Experts warn about perils of morning-after pills

Blaming the explosion of abortion and teenage pregnancies on moral decay and then doing nothing to correct it is akin to burying our heads in the sand and hoping for miracles. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • Makanga says ECs make the uterus hostile to the implantation of the fertilised egg. They were meant to serve as a Plan 2 in situations of rape.
  • Makanga advises youth to see an obstetrician/gynaecologist for check-up before taking any hormonal contraceptives.

On a high-end university’s Facebook wall, questions and responses about emergency contraceptives (ECs), aka Plan 2 or simply P2, flow with reckless abandon: “Hey Mums, is it good to be using P2 every time after doing it?”

The first response that elicited 121 comments is: “No. Itakudhuru.” (Kiswahili for “It will harm you”.)

“So, which is the best method pliz?” “Tumia (use) condom,” she is told. An instant chorus follows: ‘No, no … I used that thing last month sai periods zangu zimedelay kukam …” (I used the condom last month and now my periods have delayed).

“You are paged, siku hizi ni fake,” she is told, meaning, ‘You’re pregnant; they [condoms] are fake nowadays’.

In another chat that prompted 155 responses, a student asks: “Can P2 delay periods mums? …”

One goes: “Yeah it can mess with the cycle. Problem is when it interferes for nine months.”

PREGNANCY

The cynicism is obvious: “Yes but for only nine months then utapata matokeo”, meaning, “you get the results in nine months”.

That, too, is picked up as if it were just a light joke. “Yes, mine delayed for nine months. The results. Owesome (sic) baby boy now two years …”

Clearly, P2 is delivering more than what the young women may have bargained for.

Interviews with specialists and youth familiar with ECs and their use suggest so.

Kenya’s young women are virtually riding the tiger as they get hooked onto a drug that should be used not more than twice a year and only in emergency situations.

The alarm is sounded by young experts like Dr Juliet Obanda Makanga. The lecturer at Kenyatta University School of Pharmacy, who is a neuropharmacologist and stem cell researcher, has a terse message for young women who abuse the morning-after pill: 'Stop it!'

MISUSE

At 33, the Alliance Girls High School alumna holds a doctorate in pharmacy and also a PhD in pharmaceutical sciences engineering.

Pharmacology is how drugs and substances work in the body and how they affect the functioning of the brain. Stem cell engineering makes it possible to use body cells as pharmaceuticals.

Dr Makanga says ECs prevent ovulation and may also interfere with receptivity of the uterine wall to the fertilised egg. They were meant to serve as a Plan 2 in situations of sexual assault and possible contraception failure such as improper use of condoms. “We have missed the point that they are not routine contraceptives.”

In a number of developed countries, she says, they are prescription-only drugs.

“What is wrong in our situation is that inasmuch as the drugs are extremely useful in certain situations, their ready availability and repeated use is a problem. Acquiring your Plan 2 is as easy as acquiring a Panadol.”

There is need to tighten regulations governing their use and counsel users, Dr Makanga says, adding that most young people do not realise the dangers associated with routine use of p2s.

She cites infertility as one such risk. Routine use of p2 may change menstrual cycle and alter the structure of the uterus lining such that when the woman is ready to start have children, the chances of the egg attaching to the uterus or sustaining a pregnancy are lower. Ectopic pregnancies and cancers are other potential problems.

“Ultimately, this is a foreign substance that you’re putting into your body,” warns Dr Makanga, a 2018 winner of the Nation Media Group’s Top 40 Under 40 Awards recently administered by the Business Daily.

In an interview with a former graduate of Moi University, who preferred not to be named, the man in his 20s seemed to agree with Dr Makanga’s association of P2 with difficult pregnancies.

“I had a friend whose mother is a doctor. She had easy access to these pills. She told me of her friend who had an ectopic pregnancy that was associated with P2. Misuse of P2, from what I know, can lead to complications such as ectopic pregnancy,” he said.

“Apparently, they are not supposed to be taken frequently; at most, twice a year.”

ABORTION

He said a friend once sent him to buy those pills, but she later procured an abortion. “My take is that P2 is a gateway to abortion,” he said.

A young woman, also in her 20s, and a graduate of a prestigious private university, said she first heard P2 advertised on radio when she was in high school.

“This was mostly advertised between 5pm and 9pm when high school students are listening in. I see a lot of posts on Facebook, like, ‘In my marriage, I can’t have babies’, which are dismissed with ‘you must have taken too much P2.’”

She adds: “I’ve heard that it’s a fast-seller in chemists; it sustains many chemists, especially on Monday mornings. I’ve also read on Facebook that it has failed many people, who have got babies even after taking them.”

Some of them later aborted, while some of those who kept the babies say, ‘This baby is my blessing’.

Nairobi obstetrician and gynaecologist Stephen Karanja is equally concerned about the abuse and misuse of P2.

INFERTILITY

The morning-after pill has a compound, Levonorgestrel, a hormonal medication that is used in a number of birth control methods, he says.

Its brands include Next Choice One Dose (Actavis UK), Opticon One Step (Sun Pharma), Option 2 (Perrigo, Australia and UK), and Plan B One Step (Teva, Israel and US).

Though the recommended dose is 0.75mg for post-partum mothers, which is not even needed as breastfeeding has contraceptive properties, Dr Karanja notes that children as young as 10 years are being exposed to 25 times that dosage.

He blames the high infertility rates in recently married young women and low sperm count in young men on mothers who were put on Microlut, a version of Levonorgestrel, which is routinely administered to women six weeks post-partum.

Most young women have irregular monthly periods due to poor ovarian function, likely because they ingested hormones from breastmilk.

CANCER

Dr Karanja sees one patient a day on average complaining of menstrual irregularity, making it hard to tell whether or not they are pregnant.

Others complain of lack of periods and bleeding too much, while some present with ectopic pregnancies. Headaches, anorexia (lack of appetite) and excessive weight gain are other problems.

The doctor has attended to young patients whose breast cancer could be linked to the abuse of ECs.

The correlation between breast cancer and Levonorgestrel has been scientifically proven, Dr Karanja says.

He expressed concern that children as young as 14 years are being exposed to the morning-after pill. He, too, expressed concern that P2s are available over-the-counter (OTC).

Dr Karanja recalls a visit to the implant Jadelle factory in Sweden, which is clearly labelled: “Not for use in the EU. For export only”, hinting at a population-control conspiracy against Africans.

Dr Makanga advises youth to see an obstetrician/gynaecologist for check-up before taking any hormonal contraceptives.

She wishes to do a prospective study on long-term use of P2s. She also wants regulatory authorities — the Pharmacy and Poisons Board in particular — to act on OTC sale of P2s and contraceptives.