not used it as a regular form of contraception, I have never said that I used it as such. How would anyone manage to do that anyway? No matter which brand of condoms one buys, inevitably there are accidents, and I do not take chances regardless of where in the monthly cycle I am. I would not advise any woman to do so either. As for a "duty of care" whatever you mean by that, I am not, as far as I am aware, caring for anyone as a patient on this website. I'm giving my honest opinions and as much information as I can with them, which is what everyone else here is doing as far as I can see.

Agnes  Posted: 01/09/2006 22:35

Anonymous, I think you should read what I said in my last posting. I did not say that Exhausted Doc was using the MAP as birth control. BUT, she did state that she was intolerant to ocp's & if so, she must be more intolerant of the MAP, surely? It can't be a great option if there is intolerance & therefore it is no more effective than any other method either, if there is an intolerance! What I said was I was concerned with the unyet documented health risks & with 100,000 women using MAP in Ireland last year. I feel that it is important that women have access to the MAP but there is also some concerns over vast amounts of women taking high dose 'hormone' medication without any guidance. Mary, the MAP was not readily available to women in the '70's in the UK and certainly not in Ireland. The risks of HRT are now well documented so regardless of whether some women think its a 'wonder drug', the fact is, that the risks are much higher when taking HRT than when not. That is not something I am saying lightly, it is fact. Nevertheless, there are women I know who have been on hrt since age 40 & are now in their 50's but any Doctor I have attended regarding this, have encouraged me to try to do without it if possible BECAUSE of the well documented, much more serious, health risks.

Anonymous  Posted: 01/09/2006 14:13

Agnes, since you feel that by using the MAP twice, Exhaustedoc, is using it as her usual means of contraception, I take it you reckon she has only had sex twice???? I would imagine she is using a combination of "natural" methods and condoms on an ongoing basis and has had 2 incidents where she felt she needed a backup for whatever reason. We have no idea, nor is it our business to know, how long she has been sexually active, but under her circumstances she would seem to me to be acting perfectly responsibly and doing pretty well statistically. Rather than being judgemental, can you explain what alternative measures you would suggest for her or anyone like her?

Mary  Posted: 01/09/2006 12:54

Surely Agnes, Doc IS being responsible for seeking it when she needs it. It would be far more irresponsible to have an unwanted pregnancy surely. As far as I am aware using it twice could not in any way make it seem like a form of regular birth control. As a side note, for many women HRT is stll a wonder drug. The MAP has been around since the 70'S even if not in Ireland. As i said, all drugs have risks, including the OCP, it's a case of weighing the risks against the benefits. Actually it IS about having children that you do not want - which is exactly what can happen without better MAP availability. It is simply not suitable to be taken on a regular basis and cost-wise would make little sense anyway.

Agnes  Posted: 31/08/2006 19:04

First of all, Exhausted Doc, I apologise if you think I was judging you. I thought I made it obvious that I was not judging you & that I do not have any moral objections to the MAP. My comment did sound glib in terms of the "Fool me once..." etc but that was a reference re taking it twice. Having a scare once & taking it is one thing but for me, 1 scare would be enough to make me act more responsibly & take more care. (And, believe me, I have been there!) As a Doctor you have (whether you like it or not) a duty of care & the fact that you said you used it twice, came across to me as some sort of recommendation to younger women who may not be fully aware of their own bodies. It could also be picked up by young females that if a Doctor uses it as a form of contraception, as they could see it, then its alright for them to do so also. If you read on this site the comments made by women on what their G.P.'s tell them or don't tell them, re. blood tests, smears, etc it is clear that there is a lot of misunderstood Health Care Providers out there. My reservations with the MAP are to the health issue & the fact that 100,000 women took this medication last year in Ireland. That number implies that a certain number are using it as a back-up rather than in a responsible way. Also, it is a relatively new drug & yes, it will have side effects. When HRT was brought to the market some many years ago, it was hailed the 'wonder drug'. There are now a lot of Medics who are not happy to prescribe it & who have genuine worries about the side effects, which have been now PROVEN to be dangerous to some women. Mary, this is not an issue of having children that you do not want, it is about whether the MAP should be available otc & tied in with that is the issue of responsible birth control. There is a multitude of choice now in regard to birth control & at the end of the day, its up to us women to take responsibility for that. For a mature woman to take the MAP or any woman to take it in a crisis,is 1 thing, but for young girls to take it unsupervised, & on a regular basis, to me, will inevitably cause long term effects. The stats back that up ie. 100,000 MAP in Ireland last year!

Cleo  Posted: 31/08/2006 16:40

I agree with everything that mary and exhausteddoc have said above. It seems that some people feel the need to sit in judgement of others; why else declare that people who take the MAP are irresponsible? It is a very smug person who cannot even try to see where another person is coming from. Being intolerant to OCP's means that your contraceptive options are severely curtailed. Would the detractors wish that everybody relied on condoms (not as effective as you might think people!), or even worse 'natural' methods? What century are we living in here at all? As exhausteddoc and mary have pointed out, having children when you don't want them is far worse than taking the MAP. Does agnes object to OCP's as well, i wonder?

Mary  Posted: 31/08/2006 14:50

Agnes, all drugs have risks and contraindications including the OCP. It is a case of balancing the risks agaist the benefits. It is unfeasible to use it as a form of birth control as it s only suitable for use once in each cycle and the cost of using it as a form of birth control would also be prohibitive. You find it rather disturbing that Exhaustedneeded it twice?? I would imagine it would be considerable moe distubing if she brought two human beings into the world that she did not ant and could not look after. Agnes, in my view taking responsibility is EXACTLY what Exhausted did. It would not have shown much responsibility if she did not take the MAP and had an unwanted pregnancy. As for shame, I sincerely hope we have moved on as a society from a stage where anyone need feel shame for seeking medical treatment.

ExhaustedDoc  Posted: 31/08/2006 12:42

This IS an off topic comment. I'm not completely sure that it did need a response, but I will respond anyway. Testicular cancer already has fairly good rates of survival and well established effective chemo regimes, as far as I know, although teratomas are fairly poorly prognostic, I believe. One would have to ask an oncologist for further info regarding survival rates, prognosis etc with regard to testicular tumours, as I don't currently work in oncology. Prostate cancer tends to occur in older men, often runs an indolent course, can be controlled effectively for the most part with hormonal therapy, and most men who have it die with it, not because of it. That is a generalisation, not taking into account specific cases, but a fairly accurate reflection of the situation with regard to prostate cancer, I believe. Breast cancer, on the other hand, kills younger women pretty regularly, metastasizes to liver, bone, brain almost inevitably, and can recur years later in these sites after removal of the primary. It is more common than testicular cancer and deadlier by far than prostate cancer. Hence it probably merits a lot more funding than the above. Of course, in an ideal world all diseases would get all the funding they needed, but we don't. I don't have any particularly strong feelings on this topic either way, I don't really believe there is a significant gender bias in medical research and treatment and if there is, then I think it would probably be in favour of men! as in the case of cardiovascular disease where men are treated earlier, more effectively, and taken more seriously. In actual fact women and men get cardiovascular disease with pretty equal incidence, but women are less likely to receive optimum treatment from their doctors, less likely to respond to current mangement, and have a greater mortality associated with it.

Andra  Posted: 30/08/2006 12:54

ExhaustedDoc you say that the "I think at last the human race is starting to wake up." Yes perhaps... but only for matters relating to females. Matters relating to males unfortunately are conveniently swept under the carpet. You as a doctor would know exactly how much funding is spent on research relating to female issues ie breast cancer and how much money is spent on male issues ie prostrate cancer, testicular cancer.... I know this is slightly off topic but a comment as the one you made needs a response.

ExhaustedDoc  Posted: 30/08/2006 11:06

Furthermore, Agnes, doctors are people. Do you think that because I am a doctor that I never ever slip up or get caught in a less than ideal situation? I am human. At least I acknowledge this and deal with its limitations in the best ways I can, which I think makes me a better doctor and more able to understand where my patients are coming from. At the end of the day I can sympathise with my patients, rather than feeling morally and ethically superior to them, as you seem to be suggesting.

ExhaustedDoc  Posted: 30/08/2006 10:59

As I said, Agnes, I am intolerant of all OCPs. My husband and I have a normal loving relationship. Condoms are not foolproof. To go into further detail would be both an invasion of my privacy and probably inappropriate for the discussion. I consider taking it when I was genuinely concerned about the possibility of a pregnancy I did not want and could not at that time have to be being very responsible. Perhaps you are suggesting that my husband and I permanently abstain. I don't really know what that "fool me once" saying at the end is supposed to mean, as I have not fooled anyone, either professionally or on this discussion, but I suppose it helped to dress up your comment. Why do you find it disturbing that I took the sensible responsible option and chose not to take the risk of having children at a time when I could neither afford to become a parent professionally or personally, and when I did not want to? And as a medic, as far as I have seen on my previous posts, which perhaps you did not care to read properly, I have been strongly advocating that women who find themselves in that situation should have the choice of doing the responsible thing and taking the MAP if they wish to. I have taken responsibility for my own health. I am stating that other women should have the same choice open to them. I believe that as a medic and as a person and occasionally when I see a patient who wants the MAP, after a pregnancy test, if they still want it, I give it to them. It is not wrong. It prevents fertilisation. It is not an abortifacient. Yes, all drugs have side effects. However, the risk/benefit ratio, ie. the risk of known side effects versus the benefit from actually taking the medicine in individual cases who feel that pregnancy is the worst possible outcome of their situation, is greater in those cases. Studies have not shown any terrible longterm side effects. It is in effect, a larger dose of similar hormones to that used in the OCP, but a once off. Because there is some perceived moral issue here for some people, they lash out against one effective solution. Back in the day, I suspect those same people would be packing girls off to the Magdalene laundries and giving away their babies. Bottom line, for hundreds of years, people have been being caught out. Every century has had it's own way of dealing with this, often stoning the girls to death, ostracising both them and the child for life, sending the women to become institutionalised for life, fear of consequences so great that women rush off to have abortions, and now at last we have a safe and effective solution if a woman doesn't want a child. Even though we still have the "moral" dissenters, I think at last the human race is starting to wake up.

shinny  Posted: 30/08/2006 10:42

Agnes, I think that was very unfair comment you made to ExhaustedDoc. As she mentioned, "I am intolerant of pretty much all the OCPs and accidents do happen" this means that she is at a much higher risk of conceiving. I am in the same boat & cannot take contraception. I'm currently not in committed relationship & I don't do casual sex, but in the past I have had a few scares with my partners with not being able to take the Pill. I didn't take the MAP at those times (twice) and could have ended up pregnant. Luckily I was ok, but the reason I didn't take the MAP was because I didn't want to go to my Doctor. Now that I am older I realise how silly that was, but 16-24 year old girls feel ashamed of this & end up pregnant with children they are not ready to raise.

Mary (Mary G.)  Posted: 29/08/2006 23:23

exhausted doc - fair point that the responsibility for our bodies lies with ourselves and the doctors and pharmacists responsibility only goes so far. Still seems to me that some medical advice at least and also some counselling if required would be beneficial. In a less than ideal world though I suppose it's availability OTC is better than not in many cases, hopefully accompanied by some useful printed information about contraceptive advice, counselling etc. if necessary.

Agnes  Posted: 29/08/2006 16:17

Personally I have no strong arguement for the MAP being sold or not sold over the counter but I would worry about women's health in the long term & I feel it should be taken with caution and preferably with some medical advice. Only yesterday the media reported that 100,000 MAP's were prescribed last year. I find that a horrifying statistic as I genuinely feel, like all drugs, there has to be some side effects which have not even come to light as yet. Only time will tell on that one but by then it will be a problem for the women involved. I think it should be available for anyone who is genuinely 'caught out' (whatever their situation)BUT it should be used responsibly & certainly not used as another form of birth control. If 100,000 women used it last year, then I suspect some proportion of them are using it as birth control. Exhausted Doc. I find it rather disturbing that you resorted to using it twice. Little point in telling us, as a Medic, that we should take resonsibility for our own health when you do not do so yourself. 'Fool me once shame on you, fool me twice shame on me as they say'

Mary  Posted: 29/08/2006 14:25

Camie, are unwanted pregnancies and potential abortions the right impression to be giving to young people? Are the young people you know "bad enough". That's quite unfortunate. Just in case you hadn't realised, it's not only young people who need the MAP. "if its sold like sweets you will have young girls using it as their method of contraception". Nonsense - it is suitable for only one use per cycle and finincially it would would make no sense to try using it as a regular method of contraception. I agree tho' that the door should ALWAYS be open to women of all ages to discussing their contraceptive needs with their doctor.

Chana  Posted: 29/08/2006 14:20

Wise woman, if you are seriously deluded enough to beleive that the MAP should only be available in the cases of rape or incest, then you are NOT a believer in the womans right to choose. Who are you to decide when it should be used and in what circumstances? Would you prefer all those who needed it and didn't get it, have abortions? Yes it would be " used in certain needs" - i.e. when the women needs it. "low moral characters" - whatever the heck that is supposed to mean. Will you get your head out of wherever it is you have it. This is a HEALTH issue? How dare you stand in judgement and presume to tell people whether they shoud or should not get their tubes tied. If you really think having our tubes tied is that easy or that the MAP is used only by those who have fliungs then that just shows how out of touch with reality you really are.

ExhaustedDoc  Posted: 29/08/2006 13:56

"Wise Woman", I am a married woman and have twice used the MAP as I am intolerant of pretty much all the OCPs and accidents do happen. I used it because I am not in a position to have a child right now in my career and I don't want one at the moment either! Am I of "low moral character" then? Should I have my tubes tied? I hardly think so, as in a few years I would love some kids and have names already picked for them. If narrow mindedness like yours was widespread, which thankfully it is not, I would be struggling to juggle 100 hour weeks with two small UNWANTED children and miserable. Instead I am going to electric picnic this weekend with my hubby and some friends. I am changing careers and retraining next year, something I would not be able to do had I two small children to try and support. What on earth is wrong with you?

camie  Posted: 27/08/2006 22:18

I don't think it should.It will totally give out the wrong impression to young people as if they aren't bad enough.Anyone can have an accident and require the MAP which is the reason its there. if its sold like sweets you will have young girls using it as their method of contraception and avoiding going to their GP for proper health checks. At least by going to the GP for it in the first place it opens the door to discussing contraception with young girls and might encourage them to decide on more long term methods.

wise woman  Posted: 27/08/2006 05:49

I am a staunch believer in a woman's right to choose. However, the morning after pill should only be available in the cases of rape or incest. I haven't heard yet if such a prescription would be hard to get from a doctor or if it would be used in certain needs. I am hoping that this kind of prescription would not be available like buying asprin. There are so many available methods of preventing pregnancies now, why provide a pill to those of low moral characters? If you insist on having your flings, get your tubes tied.

Anonymous  Posted: 24/08/2006 21:07

Mary posted 21-08-2006. 10:53. Of course Mary you are right there, that the pill does also not protect against std's. from anonymous posted 19-08-2006. 00:24.

P.B  Posted: 24/08/2006 16:21

They should be available over the counter. Its ridiculous that you have to go to a GP for the perscription. It was the same story with condoms 20 odd years ago, you would have to go to your GP to avail of them. I agree with Jesse, lets get Ireland up to speed with the rest of the world.

C.J.  Posted: 24/08/2006 14:34

All I see is young single mothers who are either ignorant, or claiming whatever they can off the system. I feel punished for being married, no hand outs for me! I think they should be handing out the morning after pill free to everyone!!!!

Jesse  Posted: 24/08/2006 12:33

No fast enough I say. What about the burst condom? Tummy bug while taking the pill? Taking precautions does'nt necessarily prevent pregnancy. Accidents do happen. Why should I condem My teenage daughter or sister etc to an unwanted pregnancy because I feel they need time to "Think things through"? Some girls are just too young to make these decisions. And I can hear you before you start. "If they are old enough to have sex they are old enough to make decisions" Just put yourself in their position. Think what it was like when you were young! Also some women find that they have had enough children or are too old to start again. Put an age limit on who can buy it but get it into the shops soon. Give our kids a chance and bring Ireland up to speed with the rest of the world.

Mary  Posted: 24/08/2006 12:07

Let's take our heads out of the sand! - means precisely what it says I imagine. Lets face the truth, recognise reality. Play it safe? That is PRECISELY the OPPOSITE which is being achived by the MAP not being available OTC in pharmacies. If you wanted to play it safe then it should be made far more accessible. Just for your infomraiton, the vast majority of teenagers do NOT use the MAP, sometimes in situatiosn where perhaps they could or should have used it in order to prevent an unwanted pregnancy. But plenty of older women have used it too. Regardless of the best plans and care, contraceptive medicine, like medecine for any other health issue can and does fail. Exhausted again maks perfect sense. Altho', you ae lucky in hat your GP works very long hous and is more available for patients but this is not the case in every area.

Martina  Posted: 23/08/2006 23:16

Shinny, What kind of a statement was that? Let's take our heads out of the sand! Do you think we have no brains at all and are we not entitled to give our opinion? I would definately prefer to play it safe for another while at least. Maybe this information should be sent into the schools first and leave the teenagers discuss it amongst themselves. It will be the majority of them who will be using it anyway.

ExhaustedDoc  Posted: 23/08/2006 19:07

Martina, any doctor who sends a woman away to think about "the impression that the potential child must just wait a little longer rather than thinking that she could be killing someone", when they come looking for the MAP is a)not a qualified doctor and GROSSLY misinformed and b)a cause for concern that perhaps needs to benefit from this competence assurance lark that they are bandying about these days. The MAP is NOT an abortifacient. If you send someone away to think a little longer for whatever reason you suggested the window of opportunity of 72 hours to PREVENT FERTILISATION OCCURRING will be lost. I used caps there because I wished to illustrate the point that fertilisation has NOT occurred yet, the MAP PREVENTS it. Your post illustrates to me the alarming reality that quite a lot of women in Ireland must be very ill informed and not educated with regard to their own health, their bodies and how to make informed choices for themselves. I hadn't totally realised this before. Perhaps it is an issue for Public Health. Floozy, aren't you lucky your GP was available when you needed them? GPs work long hours and they can hardly work any more, but out of hours cover is still not adequate due to a lack of GPs. The side effects as far as I'm concerned are nothing that couldn't be explained by a pharmacist and put on a leaflet that comes with the box. Aspirin has far more serious side effects than the MAP and it is sold OTC everywhere, for heaven's sake. Since everyone is so concerned about these serious and traumatic side effects I'll sum it up in less than 20 words. (and by the way the OCP has more side effects and long term effects by FAR and I don't see anyone giving out about it) Here: Nausea, vomiting, menstrual irregularities, breast tenderness, bloating. Anything else, go see a doctor. In a nutshell.

shinny  Posted: 23/08/2006 15:55

I'm actually shocked at some of the ignorant statements that have been made by a small number of posters. The MAP does not cause an abortion, it prevents pregnancy. There is a big difference there. Here's how; ** The active ingredients in morning-after pills are similar to those in birth control pills, except in higher doses. Some morning-after pills contain only one hormone, progestin (Plan B), and others contain two, progestin and estrogen. Progestin prevents the sperm from reaching the egg and keeps a fertilized egg from attaching to the wall of the uterus (implantation). Estrogen stops the ovaries from releasing eggs (ovulation) that can be fertilized by sperm Morning-after pills aren't the same thing as the so-called abortion pill. Emergency contraceptive pills prevent pregnancy. The abortion pill terminates an established pregnancy — one that has attached to the uterine wall and has already begun to develop ** Yes, it should be given Over the Counter. Lets take our heads of out of the sand here folks !

Mary  Posted: 23/08/2006 15:08

A Dr. who refuses to perscribe the MAP MUST refer the patient to a Dr. who can look after her. He is obliged to do this. Of coure timign is of the essence in that regard also. Which is another reason why accessibilty would be so much better if it was also via a pharmacy.

Cleo  Posted: 23/08/2006 13:06

Of course the MAP should be available over the counter, just like it is in britain. I was assaulted many years ago while away at a festival. The attack happened on a friday night. Despite my best efforts, i couldn't get a GP to see me the following day in that city. The family planning clinic was closed until the following tuesday. I was forced to go to a&e on the saturday evening to obtain the MAP. Not all people who need the MAP are fools who can't get proper contraception organised. Incidentally, GP's can refuse to prescribe the MAP due to personal objections, just like a chemist can refuse to fill a prescription for it. There seems to be an awful lot of misinformation surrounding the issue. People who have no real knowledge or experience of the issue (could that be you, anonymous 19/08?)should take care when making sweeping generalisations. It only serves to muddy the waters further.

Mary  Posted: 23/08/2006 12:48

Killing someone??? Potential Children?? ,Martina - what ARE you talking about? Non one is talking about anyone killign anyone or potential children at all. The MAP prevents prenancy. That's IT. As for what she would like to do with her life befre or if she decides to have children, that surely is nothing to do with the Dr. or indeed pharmacist.

Martina  Posted: 23/08/2006 10:53

I think it is vital that MAP's are not given over the counter. I also believe that a doctor should be trained very carefully in this area. He should be able to convey the message to the woman that the timing is not quite ready yet for her if there is a possiblility of a potential child. The woman needs to come away with the impression that the potential child must just wait a little longer rather than thinking that she could be killing someone. Questions should be asked like when would she like children for the future or what would she like to do with her life first. It would make a far better impression on her mind then leaving her just walk into the chemist by herself with thoughts that could be narrow-minded at the time. The last thing one would want is for a woman to think that she could have killed someone even when absolutely nothing happened. Some women are extrememly sensitive in this area.

Mary  Posted: 23/08/2006 10:19

Flozzy, there are side-effects with the MAP, but I imagine the side effects from an unwanted pregnancy is even greater. The issue her eis not just cost - the 50e for the Dr. but also accessibility.

Floozy  Posted: 23/08/2006 09:36

MAP should definetely NOT be available over the counter. Like with all drugs there are side-effects of taking this and they should be discussed with a medical practitioner before people start taking them willy-nilly. I have taken the MAP about 4 times in my life, mostly after one-night stands when I wasn't currently on the pill. I went to my GP (no need for embarrasment, they can't judge you or discuss it with anyone else) and she explained all the pros and cons and side effects and then safely prescribed it for me. It is worth 50euro for a doctors visit for that peace of mind.

Mary  Posted: 22/08/2006 10:07

The MAP works up to 72 hours, but the later it is taken the less effective it is likely to be. Certainly it has been available on perscription for years and there are still unwanted pregnancies. I think if the access issue was sorted out this would help to reduce that number even more.

Agnes  Posted: 21/08/2006 23:59

I fully believe it should be widely available but there are risks with any drug & there are side effects. Some people take drugs like MAPs responsibly some do not. But surely getting medical guidance with any drug is important. If we all acted responsibly all the time we wouldn't need MAPs at all. Unfortunately we are human! Condoms do not cause side effects in themselves Mary so there is no problem with them but any drug will cause side effects. If it works up to 72 hours then surely the guidance of a G.P. is a good thing. MAP's have been available on prescription for a long time now & still there are unwanted pregnancies. But I agree with Exhausted Doc in that it is a silly situation that any girl would have to go to an A & E for MAP's. That is totally ridiculous in this day & age.

Helen  Posted: 21/08/2006 13:22

I think that with so much alcohol being consumed by teenagers today, they are at particular risk of an unwanted pregnancy and may not want to go to a family doctor. Yes the morning-after pill should be available to all girls and women over the counter in pharmacies.

Anonymous  Posted: 21/08/2006 11:54

What a lot of preconcieved ideas and misconceptions get bandied about by people with set opinions and little real knowledge or experience. The VAST majority of women seeking the morning after pill do so after a once off mistake or accident. Even the most responsible people find themselves in these situations sometimes. Often married women or women in longterm monogamous relationships. It really riles me to see such nonsense as written by anonymous on 19th. Nobody is using the MAP every time they have sex. That would far too expensive, embarrassing, stressful and risky in contraceptive terms. Making it available OTC won't make that happen either, but it might prevent some unwanted pregnancies. Yes, it can be taken up to 72 hours after the "episode" but the earlier the better. Each 12 hours nearly doubles the risk of pregnancy so it is not ideal to have to wait. Sperm can survive for up to 7 days in the female!!!

Mary  Posted: 21/08/2006 10:53

Anonymous Posted: 19/08/2006 00:24 Perhaps you are very lucky but to many people despite contraceptive use, mistakes and accidents do happen. Just to note. The pill does not prevent STIs either. Anon Posted: 19/08/2006 01:13 - it is my understanding that the earlier it is used the better. If you had an accident on Friday night, would you want to wait until the Tuesday aftr a Bank holiday to get the medication you needed? "If you could buy it over the counter then you promote widespread use of it without any medical guidance " - strnage but that has not happened with condoms, which indeed my be a pity. The MAP ius suitable only for single use during any menstrual cycle.

Joan  Posted: 20/08/2006 21:13

Absolutely and 100% the MAP should be available in pharmacies. For those who dont ever want to take it, no one is forcing you. For those who do, everyone else needs to mind their own business.

hermon (GVQ47886)  Posted: 20/08/2006 18:02

Yes it must be available

Sandman  Posted: 19/08/2006 13:01

If I want holiday photos developed I'll go and see a pharmacist. The health implications, side effects, sexual health risks etc cannot be dicussed over the counter in a chemist while an old dear next to you wats for her Canasten

Anon  Posted: 19/08/2006 01:13

I was under the impression that you could take the map up to 72 hours after sex. If that is the case, there is no reason why you cannot see a G.P. & therefore would never need to go to an A & E. If you could buy it over the counter then you promote widespread use of it without any medical guidance & surely that cannot be good for any woman's health in the long run. Surely we should be trying to educate women in the safe usage of these drugs not just give them the impression that they can take them any old time regardless?

Anonymous  Posted: 19/08/2006 00:24

not at all, the morning after pill is not something to be used willy nilly "pardon the pun" if you plan or are haveing sex you need to be on the pill and not just use the morning after pill after everytime you have sex. and it does not stop std's.

ExhaustedDoc  Posted: 18/08/2006 20:12

Furthermore, one is quite likely to get pregnant if you have sex straight after your period. That's what, say day 7 or day 8? Sperm can survive in the female genital tract for almost up to three days (scary little buggers) and quite a lot of women don't ovulate on day14, indeed it is perfectly normal to ovulate on day 10. Hence it is a potentially really dangerous time to have an accident.

Anonymous  Posted: 18/08/2006 18:17

In principle, I think it should be available OTC, but I would be concerned about the practical details. When I give someone the morning after pill, it takes at least 10 minutes to ascertain that it is needed under the particular circumstances, that it is advisable for the individual conderned and then to explain how it works, the possible side effects and consequences. How can this be done in privacy in a busy pharmacy? I also know of one(hopefully unique) pharmacist who is spreading the word that 3 ordinary contraceptive pills taken together is just as effective when this is incorrect! I found out about him when I saw a young girl with a positive pregnancy test as a result of his advice. It would be good if people could access it easily and cheaply. Practice nurses would be ideal. My practice, while charging for the initial visit, gives a free follow-up appointment 3 weeks later which can be used to discuss future contraception etc so that makes decent value for money.

thepokerqueen  Posted: 18/08/2006 15:44

definately it should, at least then it might stop some unnecessary abortions...

Anonymous  Posted: 18/08/2006 14:41

Oliver, you are missing something, female reproduction organs.

Mary  Posted: 18/08/2006 11:15

Hibernia, the MAP is NOT an abortifaciant. You are either grossly misinformed, mixing it up with RU486 which is completely different or telling blatant untruths. Believe me, without the MAP there would be a much higher rate of abortion. Would you prefer us to prevent the problem or export it after it occurs? More good advice Exhausted - providing a pregnancy test kit and anti-nausea meds with it. Thank you for your good sense.

Anonymous  Posted: 18/08/2006 09:49

why not - you can buy it on the internet...yes i know all the arguments about buying meds over the web...but it still happens.

ExhaustedDoc  Posted: 17/08/2006 22:12

To mary who asked what if someone is pregnant already and takes it? Many women are prescribed 3-6 months of the OCP at a stretch and though they have been advised on how to take it, they are not under direct medical supervision all during those months. They take it whatever way they want to, be it as directed or wrongly. A person I know forgot her pill for a week, then took 7 in one day!! while you may say this is stupid, the fact is that women are already administering hormone preparations as they see fit, once prescribed. Who is to say these women are not taking the pill incorrectly, getting pregnant, and continuing to take it while pregnant? All any doctor/pharmacist can do is provide advice, at the end of the day it is your choice whether or not to follow it, and your responsibility if not following it correctly gets you in trouble. If it were to be sold OTC, perhaps a pregnancy test should come with it, to be used AT YOUR DISCRETION. It is not actually anyone else's business if someone is pregnant unless they wish it to be. Oliver, on a weekend or at night, the doctor doesn't treat the side effects, you get prescribed the pill, you take it, and if something happens then you are right back where you started from, looking for an out of hours doctor. Hence it should make no difference whether or not a pharmacist or doctor hands this out. The commonest side effect is usually nausea and vomiting, and an anti emetic is usually prescribed with the MAP. However, nausea and vomiting as a side effect of the MAP isn't really an indication for further major treatment. And a spare pill is often given in case of sickness also. Yes we are sending out the right message: that an unplanned unwanted baby can ruin your life and that of the child's also, so to take precautions. We are sending out the message that we can help that to stop from happening and that if a girl/woman finds herself in this situation, that it is ok, there is easily accessible and convenient help at hand.

Hibernia  Posted: 17/08/2006 20:17

MAPis a potent abortifacient if the taker is pregnant. Abortion is illegal in Ireland and so should the MAP.

Anonymous  Posted: 17/08/2006 19:57

I am a teacher of biology and research. I believe I would wait until further results before making them "over the counter". They do NOT "abort" as there is no pregnancy, but they are only designed as an "emergency measure". My greatest concern is that many people will not consider the full side effects possible when rushing to use it after manufacturers (eager to sell their product) concentrate on the "lesser" side effects. There ARE people who should NOT use MAPs just as there are those who should not use regular oral contraceptives due to the components(ie:allergies, health conditons,sensitivies). As yet, "long term" effects are unknown concerning women who use the MAP continually, disregarding guidelines because they are advertised as having "advantages outweigh the proven risks". Really? Do keep in mind the producers of MAPs are in a money-making business as well. Will this be at the expense of many women? The future will help us decide. My only consideration is for the health of present and future populations.

Mary (Mary B.)  Posted: 17/08/2006 17:08

mary, the morning after pill will not work if you are already pregnant. If a women believes or suspects that she is already pregnant. This should be determined first and she should be referred to her clinic or GP. If you have sex stright after your period you are unlikely to becoem pregnant but it i still possible which is why the MAP may be required. Anonymous Posted: 17/08/2006 14:39, you are completely and utterly wrong. RU486 is a medical abortion but this is NOT the same as the MAP and you are simply spreading misinformaiton to suggest that it is. They they are completely chemically and biologically different. This is established medical and scientific fact. Oliver I sincerely hope a chemist will treat or refer any side effects. Our pharmacy opens for two houers on Sunday Morning as are many bigger city pharmacis. Are we sending out the right message?? Do you think unwanted or crisi s pregnancies are he right message. Greater access to contraception has reduced unwanted pregnancies. But now we don't effectively imprison women in convents and laundaries when it happens. But regardless of contraceptive acces, accidents DO happen.

Oliver (owhyte)  Posted: 17/08/2006 16:26

Will the chemist treat the side effects? How easy is it to get a chemist on a Sunday or bank holiday Monday. Are we sending out the right message. Liberalization of contraception was supposed to reduce single parent pregnancies - it has rapidly increased since it's introduction. Am I missing something?

Cee  Posted: 17/08/2006 15:42

Women in border counties are already travelling North to get it, why not make it available here too? Pharmacists make a point of talking to someone wishing to buy the MAP to advise them on better options. I think the price it's sold at (25 pounds Sterling) further encourages people to only use it in emergencies. Accidents DO happen no matter how much the Irish population wishes to think they don't.

nevermind  Posted: 17/08/2006 15:33

the morning after pill should be availble over the counter.i ve never had to use it.. but if i ever have to i would prefer to go to he chemist than glo to he doctor. also will prevent alot more unwanted pregnancies

Mary  Posted: 17/08/2006 14:46

Absolutely. It will make the morning after pill far more accesible in a much more timely manner in an issue in which time is off the essence. Maeve can we stop looking at this as a sex/moral issue and start looking at it for what it is - a health issue. It NEEDS to be easier for people to get - regardless of age. Of course there are other things of concern. It can only be used once in any cycle and the pharmacist should refer the patient to their clinic or GP to discuss contraceptive needs as required. WELL SAID Exhausted, this will lift the pressure off A&E, where a lot of women are forced to go for this should they need it outside of 9 - 5. Charlotte "People need some time to think through what they could be doing and it would make them more careful in the future" - And this I'm sure explains all the unwanted teen pregnancies that we have. I don't think. The 5 or 10 hours could be the precise CAUSE of all the heartbreak in the furture if an unwanted or crisis preganccy occurs. Remember, sex is NOT a lifelong decision. A baby is. Saroco :"the cop on to be careful". Have you never ever had an accident of any kind in your life. The need for the MAP IS a genuine health concern.

Anonymous  Posted: 17/08/2006 14:39

RU486 is a chemical abortion - in my mind the MAP is no different.

Anonymous  Posted: 17/08/2006 14:04

I know 2 girls who because they had to wait to go to the doctor to get the morning after pill, ended up being pregnant even though they took it within the time period. The sooner women can get their hands on the pill the better and therefore it should be available in pharmacies.

Molly  Posted: 17/08/2006 13:59

100% agree that morning after pill should be available over the counter it is ridiculous that women are expected to pay €40 to the doctor and then pay at the pharmacy as well. I also think the contraceptive should be available over the counter as again it is ridiculous that Doctors get €40 just to write a perscription, it is a complete rip off my doctor doesn't even check my blood pressure and gets €40 for just writing his signature.

mary  Posted: 17/08/2006 13:54

exhausted doc, you are a doctor, I take it. what happens if a girl or woman is pregnant already, is unaware of it and takes the morning after pill? this is why I would be against it. I think it requires some kind of brief interview to establish the context and if indeed it is necessary at all because if you have sex straight after your period it's very unlikely that you become pregnant. would or should a pharmacist be able to make such a judgement over the counter. do you think young girls in this country or women are sufficiently educated about their bodies and their menstrual cycles to make this decision for themselves.

joanna (GZQ38358)  Posted: 17/08/2006 13:35

We have the MAP available over the counter in scotland, and it makes it much easier to get when its required.

kit  Posted: 17/08/2006 13:08

yes it should be available over the counter.

Maglite  Posted: 17/08/2006 12:59

The MAP is in huge demand, and should be available in pharmacies. In France they have the "up-to-six-weeks-after pill" - RU486. You don't need to take it unless you have a positive pregnancy test. Perfect.

swanangel  Posted: 17/08/2006 12:53

I am a 20 year old girl I met my boyfriend at 17 I was a virgin he was not so I asked him to get tested before we started having sex and at the same time I went on the pill. 3years ltr we are still together living in my parents house, we use the pill and condoms and have never had a scare. Adults have some faith, us young people are not all the same! The MAP should be sold in chemists, people will continue to have as much unprotected sex as usual if it is or not. But this will cut the amount of unwanted children born to ''mothers&fathers'' untill they are mature adults that can raise a child.I bet those of you who do not want the MAP avb in pharmacies are the same people who tut tut at the young girl pushing a pram! I know to many young mothers who would have got the MAP but could not pay the docters fee or were scared of the judgement they would get from there GP.People open your eyes!

kit  Posted: 17/08/2006 12:35

yes it should be available over the counter.

Claire  Posted: 17/08/2006 11:36

exhausted doc said it all. Maeve your response is startling. And Chuckles young people having sex is not a matter for disdain.Nuff said.

Sue  Posted: 17/08/2006 11:12

This country needs to come out of the 50's and realise that people cannot afford to take time off work should they be unfortunate enough for a slip up to occur.

gretts  Posted: 17/08/2006 10:51

absolutely doctors are not available in some rural parts of ireland at weekends when the pill is mostly required as per reports on the news

saroco  Posted: 17/08/2006 09:17

yes,of course it should!if not then this is only adding to the already over worked gp s daily amount of patients.why should people who have genunine health queries or problems be told "no,you cant have an appointment today" just because some silly person has choosen to clog up the system because they dont have the cop on to be careful in the first place?!

Charlotte  Posted: 17/08/2006 04:01

Too fast I say. People need some time to think through what they could be doing and it would make them more careful in the future. Five or ten hours could save a lot of heartbreak in the future form making a decision you might regret for the rest of your life.

ExhaustedDoc  Posted: 15/08/2006 20:53

Yeah Chuckles, but having a high risk teen pregnancy and an unwanted child definitely gives the right message to the kids. Maeve, quite obviously if someone goes to the trouble and expense of seeking out the morning after pill, they are looking out for the consequences in the most responsible way possible. An unwanted child is a huge struggle and burden, and literally puts these girls' lives on hold or, in some cases, ruins them completely. Whereas easy access to an effective pill that is given under the guidance of a pharmacist would effectively eradicate these situations. Chuckles, to come back to this "wrong message", do you think condoms for sale is also the wrong message? while I do realise that condoms have the advantage of protecting one against disease and the MAP obviously does not share that advantage, what about people who are being "responsible" ,and using them, and they break or come off or something? There are always situations like these. And as Ireland has this stupid tradition of medical services being primarily based around a 9-5 model Mon-Fri, how are people meant to get the MAP at nights and weekends, (for those of you who are getting some, you will know that this is by far the commonest time for accidents to happen). Also, like a foreign girl I saw last weekend in the A&E, some people who are not from Ireland and do not have a GP are forced to go to A&E and 1) wait 5-10 hours for a stupid pill and 2) help to further clog the A&E with small things that should not really have to be there. Bring it on!!!

Chuckles  Posted: 15/08/2006 18:28

There are arguments for and against it, but I think there are a lot of other medications that should be available over the counter ahead of the morning after pill. I think it would make it too easy for people to get it - it will give the wrong message to young people in particular.

sunny  Posted: 15/08/2006 15:31

Of course it would be better. Pharmacists are only a step behind doctors often you will find that there advice is 100% better than the doctor. It will make the morning after pill more affordable for teenagers

Cleo  Posted: 15/08/2006 13:04

Of course it should! Pharmacists are well-qualified to advise on side-effects, frequency of use etc. Many people can't afford the g.p. fee plus the prescription fee. If the middleman was cut out, it would be easier financially and geographically to access it.

maeve  Posted: 14/08/2006 22:56

Why? That tells eveyone we expect them to have sex without bothering to look out for the consequences. If we encourage that, then we have more Sex transmitted diseases to cope with.

beelzebub  Posted: 14/08/2006 16:40

Absolutely. This is a no-brainer.