FDA Advisory Board Approves First Over-the-Counter Birth Control Pill

12:02 minutes

Oral contraceptive pill on pharmacy counter with colorful pills strips background.
Credit: Shutterstock

This week an FDA advisory board paved the way for the first over the counter birth control pill, with an unanimous decision 17-0.  The FDA must accept the recommendation before the pills are available for sale, which is expected in a few months time. If approved, the progestin-only pill would be manufactured by the company Perrigo, under the brand name Opill. 

Ira talks with Maggie Koerth, science journalist based in Minneapolis, Minnesota, about that and more including; Voyager spacecrafts get energy boosts, wild axolotls face extinction, testing airplane waste for COVID-19 and more.  

Segment Guests

Maggie Koerth

Maggie Koerth is a science journalist based in Minneapolis, Minnesota.

Segment Transcript

IRA FLATOW: This is Science Friday. I’m Ira Flatow. Later in the hour, talking with Dr. Anthony Fauci about the government’s calling an end to the COVID health emergency and how prepared are we for the next pandemic.

We’re going to be taking your calls. You can talk to Dr. Fauci. Our number is 844-724-8255, 844-724-8255 or tweet us @scifri. But first, this week, an FDA advisory board paved the way for the first over-the-counter birth control pill.

It was a unanimous decision, 17-0 in favor. The FDA must accept the recommendations before the pills are available for sale, which is expected in a few months time. Joining me now to talk more about this and other top science news of the week is my guest, Maggie Koerth Science journalist based in Minneapolis. Welcome back, Maggie.

MAGGIE KOERTH: Hi, Thanks for having me.

IRA FLATOW: Nice to have you. Tell us more, how does it work? Tell us all what you know about this pill.

MAGGIE KOERTH: Yeah, so this is really something– this is a type of pill that’s existed for a really long time, since the late 60s or early 70s. It’s called a mini pill, which is basically a type of birth control that only has one of the two hormones normally found in standard pills, in this case, progesterone only, no estrogen.

And mini pills have been shown to be highly effective, but they’re effective in different ways than typical pills. So pills with estrogen suppress ovulation, but that only happens for about half the people who take a mini pill. Instead, mini pills usually work by thickening cervical mucus and thinning the uterine lining. And that makes it harder for sperm to get to eggs and for fertilized eggs to implant.

IRA FLATOW: And what were some of the risks and benefits the panel weighed while making their decision?

MAGGIE KOERTH: Yeah, so there are some ways that these are better than the standard birth control pills and some ways they aren’t. On the downside, to get to that 99% effectiveness that these pills can reach, you have to take the mini pills at not just every day but the same time every single day. Otherwise, that affected effectiveness will drop to about 91%. But the risk of blood clots is lower with mini pills, and you can also take them while you’re breastfeeding.

So the FDA’s panel was really kind of bouncing around some of these things. Without a doctor’s involvement will people miss important information like the timing thing, or the fact that you shouldn’t take many pills if you’ve had breast cancer. But the people on the committee really ended up focusing in on the fact that this is going to be a lot more effective than any other over-the-counter contraceptive. And the benefits really outweigh the risks.

IRA FLATOW: So you’ll just be able to walk into the pharmacy and buy the pill yourself without a prescription?

MAGGIE KOERTH: If the FDA approves it, Yeah.

IRA FLATOW: If they approve it, interesting. This next story you brought us is about Energizer bunnies of spacecraft. I’m talking about Voyager 1 and Voyager 2. They were launched in 1977. And they’re still going right in space.

MAGGIE KOERTH: Oh yeah, NASA’s unmanned spacecraft have this history of being really long-lived, but these two are just crazy. You’re probably most familiar with them from the photos that they took of Saturn and the pale blue dot shot of Earth, but these craft hit interstellar space in 2012. And they are continuing to send back information about what space is like outside of our solar system, things like magnetic fields and cosmic rays, they’re taking measurements on this all the time. But to keep doing that, NASA’s had to figure out how to keep these things alive.

They run off of what are essentially nuclear batteries, little generators that turn plutonium 238 into electricity. And that power runs all the instruments on board. But over time, NASA’s had to turn off some of the working parts to keep others running.

So in 2019, they turned off the heaters that was keeping some of the scientific instruments warm. And then in March, on Voyager 2, they turned off a safety mechanism that was meant to protect the system from voltage spikes. Now, the good news with that is it’s probably going to be enough to keep everything running on Voyager 2 until 2026 without shutting off any other scientific instruments.

IRA FLATOW: Wow, I love Voyager 1 and Voyager 2 because not people– many people don’t know they have a special eight track recorder, the high technology of the day. There’s an 8 track on it. It’s a little industrial design, but that’s fun.

It’s maybe the most famous for that brilliant picture they sent back from Saturn and Jupiter. It’s some great stuff. But as you say, they’re way, way out, way out past the solar system now, right?

MAGGIE KOERTH: Yeah, and the hope is that by chopping off one little bit of their functionality at a time, they could maybe limp their way into 50 years of service.

IRA FLATOW: Wow, that’s really amazing. All right, your next story is about an animal that unfortunately is facing extinction. Tell us about that.

MAGGIE KOERTH: So ocelots, they are the cutest amphibians ever devised by nature. I’m not sure if you’ve seen them they’re squishy looking, perpetually smiling little creatures. They’ve got frills around their heads like they’re off to a summer festival some of them are even pink. Unfortunately, as you say, they are also extremely endangered.


MAGGIE KOERTH: They are native– I know, it’s the worst. They’re so cute they’re native to lakes and marshlands and sewers, actually, around Mexico City.

And ocelot populations have fallen rapidly in recent decades. So there’s a 1998 survey that found $6,000 per square kilometer. And by 2015, that was down to 36% square kilometer.

IRA FLATOW: And so they have special things they can do, like they can regrow their limbs?

MAGGIE KOERTH: They can. And as Richard Stone writes in science. One of the problems with causing them to be going extinct right now is actually part of what makes them special. So they’re adapted specifically to what is now Mexico City, nowhere else in the world.

And they’re related to these boring old normal Tiger salamanders. But at some point about a million years ago, they just stopped going on land as adults. And they ended up remaining their whole lives in these plentiful what were once predator-free waters. And so they kept some of those juvenile features like limb regrowing.

IRA FLATOW: Wow, wow, so is it because that they’ve run out of their natural habitat that they’re in danger now or–

MAGGIE KOERTH: Yeah, yes, so that habitat has changed drastically around them from the time the Spanish colonists started draining many of the lakes after they invaded to the 1970s when the Mexican government started stocking these lakes with carp and tilapia, which is a delicious food that unfortunately also eats ocelots. And now their remaining habitat is threatened further by gentrification as some of these canals and lakes get turned into restaurants and soccer fields.

IRA FLATOW: And a lot of them, though, are existing mostly in labs, right, for research?

MAGGIE KOERTH: Right, yeah, they’re in labs for research. There’s actually a growing pet industry around them. So they’re not going to die out completely but their numbers in the wild are really not looking very good right now.

IRA FLATOW: Wow, sorry to hear that. OK, let’s move on to another animal that’s in short supply in the lab but not in nature. And I’m talking about monkeys. How did we get into a research monkey shortage?

MAGGIE KOERTH: Oh, this is so interesting. So there’s– the National Academies report recently found that 2/3 of US scientists are having trouble getting monkeys for their experiments. And the US uses about 70,000 monkeys a year, mostly for research on infectious diseases, neuroscience and aging.

But as David Grim writes, in science, the availability of these monkeys just plummeted after the COVID pandemic. Now, a big part of that is because we were getting 60% of our monkeys from China. And they basically cut off that supply at the beginning of COVID.

Then we started getting them from Cambodia, but then the dealers in Cambodia got caught in a smuggling scandal where they were basically selling wild caught monkeys and claiming they were lab bred. Then all the major airlines have pretty much stopped agreeing to ship lab animals. And the monkey that was used most frequently was declared endangered. So now we have all of this growing amount of research on things like infectious diseases and neuroscience and aging, and demand has shot up but supply is way, way, way, way down.

IRA FLATOW: So that means the price of a monkey has gone way up.

MAGGIE KOERTH: The price of a monkey has gone up a lot. Researchers told science that they used to be able to get a monkey any time they wanted one for $2,000. And that process can now take months and cost upwards of $19,000.

IRA FLATOW: $19,000. This next story is some very good news for people who hate to eat their veggies. Scientists are working to make veggies taste better using gene editing technology. Now, this I have to hear.

MAGGIE KOERTH: Well, if you’re anything like me, Ira, you probably have memories of Brussels sprouts as a national punch line, like people– the thing you’re threatened with as a child. And then it’s crazy when you turn around and see today they’re this restaurant side dish everywhere. And it turns out that this is not just cultural gaslighting.

Brussels sprouts actually did used to taste bad. And that changed in the late 1990s because these breeding programs figured out this bitter tasting chemical called glucosinolates could be actually removed from the plant’s flavor profile by breeding sweeter tasting Brussels sprouts with Brussels sprouts that also produced a lot of sprouts. And so now we have this really popular vegetable that was not really popular before. And Meghan Bartels has a cool piece in Scientific American looking at efforts to do the same thing for other veggies this time using DNA sequencing and CRISPR gene editing.

IRA FLATOW: Wow, our last story, this week, the COVID public health emergency officially ended in the US. So we’re going to be talking a bit about that with Dr. Anthony Fauci. But I want to talk about a fascinating way researchers are still tracking COVID by monitoring human waste on airplanes. Airplanes, tell us.

MAGGIE KOERTH: Yes, it’s so cool. So this is like an early Warning system for new variants, basically, there are fewer people getting tested in any documented way. So scientists are turning to toilets to understand what’s going on. And this new program is testing wastewater from airplanes as they land in San Francisco.

But the program is only looking at international flights. This is from a story by Betsy Ladyzhets in Science News. And that’s because, to put it delicately, people are less likely to poop when they fly domestic.

IRA FLATOW: A-ha, I get it. I get it.

MAGGIE KOERTH: Yeah, so there’s more samples on the International flights. And the scientists are hoping that this will give them a good idea of what new strains are entering the country. And they hope that maybe this could be expanded to track other diseases as well in the future.

IRA FLATOW: Great stuff, Maggie. Always a pleasure to have you. Thank you for taking time to be with us today.


IRA FLATOW: Maggie Koerth, science journalist based in Minneapolis.

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