If the relationship between emergency contraception and ectopic pregnancy needs to be further confirmed, it has become an indisputable fact that emergency contraception has been abused for more than 10 years. Shen Huan (not her real name), 38, has been considering whether to adopt a child. "I want a daughter, carrying a red bag and wearing a red skirt, to go to school."
No children were the result of an accident three years ago. At that time, she had a big fight with her boyfriend and was ready to break up under various grievances.
However, it seems to be an 8 o'clock TV series. She was pregnant before breaking up, and it was an ectopic pregnancy. At that time, she was almost 35 years old, and the result of this toss was unilateral salpingectomy.
Ectopic pregnancy is also called "ectopic pregnancy" in medicine. Generally speaking, the fertilized egg is not successfully implanted into the uterus, but in other places, the most common one is implanted into the fallopian tube. This disease is a serious threat to women's health. If not diagnosed in time, it will cause massive bleeding, endanger life or lose fertility.
Almost at the same time as Shen Huan, Xiao Duo (pseudonym) in Hangzhou also experienced the same "disaster". In 2007, she also suffered from ectopic pregnancy, and it was a rare cervical pregnancy.
"Cervical pregnancy, how can you encounter such a rare disease?" Xiao Di had never heard of this term before.
The treatment process is like an adventure. What she remembers vividly is that all the doctors in the hospital marveled at her luck.
"She said it was more difficult for me than winning the lottery." Even obstetricians and gynecologists have only seen it in textbooks.
The so-called cervical pregnancy is also a kind of ectopic pregnancy. It means that it is extremely rare for fertilized eggs to implant and develop in the cervical canal.
Shen Huan and her boyfriend broke up completely after the operation. Because of this ectopic pregnancy, her boyfriend even thought that she might have hidden some "unbearable memories" from him, which made Shen Huan puzzled, because she had no gynecological diseases and no history of abortion, and she didn't know why she met with ectopic pregnancy.
Until last March, Shen Huan mentioned in a popular science book about pregnancy abroad that some ectopic pregnancies were related to taking levonorgestrel. A mysterious part suddenly appeared before her eyes.
Shen Huan remembers walking alone on the street in Shanghai at night after a big fight with her boyfriend. It suddenly occurred to her that she didn't take any contraceptive measures the night before. With full of resentment, she didn't think much, turned into a drugstore and bought a box of "Yu Ting". "That was the only emergency contraceptive I knew at that time."
Then there is pregnancy-ectopic pregnancy surgery-tubal removal, a series of nightmares.
"Yuting" is the trade name of a contraceptive, and the drug name is "levonorgestrel". In the classification of contraceptives, it is classified as "emergency contraceptives", which is different from ordinary contraceptives. It is a remedial contraceptive measure after unprotected sex. By inhibiting ovulation, preventing the implantation of pregnant eggs, increasing the consistency of cervical mucus and increasing the penetration resistance of sperm, it plays a role in quick-acting contraception. Therefore, it is also called "the morning-after pill".
In addition to Yuting, the manufacturer of Beijing Zizhu Pharmaceutical, there are similar drugs such as An Ting and Huiting produced by Shenyang and other pharmaceutical companies on the market.
In the network crusade all over the sky, the fire was aimed at Yu Ting. In fact, Yuting is synonymous with a drug called "levonorgestrel" only because of its most famous reputation.
On Tianya Forum, an article titled "Yu Ting: How many ectopic pregnancies will be created?" Post, more than 2000 people communicated with the post. The landlord disclosed in the post that 19 of the 30 patients with ectopic pregnancy in three months had taken Yuting as interns in obstetrics and gynecology.
This data may be exaggerated, but it is the first time for many people to hear about the connection between ectopic pregnancy and Yuting, including Xiaoduo. She always regarded her pregnancy experience as her bad luck until one day a friend showed her this post. "All the same as me!" She clearly remembers that before that pregnancy, she took Yuting, "powder shell, ten dollars."
In fact, in recent years, some gynecologists have paid attention to the possible risks of levonorgestrel. In 2006, Han He and two doctors from Beijing Maternity Hospital made a quantitative analysis of 309 patients who came to the family planning clinic of Beijing Maternity Hospital. All 309 patients went to the clinic to terminate their pregnancy after failing to take levonorgestrel.
Among these 309 people, there are 9 cases of ectopic pregnancy (commonly known as ectopic pregnancy), accounting for about 3%, while among ordinary pregnant women, the proportion of ectopic pregnancy is about 1%, which is nearly twice as high.
In addition, Yu Tao, a gynecologist from the First People's Hospital of Kunming, Yunnan Province, and the gynecologist from the First Affiliated Hospital of Dalian Medical University also wrote articles to analyze that in the cases of ectopic pregnancy they experienced, excluding inflammation and other interfering factors, the failure of emergency contraception became the possible pathogenic factor of ectopic pregnancy.
China Obstetrics and Gynecology 1999 published by People's Health Publishing House analyzed the mechanism of ectopic pregnancy caused by emergency contraception: "Low dose progesterone did not inhibit ovulation, but tubal peristalsis was blocked, so tubal pregnancy (ie ectopic pregnancy) increased significantly."
Impossible rights protection
A year ago, Shen Huan got married and wanted a child for the first time.
However, Shen Huan, who had one fallopian tube removed, found that the only remaining fallopian tube had some adhesions in her later pregnancy examination. If she wants to get pregnant, she must be a test-tube baby. The sudden change of wind and rain was due to her husband's sudden cerebral hemorrhage, so Shen Huan didn't have the energy to put into the long "test tube" process. "Then don't be a mother," Shen Huan made a difficult decision.
Fortunately for Shen Huan, Xiao Di received conservative treatment at that time, so she didn't lose her reproductive function in this accident. But after more than two years, she still dare not have children, even dare not think about it. "At first I thought I still wanted to play, and I never thought about having children. In fact, this inexplicable shadow has always been there. " Xiao Duo said.
People who have eaten ectopic pregnancy are likely to have ectopic pregnancy next time. This kind of threat is real, not to mention the insurmountable psychological barrier. The pain of not having children is clear, however, who can be responsible for all this is extremely vague to them.
Shen Huan found that she was not alone. She entered "emergency contraception ectopic pregnancy" in the online search engine, and more than 330,000 messages popped up. In the post bar of a website, there is a post that spans three years. From April 2007 to now, hundreds of people have complained on it.
Shen Huan once called according to the telephone number published on the manufacturer's website, and the other health consultant explained everything with "any contraceptive measures may fail".
In April, 2009, Huang Rui, a female lawyer of a law firm in Shanghai, planned to recruit victims of the so-called "Yuting" and launched a collective claim action "because I am also a woman".
Shen Huan saw these collections and contacted Huang Rui. She also thought about taking the road of legal proceedings, but this road is equally difficult. Huang Rui said that more than 10 victims have contacted her, but from a legal point of view, it is very difficult to file a claim. In fact, most people who have experienced this kind of experience only heard about the connection between the two after surgery, so it is impossible to keep some relevant evidence in advance.
Emergency contraception is not a prescription drug. You can buy it at any drugstore. Most people will throw away the receipt. From the lawyer's point of view, the first step of claim is not smooth. "How can I prove that I took this medicine?" Huang said.
Even if there is strong evidence that you have taken this medicine, it is not easy to attribute ectopic pregnancy to a single one. It turns out that the cause of ectopic pregnancy is more complicated, and some gynecological inflammations, such as inflammation and cervicitis, may infect fallopian tubes and cause salpingitis. In addition, repeated abortion, appendectomy and pelvic inflammatory disease will increase the risk of ectopic pregnancy.
Procedural difficulties have scared most people, not to mention that they involve women's very private lives. Huang Rui further analyzed: "For example, at a certain stage, you may be asked to describe your sexual history as needed, or there are many proofs, such as no gynecological inflammation and no history of abortion." Shen Huan was not married at that time. For a woman, she knows what this means.
Six months later, this claim activity ended in failure. For most women with similar experiences, there are almost no more channels except to tell their own experiences and condemn them on the Internet.
In some QQ groups with ectopic pregnancy after taking emergency contraceptives, they are all talking about the topic of treatment, but they are not very interested in some statements. "The lawyer said there was no way out. What's the use of news reports? "
Unlike Shen Huan, who took the initiative to find a channel to reflect the truth, Xiaoduo immediately threw away all the medical records in her hand after the treatment, and there was no evidence of purchase at all. "It's like erasing this nightmare." She said.
"Even my husband is against accepting your interview. I don't think I can see this. Is it possible to make any claims? " In fact, from beginning to end, Xiao Di didn't do anything wrong, but somehow it turned into an unspeakable past.
It is precisely for these reasons that there are no intellectuals in this hurt group, and it is even difficult to see a complete and clear person, only pseudonyms and screen names hidden in 330,000 pieces of information on the Internet.
Different explanations
Apart from the inability to defend rights, Shen Huan thinks it is equally important to warn everyone.
As an over-the-counter drug, the instructions become the only way for patients to understand the precautions, contraindications and possible adverse reactions.
In fact, Yu Ting's instructions "Precautions" and adverse reactions indicate some hints of "vomiting, nausea" and contraindications, which have hardly been revised for more than ten years. And similar drugs produced in China, such as Jin Yuting, Huiting and Anting. There are similar items in the instructions, and there is no hint of ectopic pregnancy.
The price of the similar medicine "Bao Shi Ting" produced by Hungarian Jirui Pharmaceutical Factory is slightly higher, and Shen Huan once bought a box of this medicine specially. The name of this drug is levonorgestrel. In the "Precautions", she found the difference from Yu Ting's instructions: "If you get pregnant after taking this medicine, or consider ectopic pregnancy".
On August 24, 2006, the US Food and Drug Administration approved an emergency contraceptive, which can be sold as an over-the-counter drug to women aged 18 and above. The generic name of this contraceptive is "levonorgestrel" and the trade name is "PlanB", which is the most widely used emergency contraceptive in the United States. According to the data provided in PlanB, in the United States, 65,438+00% of daily users of progesterone contraceptives have ectopic pregnancy, and the overall incidence of ectopic pregnancy is 2%.
Since it is the same medicine, since the foreign instructions are so clear, why can't domestic manufacturers add this? In the official website of Zizhu Pharmaceutical, there is no explanation or explanation about the relationship between Yuting and ectopic pregnancy.
In fact, Shen Huan was not the only one who questioned the instructions for emergency contraception.
Experts such as Dr. Han from Beijing Maternity Hospital even wrote the suggestion of revising the instructions into the "research report". In their report, they pointed out that there is a certain connection between emergency contraception and ectopic pregnancy, and the signs of ectopic pregnancy should be indicated in the instructions to help patients see a doctor in time, so as not to delay their illness and seriously endanger their lives.
Abuse of emergency contraception
If the relationship between emergency contraception and ectopic pregnancy needs to be further confirmed, it has become an indisputable fact that emergency contraception has been abused for more than 10 years.
With the confusion of Xiao Duo and Shen Huan, Yu Ting and other emergency contraceptives have achieved great success in business.
In a pharmacy near Beijing West Railway Station, Yuting sells about thirty or forty boxes a week, which is several times that of other birth control pills.
According to relevant statistical reports, from the perspective of total sales in China, emergency contraceptives account for about 2/3 of the contraceptive market share, and Yuting's sales in 2004 exceeded 30 million boxes. In the 2009 national OTC product ranking released by the National OTC Drug Association, Yu Ting of Zizhu Pharmaceutical ranked third in children and facial features.
In this drugstore near Beijing West Railway Station, a girl who looks about 20 years old came in and bought three boxes. "Anyway, it may come in handy in the future, and it will be easy to get out of trouble."
What the girl said was a slogan. From 1998, through TV advertisements, websites and other communication channels, "Yuting" has become more and more influential among young men and women, and even become synonymous with "contraceptive pills" in some people's minds.
"She just matched the trend that premarital sex has become more and more common in the past decade. Who will use this medicine in our last generation? " Shen Huan said with some helplessness, "We are the' Yuting generation'."
"The emergence of this medicine used to be like a savior." Xiaoduo also clearly remembers the university campus at the end of last century. The advertisement of this drug appeared at the school gate together with condoms, which became a symbol of some kind of "liberation" in that era.
In a summary report on media promotion of Yuting brand promotion, a website conducted a special survey, in which more than 33,000 women participated, and nearly 50% of them agreed that "Yuting is always at home and can be remedied in an emergency". In the report, this data is considered as "the communication strategy has achieved great results".
Xiao Di can hardly remember whether he has heard of the suggestion of "leaving Yu Ting at home", but in fact it has been two or three years. For various reasons, it often appears in Xiao Di's medicine cabinet like cold medicine. "I always feel that with the last line of defense, I don't pay much attention to other contraceptive methods." What scares Xiao Di most is that just after she finished the treatment of ectopic pregnancy, she took Yu Ting away because she didn't know the inside story.
Now, in the gap between some popular TV dramas on TV stations, advertisements of "getting out of trouble easily" are still being broadcast. Most women who have taken such drugs can't remember how they first heard about it, but these slogans are familiar to everyone.
Netizen "Du Yehe in Han and Tang Dynasties" said that those boys and girls who didn't have this knowledge thought that they would be fine after eating Yuting anyway. Even the last time I saw a girl who said she would eat it every month, now she has amenorrhea and her boyfriend dumped her. Isn't this killing for money (medicine money) (no BB)? !
As this netizen is worried, in the Yuting brand promotion report produced by a website, it is indicated that the promotion subject is "1women aged 6-30", that is, unmarried women become their main potential customers, which is also the most dangerous, because they will have children in the future. "I am 20 years old, and I eat Yuting almost every month. Now amenorrhea. What should I do? " On the internet, it is not uncommon to ask for help like this.
A survey of nearly 600 "teenage mothers" by the Scientific Research Institute of the National Population and Family Planning Commission shows that their average pregnancy age is 17 years old, and 2 1% of them have used emergency contraception.
Fan Guangsheng, chief physician of Obstetrics and Gynecology Department of Peking Union Medical College Hospital, pointed out that as far as emergency contraception itself is concerned, its side effects mainly include nausea, vomiting and menstrual disorder, but if it is taken blindly for a long time, the consequences will be extremely bad. Emergency contraceptives contain large doses of progesterone, which can inhibit ovulation for a long time, make women gain weight and increase the risk of thrombosis and migraine. Especially for young people in their twenties, taking a large amount will lead to amenorrhea and premature ovarian failure.
Although she suffered a lot, Shen Huan still stressed that she was not only targeting at one brand of drugs, but the whole emergency contraceptive industry was "misled". She said: "What is wrong is not even the medicine itself, but the way of selling medicine and the incomplete information."
interconnection
Emergency contraception abroad
● Internationally, different countries have different attitudes towards emergency contraception, but the same thing is that it must be used under the guidance of a doctor or pharmacist, and it can only be used as a remedy afterwards, and it will certainly not become a mainstream drug.
● In Germany, South Korea and Japan, Japanese pharmacies are not allowed to sell them at all, except for prescription purchases. Women in need must go to the hospital for treatment.
● In France, although emergency contraceptives are over-the-counter drugs, they must be reviewed by the French Health, Safety and Health Products Committee before advertising. When you declare an advertisement, you should not only provide a description of the drug you plan to put in or sell, but also specify the target of the advertisement, that is, who you plan to sell it to. If it is endangering public health, cheating, etc. , the relevant departments will immediately take back the advertising rights.
● In 2007, when the US Food and Drug Administration changed emergency contraceptives from prescription drugs to over-the-counter drugs, it caused quite a controversy. The result is a strict and scientific sales method: pharmacies must be equipped with professional pharmacists and health consultants, and only when they are present can women buy emergency contraceptives directly without prescription; Before purchasing drugs, pharmacists will first understand women's menstrual cycle and the time when they have sex, so as to preliminarily evaluate whether they are pregnant; Subsequently, they will clearly inform the potential side effects of such drugs and remind women to pay attention to using conventional tools for contraception; After drug sales 1 week, pharmacists will pay a return visit to judge whether women have side effects; After 3 weeks, I will call again to confirm that if a woman's menstruation still comes, she will be prompted to have a pregnancy check.