Youths risking life by misusing pills that prevent pregnancies

ECPs are not regular contraception pills, which can be consumed on a daily basis

Kathmandu, July 10

Renuka (name changed), a 22-year-old bachelor’s level student from Patan Multiple College, felt a sharp pain in the lower abdomen while attending a class on a recent morning. Soon afterwards she could feel the blood gushing out of her vagina.

This was not normal because several days were left for the regular menstruation cycle to begin, she said. Yet she did not seek any medical assistance, assuming the bleeding would stop. But it did not. Instead, the bleeding started getting heavier. And one day she had to be rushed to the hospital by her friends. As the diagnosis began, she revealed that she had been consuming emergency contraception pills (ECPs) for quite some time, as her boyfriend had stopped using ‘condoms’.

“I had consumed six of those pills in about a month before I started bleeding profusely,” Renuka said. The doctors told her that those pills were the root cause of heavy bleeding.

Youths like Renuka and her boyfriend, who indulge in unprotected sex every now and then, are fuelling the demand for ECPs.

It is therefore not surprising that Dr Geeta Gurung, a senior gynaecologist at Tribhuvan University Teaching Hospital, has been receiving three to four female patients suffering from heavy bleeding every week.

But little do these youngsters know that ECPs are meant for emergency purposes and not for frequent consumption. This practice of rampantly consuming ECP to prevent unwanted pregnancies is putting lives of females at risk and making both the partners vulnerable to sexually transmitted diseases, experts said.

A snap survey conducted by THT in 15 pharmaceutical shops in Kathmandu showed that demand for ECPs had jumped over 10-fold in the last two years. Each of the dispensaries that THT visited was selling an average of 100 to 600 ECPs a month. They said 70 per cent of their customers were youngsters.

The surge in demand for ECP has raised eyebrows of doctors, who say the medicine should be taken only if it is completely necessary. And if one has to resort to those medicines, they should be used at intervals of at least six months, according to Dr Usha Shrestha, senior gynaecologist at Maternity Hospital.

“ECPs are not regular contraception pills, which can be consumed on a daily basis,” said Dr Khem Bahadur Karki, member secretary of Nepal Health Research Council.

Frequent consumption of ECP is not recommended because it contains a high dose of steroids, which manipulate hormonal structure in females, according to Karki. “They can also cause excessive menstrual bleeding, nausea, vomiting and vaginal infection,” Karki said. “If overused, it can affect the liver, make women infertile and raise chances of contracting cancer, including breast cancer, by three-fold.”

The government allowed over-the-counter sale of ECPs in Nepal in 2003. Currently, around 12 brands of ECPs are available in the market. These pills must be taken within 72 hours of engaging in unsafe sex to avoid pregnancy.

“Although these pills prevent a woman from becoming pregnant, they do not insulate partners from sexually transmitted diseases. So, partners are advised not to engage in the risky sexual behaviour,” said Dr Karki, adding, “Awareness campaigns need to be launched to prevent misuse of the drug.”

One way to curb rampant misuse of the drug, according to doctors, is inscribing cautionary messages and pictures on the medicine cover.

However, the government is not mulling over taking any measure to put the brakes on unnecessary use of ECPs.

“We are still focusing on disseminating information on benefits of using ECPs to avoid unwanted pregnancies. We have not thought of launching awareness programmes to control their use,” Director General of Family Health Division Tara Nath Pokharel said.