Some applaud the decision on adolescent contraception, others criticize it, saying that a machine gun is proposed to fix the problem.

On March 22, Health Minister Arūnas Dulkys amended the order by adding Levonorgestrel to the list of reimbursable drugs.

According to him, levonorgestrel coils (13.5 mg Fleree system for uterine cavity) will be available to “18 to 20 year old girls who see a gynecologist for contraception” and “15 to 17 year old girls prescribed by the procedure of the Ministry of Health “.

The Minister has not yet established a separate procedure and the product is not yet included in the Reimbursable Medicines price list, so patients cannot yet purchase it as a reimbursable product.

But the price list will be updated.

Decided to wait for everyone to agree

In April last year, former Health Minister Aurelijus Veryga added levonorgestrel to the list of reimbursable drugs.

It expects the drug to be administered to “girls between the ages of 15 and 20 who consult a gynecologist for contraception.”

Part of the public was outraged by this decision, so A.Veryga did not take any further action: he announced that the drug would not be included in the price list of Reimbursable Medicines for some time, patients would not be able to buy it as a reimbursable medicine in pharmacy.

A.Veryga formed a working group that had to assess the appropriateness and need for levonorgestrel compensation for sexually active girls aged 15-20 years.

“Some doctors were very skeptical and cautious <...>. It was logical to wait, to put everyone at a common table to agree and find out how to manage those risks ”, recalling the situation. 15 minutes A.Veryga commented.

It was logical to wait, to seat everyone at a common table to agree.

He said he was unfamiliar with the current Health Minister’s decision to prescribe hormonal spirals, but assumed the decision was made after evaluating the risks.

“If she (work group – 15min) evaluated all the risks, it is in order. The minister has the right to decide, apparently he accepted after evaluating all “in favor” and “against”, considered A.Veryga.

This contraception is called “heavy artillery”.

Some of the conservatives at Seimas, including MP Vilija Aleknaitė-Abramikienė, previously demanded that the decision to compensate and prescribe hormonal spirals to adolescents be reversed.

When asked how he evaluated Minister A. Dulkis’ revised order that levonorgestrel coils could be administered to adolescents with reservations, V. Aleknaitė-Abramikienė said he was not aware of it.

True, the policy stated that, in their opinion, such preparations should not be administered to minors at all.

“There is heavy artillery here that it will affect in the future,” he said.

The public institution “Instituto de Sociedad Libre” described A.Veryga’s decision to compensate for levonorgestrel coils for adolescents as unreasonable at the time.

He maintains that the problem is social

The organizations are not satisfied and the minister’s decision has been changed.

“We do not agree with this decision, we believe that there are other ways to solve the problem of early pregnancy in adolescents.” 15 minutes said Ramūnas Aušrotas, former advisor to V. Aleknaitė-Abramikienė at the Seimas, representative of the Institute of Free Society.

According to him, early adolescent pregnancies can be prevented by educating them instead of prescribing medication.

We think that [problemą] It can be solved in another way: through proper sex education.

“We thought that [problemą] It can be solved in another way: through proper sex education and also through normal and real social work with adolescents.

Statistics show, if I remember correctly, <...> The highest risk of early adolescent pregnancy occurs in families at social risk who have many children and who often do not have a permanent father. This problem is social, not medical, “said R. Aušrotas.

Do only women need protection?

And if the problem still needs to be solved by medical means, he said, it should not be done with long-term contraception.

“If the Minister decides to solve this problem by medical means, the question is the appropriateness of the measure <...>. The machine gun that is proposed to solve this problem is the most serious tool, the hormonal spiral, which is invasive in nature, which is not placed for one day or two, ”he said.

R.Aušrotas also raised the question why the responsibility for protection against unwanted pregnancies rests only with women.

“If barrier contraceptives were used in a risky situation, there would be no consequences or health risks for men and no risk for women,” he said.

According to R. Aušrotas, there is not enough information on how levonorgestrel coils will affect the developing human body; it is said that only a one-year clinical study was conducted in minors.

Consider the lack of research, left the task force

It is said that to prevent sexually transmitted diseases, the use of condoms was suggested to the subjects.

“How then can you determine that [preparatas] Is it effective, effective and safe if there is another remedy? Daušrotas asked, noting that the use of Levonorgestrel can cause side effects such as bleeding.

“It is a wish to do clinical research on our adolescents for the money from the Lithuanian budget. We, on behalf of our parents, do not agree with that,” he said.

R. Aušrotas belonged to the working group formed by the Minister of Health, but together with the representative of the National Association of Families and Parents he left it.

The task force shifted the question of the appropriateness and necessity of levonorgestrel compensation in another direction, he said.

“Instead of considering this problem, he ultimately did not focus on whether it was appropriate or not, but on how to compensate for it. It deviated from the task set by the Minister,” assessed R. Aušrotas.

I tried to dispel the fears

The proposal to include the hormonal coil in the list of reimbursable drugs was presented by the Lithuanian Society of Obstetricians and Gynecologists.

K.Jarienė, representative of the society and researcher at the Lithuanian University of Health Sciences, evaluated “very positively” the fact that ice cream made progress on this issue.

“We have shown that we are guided by international guidelines, scientific achievements, good practices and examples, and not by ‘abusing young people and encouraging them to have a relaxed sex life.’

We hear many fears that we try to dispel, we seek solutions that will satisfy and reassure the representatives of various associations and organizations.

I am glad that science, constant work, patience, search for compromises and active cooperation of all organizations are appreciated “, – in the answers 15 minutes she taught.

Teens will be able to decide

K. Jarienė emphasized that adolescents, if the need for contraception arises, they will be able to decide on its use.

“Now we will have the opportunity to offer young people an effective compensatory contraceptive method if the need for contraception arises. At least one alternative.

And then it is their right to decide whether it suits them or not, they will take this opportunity or not.

Even 80 percent. Teen pregnancies under the age of 19 are unwanted, unplanned, and unexpected.

I remind you that even 80 percent. teenage pregnancies under the age of 19 are undesirable, unplanned and unexpected, ”said K. Jarienė.

“I also hope that this message may encourage teens to go to their doctors more often for other effective contraceptive methods, not necessarily this one alone,” he added.

– I know you urgently need information not only about contraception, but also about the dangers of unsafe and irresponsible sex.

In this way, we will not only be able to provide adequate information, but also detect possible cases of exploitation ”.

Compensated contraception: a waste of money?

The representative of the Lithuanian Society of Obstetricians and Gynecologists affirmed that the World Health Organization emphasizes that member states must apply the contraceptive compensation mechanism to all population groups, but give priority to the most vulnerable: young, low-income income, unemployed, addicts, migrants and ethnic minorities.

“It just came to our knowledge then.

I have often heard him emphasize that contraceptive compensation is an excessive waste of budget and that it is better to spend money on other diseases. I am not an economist, but I know that unwanted teenage pregnancies place an economic burden on society as a whole and undoubtedly deprive them of the opportunity to provide more funds to rescue people with serious illnesses or other painful areas.

If we speak in an insensitive and rude way, the question would be what is the added value of a seventeen-year-old who has already raised several children and has not finished and probably will not finish school?

I would very much like to increase the number of Lithuanians, but perhaps not yet at the expense of underage adolescents.

I would very much like to increase the number of Lithuanians, but perhaps not at the expense of underage adolescents, ”noted K. Jarienė.

Both the school and parents should educate

It is true that he agreed that not only the availability of contraceptives is important, but also the sex education of adolescents.

“No effective contraceptive method or increased availability of contraceptives will reduce the number of teenage pregnancies without adequate sexual education and training for adolescent girls. Not just in schools. Parents have a particularly great responsibility here.

Teens who seek and receive adequate information, and those whose parents seek ways to communicate with their children about sex, begin sexual intercourse later, use contraception more frequently, and are sober during the first intercourse. In short, he looks more responsibly at this stage of his life ”, emphasized the researcher.

Earlier, when talking about contraception for adolescents, he said that other means (birth control pills, condoms) are not as reliable as hormonal IUDs.

If we have to choose between something, let’s choose what is most effective, safest.

“After evaluating data from world and European organizations and experts, all the research, we decided that if we have to choose between something, we will choose what is most effective, safest and has the fewest side effects, such as unwanted pregnancies and abortions. “why was levonorgestrel chosen, 15 minutes K. JarienJ commented.

The prescription is available in pharmacies.

Levonorgestrel coils (Fleree 13.5 mg intrauterine system) are currently available by prescription and in pharmacies.

The package leaflet indicates that Fleree is used for three years (or a maximum of three years) to prevent pregnancy.

The drug is said to cause side effects, but it is not reported in everyone.

Very common side effects (may affect more than 1 in 10 people) include headache, abdominal or pelvic pain, acne and / or oily skin, bleeding changes, including increased or decreased menstrual bleeding, spotting, rare menstrual and menstrual cramps. ovarian cyst, inflammation of the external genitalia and vagina.

Two clinical trials were conducted with levonorgestrel 13.5 mg intraperitoneally, one with 2885 women aged 18 to 35 years and the other with 304 adolescents.

The drug was rated “very effective”.

More about this – here.