Between the arguments surrounding over-the-counter access to Plan B One-Step and the debate over whether or not Obamacare should cover birth control and abortions, you may have thought that you had heard all there was to hear about America’s famous “morning after” pill. Well, guess again.
The shocking news began in Europe when health regulators there warned the manufacturers of Norlevo of some of the pill’s serious drawbacks: this emergency contraceptive pill loses efficacy if the women taking it weigh over 165 pounds, and it does not work at all for women weighing over 176 pounds.
Although Norlevo is not approved for sale in the United States, it does have the same active ingredient as Plan B, levonorgestrel. The drug’s connection to Plan B was first made in an article by Mother Nature Magazine, and has since captured the attention of women worldwide.
The question now under investigation is whether Plan B has the same problem as its European counterpart. This decline of efficacy with increased weight could have a huge impact on American women. A study done by the CDC from 2007 to 2010 shows that the average weight of American women above the age of 20 is 166 pounds, putting a large percentage of women in the ‘gray area’ of the drug’s efficacy.
Credit: drugs.com
When Becky Aydin ’14 first heard the news, her immediate response was, “Why don’t they just increase the dosage requirements with users’ weight?” Unfortunately, the solution is not that simple.
Scientists seem to agree that this is a multi-sided problem that has to do with both the molecular complexity of levonorgestrel as well as the complications in bodily functions that arise when a woman becomes overweight. Levonorgestrel is considered a non-linear pharmacokinetic drug, which essentially means that increasing the dosage will not increase the effects. On the other side, Dr. Alison Edelman, an OB/GYN studying the phenomenon, has concluded (along with collaborators) that levonorgestrel leaves the bloodstream of obese women at a different rate than it does for normal-weight women.
Although Plan B is currently the most readily available emergency contraceptive, it is not the only option if you are in the ‘gray area’ of the drug’s functionality and need emergency contraception. Alternatives such as ulipristal acetate, or ella, in addition to copper intrauterine devices like ParaGard, have been found to be more effective than Plan B, and do not seem to have any weight limitations. The caveat, however, is that both of theses alternatives require prescription or special medical fitting and insertion by a doctor. It seems that women who cannot afford another form emergency contraceptive or are only willing to buy over-the-counter medication are out of options until the makers of Plan B can adjust the major gap in the types of people it can help.