Hallo Hallo, the Morning after pill is not a candy…

I take a narrow short cut to reach office in Jhamsikhel. It is a small path, not well kept, quite dirty but still passable enough so that many people like me can save few precious minutes on their way to work. Because is somehow isolated, between houses, the short cut is a bit a secluded, a bit hidden. Nearby there is also a pharmacy

I could not but notice a part from a good number of used condoms also several empty boxes of “morning after pill. I am not really surprised about it but definitely there is something that every time I see these empty boxes, hits my head: these pills should not be as easily available as they are.

We are talking about an emergency contraceptive, not a standard preventive method, like the condoms, to prevent pregnancy. I am afraid to think that many teenagers are making an improper use of this emergency pill. This could be really dangerous, on the long run, from the health point of view.

At the same time, the morning after pill is quite effective and do their job:  after all these magic boxes offer an easy way out of potential unwanted pregnancies, avoiding, with a very high degree, the chances of taking excruciating decisions later on.

Despite this I cannot stop thinking about their collateral effects and the fact that the morning after pill is not a substitute for condoms.

In many western countries this emergency contraceptive is only on sell after medical prescription. I do understand that basic health infrastructures in a town like Kathmandu, while widely available, at least if we talk about the private ones, might not be as accessible and easy to approach as having a family doctor at your call the way you have in Europe.

Moreover there are all the huge issues related to a conservative society in Nepal that might refrain youngsters from being open and approach the closest health facility. Pay cash at the pharmacy’s counter, this is the easy way.

It is probably a good business for the pharmacies that accurately display the pills a bit in the same way local shops display local whisky on the roads.

Still we have a problem: one immediate and another broader. The former is about creating awareness among the youth about the risks and perils related to a wrong use of the “morning after pill”.

Among others, it is scientifically proved that normal menstrual cycle can suffer from an improper use of the pills. Potentially there are also other side effects. (For more info, see http://www.morningafterpill.org/is-emergency-contraception-saf.html).

After all we are talking about an emergency contraceptive. A possible compromise could be to ensure that though the pills remain an item sellable over the counter but the pharmacist should mandatorily provide instructions and warnings about the modality of its use.

The second problem is more about equipping youth with a strong understanding of what sex is and what implies. I do not really like the term “sexual education”, call me a conservative but for me is a bit too narrow and misleading. I believe more in an open dialogue with teenagers where issues strongly related to the body, culture, society’s creeds and including obviously sex (and contraceptives) are discussed in a “package”. Love, emotions should be a cornerstone of this dialogue.

As part of the broader picture, sex could be experienced as expression of love, with responsibilities. I do not want to be moral or judgmental. No one denies that sex is fun, including “casual” sex but only having sex for sex is just, in the long run, an empty experience.

At the end of the day, sex must be fully comprehended in all its dimensions and with all its implications. It can be a magnificent thing or it might not be, some persons might be ready for it or some others might not or simply no willing. In this latter case there is nothing to be ashamed of.

There is no “one way fits all” approach to sex. It can be a journey, you might decide to take it or wait for it as you realize that is not the right time for you or simply you decided not to be interested.

It is just a personal call, a free choice. There is no right or wrong but in any case emotions can greatly magnify the experience.

Youngsters can still enjoy their sexualities but they must be careful and use the brain. They must be educated on all precautionary options available and must be capable to think first about the consequences of their actions.

Parents and schools can play a very important role in engaging youth in setting the tones for the right conversation about sex and, of course, about love.

Meanwhile emergency pill should be taken as emergency medicines not as candies!