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Oldie, 12/19/08: Now I wonder


I was reading yet another article about the trend wherein some doctors and pharmacists won't prescribe or fill prescriptions for contraceptives because of their religious beliefs. I guess I was idly thinking how glad I was never to have been victimized that way ... and then I remembered something.
Back in 2003 I went permanent as an employee at a large company that had excellent health benefits. We had insurance through a large company that offered prescriptions by mail at a discount.

My primary care physician gave me my first full physical in years and asked me a lot of questions. One of the things I answered yes to was breast pain. As a remedy, he recommended low-dose estrogen oral contraceptives.

I'd used the pill only once before that, during the year following childbirth by C-section and gallbladder surgery that came soon after. It seemed to me that getting pregnant would be particularly dangerous during that year, so I went on the pill, but gave it up after repeatedly forgetting to take it daily. Fortunately, I didn't get pregnant, but had not considered ever using it again. However, the breast pain was fairly severe, so I followed my doctor's recommendation.
I ordered the prescription through the insurer and stayed on it for about 2 years. I suppose it did help the breast pain to an extent; it didn't make much difference in my cycles, other than enabling me to know exactly when they would start each month.

But I ran into trouble repeatedly with the pharmacy-by-mail folks. I would send in my payment ahead of time, and then the medicine would not arrive. On at least 4 different occasions, I would have to get on the phone with the insurance company and explain that although I had paid for the prescription, the medicine was failing to arrive on time. Disrupting the 28-day cycle threw everything off and of course, I had to worry about becoming pregnant even with a backup method. Ultimately, I left that job and the benefits that went with it, and haven't bothered to go back on the pill. I'm 50 now and figure menopause is bound to hit sooner than later...

But it wasn't until this evening, reflecting on this news topic, that I began to wonder if my missing birth control pills were due to something more sinister than bureaucratic incompetence. Was someone deliberately "neglecting" to fill my prescription? Or were they perhaps setting my order aside or on the bottom of the pile, to give the impression that they were technically taking care of it but letting it lapse long enough to increase the chances of my becoming pregnant?

My current job has just begun offering pharmacy-by-mail, but with a different insurance company. I haven't considered going back on the pill -- my current doctor would probably discourage it simply because my pre-menopausal symptoms benefit more from topical progesterone than estrogen -- but if I ever did deal with one of these mail-order pharmacies again, I'd be much more aggressive in insisting that my order be fulfilled to my standards.

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