There’s a simple way Congress can make birth control easier to access and improve women’s health

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Nearly one in 10 women ages 18-25 say they delayed or were not able to get their birth control due to the COVID-19 pandemic.

  • Because of COVID-19, telehealth has become more commonplace and accessible.
  • Allowing women to get and refill birth control prescriptions via text or phone would increase accessibility.
  • Lawmakers must make their constituents’ continued access to basic birth control through telehealth a key focus.
  • Liz Meyerdirk is the CEO of The Pill Club, a direct-to-consumer birth control provider and wellness brand.
  • This is an opinion column. The thoughts expressed are those of the author.
  • See more stories on Insider’s business page.

There are very few upsides to the pandemic, but the accelerated deployment and adoption of telemedicine is certainly one. Our healthcare system was forced to adapt to lockdowns and social distancing, so the CDC issued emergency waivers for patients to use telehealth services from home, allowing doctors to be paid for virtual visits. Clearly, not all medical care can or should be provided virtually forever, but one category absolutely should: birth control. That’s why we’re calling on Congress to increase access to birth control via telehealth on a permanent basis.

Barriers to birth control access

The number of telehealth claims increased 3,060% nationally from October 2019 to October 2020. The telemedicine solutions worked so well that lawmakers are looking to make some emergency stopgaps permanent, and members of Congress have introduced a slew of bills pertaining to telehealth just this year.

The status quo for millions of American women today requires them to see a doctor in person every year to receive a new prescription for a birth control medication they have been on for years if not decades. Women must make these appointments not because they want to, but because in many places they have to, and in other places, because they don’t realize there is another option. Women who are already navigating multiple jobs or caregiving responsibilities also then have to drive, park, take the bus or subway, and wait in line every month at a pharmacy to get a limited supply of their medication, just 30 days at a time.

The persistent physical and economic barriers that keep women from receiving basic healthcare have only increased over the tumultuous past year. We know now that it is women – particularly black women – who are more likely to have lost their job due to the pandemic, and with it their work-related health insurance and access to affordable healthcare. A survey published last month revealed that nearly one in 10 women ages 18-25 and 7% of women ages 26-35 say they delayed or were not able to get their birth control due to the COVID-19 pandemic.

I recently became the CEO of The Pill Club, a company founded in 2016 to address this challenge and make women’s lives easier by delivering on-demand healthcare for their everyday needs. We currently provide 24/7 telehealth services from medical professionals for hundreds of thousands of women in 46 states. Our premise is that women’s health isn’t niche: it’s half the population.

An anecdote that perfectly encapsulates the absurdity of the constraints we place on women to receive this foundational care came my way recently from a current Pill Club member. She was turned away from her annual OB-GYN visit last year because she brought her toddler with her. Having her 2-year-old present violated office COVID-19 restrictions and she had to skip the appointment and forgo receiving a new prescription for a medication she’d been on for years. No one should have to get childcare or time off to gain access to this kind of healthcare.

Telehealth as a solution

“Telehealth” is sometimes used as a shorthand to mean video visits with physicians, but it also can refer to text and phone consultations. Text and phone have proven themselves to be a lifeline to increase access for seniors on Medicare during the pandemic, and we know that it can help younger women, too. Millions of Americans still don’t have high-speed internet, hi-res video, or unlimited data plans, particularly in rural areas and urban centers. Our company oversees nearly 250,000 patient visits a year, the vast majority of which don’t require video consultation. An example of a commonsense public policy change would be to permanently expand access to contraception care via text and phone consultations.

Making it easy for women to receive birth control consultations virtually and their medication by mail should not be viewed as a luxury, but rather a utilitarian tool that can save women precious time while they find a way to make ends meet, care for their children, and put their family lives back together post-pandemic.

This flexibility is even more important for the roughly 17 million women who receive Medicaid services and are currently within their reproductive years. After all, in 2018 Medicaid paid for 42% of all births in the United States, so it seems self-evident that helping women prevent unwanted pregnancies, which often result in costly care, should be top-of-mind for lawmakers.

As we move into a post-pandemic world, one in which women have borne the disproportionate cost of economic and job dislocation, we urge lawmakers to make their constituents’ access to basic birth control a key focus and permanently less of a hassle.

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Why we don’t have birth control for men

  • The condom was invented more than 5,000 years ago. While it’s made some strides since then, men are still left with few options for birth control, besides a vasectomy.
  • It’s not due to a lack of interest, but a lack of funding for research – and biology.
  • Men produce millions of sperm each day. Even if that count is reduced by 90%, they could still be fertile.
  • There are new methods coming, but experts say it will be years, if not decades, before they hit the market.
  • Visit BusinessInsider.com for more stories.

Following is a transcript of the video.

Narrator: Did you know the condom is over 5,000 years old? That’s right, some of the first forms of birth control date back to around 3,000 BC, and while the condom has made some strides since the Bronze Age, men still don’t have a much better option all these millennia later. Besides a vasectomy. Especially compared to the pills, IUDs, and implants available to women today. So why don’t we have birth control for men? In 2002, researchers asked more than 9,000 men across four continents whether they’d be willing to use contraception capable of preventing sperm production. Over half said yes. So the problem isn’t lack of interest, it’s partly human biology. Women ovulate just one or two eggs each month. Men, on the other hand, produce sperm daily, and it’s not just one or two.

There’s literally hundreds of millions of sperm produced each day, so because there’s so many sperm produced, actually, you can reduce your sperm number over 90% and still be completely fertile. Narrator: To reach infertility, a man’s sperm count needs to be somewhere around 1 to 10 million per milliliter, but getting there is near impossible, at least without side effects. That’s because sperm count is tied to the production of testosterone. In the past, researchers tried decreasing testosterone in an effort to decrease sperm count.

The problem is you don’t have any libido, you have very little testosterone to act on other tissues and so forth, and so the side effects were so dramatic that it really wasn’t ever going to be a contraceptive pill. Narrator: Scientists also tried using different compounds that attack the cells that produce sperm. But again, biology got in the way. Germ cells, as they’re called, developed inside a fortress-like structure within the testes.

So literally, nothing can get through it. There’s been a lot of small molecule studies to try and actually attack the germ cell to stop it from working. Literally, I can think of 10 or 15 different compounds that actually have been developed to do that, but they don’t work because of that barrier. Narrator: But the complex male anatomy isn’t the only problem. It’s also funding or lack thereof. In 2002, two big pharmaceutical companies took interest in male contraception, Schering and Organon. And together they funded a large clinical trial on a hormone-based contraceptive, offering hope that a pill backed by Big Pharma might be on the horizon.

Then these two companies became, as you know, acquired by bigger company, and then even bigger company, so now they are merged in huge companies, and women’s health is still a priority in many of the companies, but men’s health became part of the general matter of health. And therefore, the development of contraception becomes a really very low priority. Narrator: According to Dr. Wang, male contraception was also too risky for Big Pharma at the time. The long-term side effects were unknown. Companies were concerned that women might not trust it, and despite the survey results, it was unclear whether men would actually use a hormone-based contraception. Today, the limited funding comes mostly from government agencies like the National Institutes of Health. But there are in fact some promising lines of research. Dr. Wang is working on a gel that can lower testosterone where it matters, in the testes where sperm is produced, while keeping testosterone levels normal elsewhere. That means low sperm count and, more importantly, no major side effects.

We have preliminary studies to show that if we give the gel and if the man applies the gel, 90% of the men will reach the level that you talk about, 1 million per mil.

And Skinner is pursuing a new approach, shutting down Sertoli cells, which are a part of that impenetrable barrier that houses germ cells.

So if you shut down the Sertoli cell, then you shut down the sperm production. Narrator: But perhaps most promising is a sort of reversible vasectomy that’s in the works.

So they have this ability to inject this gel into what’s called the vas deferens, and it makes this plug, so then essentially it does the same thing, but you’re not cutting it. Then believe it or not, you can actually inject this chemical mixture, which will dissolve the plug, and so then you can get your fertility back. Narrator: But as promising as these approaches may be, they’re still years, if not decades, out, Skinner says. And without more funding, some of them may never hit the market. So at least for now, men are left with few options. Irreversible vasectomies, pulling out , and that slightly updated Bronze Age invention.

EDITOR’S NOTE: This video was originally published in April 2019.

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