Simply an Issue of Control

Sales statistics show that the sales of birth-control pills in Russia start going up in May and remain higher than usual throughout the summer. Encouraged by the warmth and sunlight and anticipated vacations, it seems that Russian women want to be prepared for whatever may come their way.

The number of Russian women who use the pill as their primary form of birth control remains low -- only between 3 and 13 percent, according to various surveys. The corresponding figure in Europe is 52 percent.

"I hate pills. They make me fat and kill my libido," said Irina, a manager at an IT company who declined to give her last name. Women discussing taking the pill on Internet forums voiced similar complaints.

"When I start taking pills, I feel no desire for sex. So then why bother to take them?" says a woman with the handle Netochka. Others found it next to impossible to take them at the same time every day.

It would certainly be an overstatement to say that the pill helped facilitate a sexual revolution in Russia the way it once did in the West. Intrauterine devices (IUD), which appeared in the early 1980s, were much more "revolutionary" in terms of introducing modern contraception to Russia.

From 1920 to 1936, abortion served as the primary form of birth control as the government worked to free women from pregnancy and keep them in the work force. After a dramatic decline in birth rates, however, abortions were officially banned.

There are no reliable surveys of how people used birth control in the years that followed the ban on abortions, although some older people remember using uncomfortable, thick domestically produced condoms.

"It still remains a mystery how the population solved their contraceptive problem after that time," said Vladimir Serov, Russia's chief gynecologist.

Abortions were reinstated in Russia in the 1960s and once again became a major form of demographic control. Oral contraceptives were first introduced in the late 1980s and initially were a cause for concern among Soviet medical professionals. They first were prescribed only as a medication for gynecological problems rather than as a contraceptive, because of some evidence that long-term usage could cause cancer.

Marina Lystseva / Itar-Tass
Condoms remain a more popular form of birth control than oral contraceptives because they require a lesser amount of preparation, although someone has to buy them.

These fears were widely reported in the media and were encouraged by doctors who were not interested in changes to their abortion service.

Today, however, Russian doctors are trying to convince women that the latest generation of birth control pills is not only an easy form of contraception, but can be good for their health.

They are fighting an uphill battle, as statistics from the Health and Social Development Ministry show that more women still prefer to have an IUD -- about 30 percent of women use them as their primary form of birth control.

"But we all know that the main method of contraception in the country is coitus interruptus," said Vera Prilepskaya, the chief specialist on contraception in Russia, speaking at a conference on contraception in Moscow in March.

Withdrawal is the only method demanding no advance preparation, she said. Even with condoms, the simplest option, someone needs to have bought them first, she said.

The continued popularity of this method of birth control may be the reason that the most popular contraceptive pill sold in Russia is Postinor, a "morning after" or emergency contraceptive pill, sold in the United States under the trade name Plan B. Pharmacies in the United States require a prescription for emergency contraception, but it can be bought over the counter in Russia.

Contraceptive equivalents
American Trade NameRussian Trade NameManufacturerAverage Price
Triphasil, Trivira-28, EnpresseTriziston, Trinordiol, Tri-Regol, TrikvilarJenofarm, Wyeth Group, Gedeon Richter, Shering80-230 rubles
Apri, Orto-Cept, Jolessa, Portia, QuasenseMarvelon, Rigevidon, RegulonOrganon, Gedeon Richter170-440 rubles
Demulen, Zovia1/35, KelnorDemulenSearleNot always available
YasminYarinaShering550 rubles
Levlen, LevoraMikroginonShering235 rubles
Plan BPostinorGedeon Richter215 rubles

Basically, all major birth-control pills can be bought in Moscow pharmacies without a prescription. Prices range from 80 to 900 rubles for a month's supply, depending on the brand. Many of the brands available in the United States have an equivalent in the Russian market that have the same balance of hormones but are sold under different trade names. For example, the oral contraceptive called Marvelon in Russia is exactly the same in composition as the American brand Ortho-Cept.

But those interested in starting a program of oral contraception should naturally see a doctor first, even if it is possible to buy the pills without a prescription. These pills, which contain a combination of synthetic hormones, are a kind of medication, which requires monitoring and can have potentially harmful side effects if given to the wrong patient, doctors say. For this reason, women should undergo a proper exam first before beginning to take them.

The complaints of Russian women that oral contraceptives cause a reduction in sexual desire are not unfounded. In 2005, scientists at Boston University found that women regularly taking oral contraceptives have one-fourth the level of testosterone of women not taking birth-control pills. Testosterone is the hormone that is responsible for libido, and the Boston study showed that testosterone levels do not always return to normal even after women stop taking the pills. Other doctors conceded that such a side effect exists, but does not occur in all women taking the medication.