Q. A person recently wrote to you about pharmacists refusing to fill birth control prescriptions because of their religious beliefs. You didn’t mention that many women are prescribed birth control pills for reasons that have little or nothing to do with actual birth control.
Oral contraceptives are often prescribed for painful menstrual cramps and ovarian cysts, among other problems. It is intrusive and unethical for pharmacists to refuse to fill such prescriptions.
A. You raise an interesting issue. A pharmacist who refuses to dispense birth control pills or emergency contraceptives on moral grounds may have to rethink this stance. Many medications have multiple uses and most people would be outraged if the pharmacist quizzed them about intimate details of their lives.
Pharmacists are divided on this controversy. A recent survey from the pharmacy publication Drug Topics (June 1) found that only 13 percent feel that “the actions of a small group of pharmacists have given a black eye to the rest of the profession.”
Many (31 percent) feel that those with moral concerns have “a legitimate right to refuse to dispense these products.” Almost as many (30 percent) think that pharmacists who won’t fill contraceptive prescriptions should refer patients to someone who will.
Q. I’ve been using Renova cream for wrinkles and I wonder if using it in the summer will make my wrinkles worse. We go to the beach once in a while and go out in the sun everyday. Should I stop using the cream in the summer?
A. The active ingredient in Renova, tretinoin, was originally developed as Retin-A to treat acne. Dermatologists discovered that this topical form of vitamin A also had the surprising side effect of smoothing fine wrinkles and reducing damage from sun exposure.
One problem with tretinoin is increased sensitivity to sunburn. A strong sunscreen, a hat and protective clothing are essential. Frequent sun exposure causes premature aging, reversing the benefits of Renova. Please discuss this issue with your dermatologist.
Q. I have a problem with flatulence. I haven’t been able to find any pattern in what I eat that might cause this, so I’m looking to you for help.
What can I do to avoid this embarrassing situation? Are there certain foods or drinks I should avoid? Please help!
A. Some people are more susceptible to gas-producing foods than others. While beans are notorious, other foods such as pretzels, bagels, broccoli or Brussels sprouts can be equally problematic. Milk sugar causes many people trouble. Such lactose intolerance often goes undetected because lactose is found in so many products (including pills).
Some readers report that natural products such as fennel seed tea (1 teaspoon slightly crushed fennel seeds per cup of hot water) or Angostura bitters (found in the drink mix section of the supermarket) can help with flatulence.
We are sending you our Guide to Digestive Disorders, with a list of foods that may cause problems, a technique for degassing beans and a discussion of Beano and activated charcoal capsules. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. G-3, P. O. Box 52027, Durham, NC 27717-2027.
The People's Perspective on Medicine