Transgenerational consequences of environmental contraceptive pills exposures

1. People usually dispose their contraceptive pills1:

Down the toilet
Down the sink
Down the drain
With household trash

2. Consequences of improper disposal of contraceptive pills2-4:

Aquaculture2-3

Fishes exposed to contraceptive pills were found to have 20

- 30% reduction in both the fertilization rate and
survival rate of embryos2.
Contraceptive-induced intersex (egg-containing
testicles) in male minnows and altered egg production in
female minnows were observed3.
These adverse outcomes may alter the aquatic food chains and ecosystems, inducing a
negative impact on the sustainability of wild fish populations3.

Human4

Contamination of water supplies or local sources used by nearby communities.

Cumulative effect of the contraceptives in drinking water on human may be hazardous to
human health, especially in vulnerable populations such as pregnant women, pediatrics and
geriatrics.
3. What can you do save the environment?5

Use drug take-back programs5

The Pharmaceutical Services Division, Ministry of Health

Malaysia (MOH) has implemented the Return Your Medicines
Program.

Through this program, patients can return their unused or excess

contraceptives kept at home for safe disposal by MOH.

Practice safe disposal of contraceptives6

Safe disposal of contraceptives is an effective preventive measure, keeping potential

biochemical hazards under control and away from natural environments, stopping them
from finding their way into our water supplies.
Taking preventive measures will be of greater effect, wiping out the upstream of
contaminants entirely.

Do not flush unused contraceptives down the toilet, sink or drain6

Contraceptives should not be flushed as it may lead to contamination of water supplies.

This is the very least one person can do to save the environment.
4. How should contraceptives be disposed?7
(1) Tablet
Dissolve the tablet in water, mix the liquid with other general waste that appears
unpalatable (e.g. dishwashing detergent)
Place the mixture in a plastic bag or zipseal bag and seal it
Dispose it with your trash and return it to the pharmacy

(2) Patch
Fold the used patch
Place the patch in a plastic bag or zipseal bag and seal it
Dispose it with your trash/return it to the pharmacy

(3) Injectable contraceptives

Re-cap the needle
Place the injectable contraceptives in a plastic bag or zipseal bag and seal it
Dispose it with your trash/return it to the pharmacy

5. How proper disposal of contraceptives protects you and the environment?8

Protects the environment (Keeps contraceptives from polluting the soil and water
supplies)
Protects pets and wildlife
Protects people from inadvertent ingestion or exposure
Avoids health problems from contraceptive misuse (eg. overdose, expired)

References

1. Pitts PJ. The wrong way to dispose of drugs [Internet]. 2013 [cited 2017 Jul 11]. Available
from: http://www.huffingtonpost.com/peter-j-pitts/drug-disposal-
methods_b_3239832.html
2. Bhandari RK, Saal FS, Tillitt DE. Transgenerational effects from early developmental
exposures to bisphenol A or 17-ethinylestradiol in medeka, Oryzias latipes. Scientific
Reports. 2015; 5(9303): 1 5. doi: 10.1038/srep09303
3. Kidd KA at al. Collapse of a fish population after exposure to a synthetic estrogen.
Proceedings of the National Academy Sciences of the United States of America. 2007;
104(21): 8897 8901. doi: 10.1073/pnas.0609568104
4. World Health Organization. Guidelines for safe disposal of unwanted pharmaceuticals in
and after emergencies [Internet]. 1999 [cited 2017 Jul 11]. Available from:
http://apps.who.int/medicinedocs/en/d/Jwhozip51e/2.8.html
5. Pharmaceutical Services Divisions, Ministry of Health Malaysia. Return your medicines
program. 2013 [cited 2017 Jul 11]. Available from:
http://www.pharmacy.gov.my/v2/en/content/return-your-medicines-program.html
6. Harvard Health Publications. Drugs in the water [Internet]. 2011 [cited 2017 Jul 11].
Available from: http://www.health.harvard.edu/newsletter_article/drugs-in-the-water
7. United Nations Population Fund. Safe disposal and management of unused, unwated
contraceptives [Internet]. 2013 [cited 2017 Jul 11]. Available from:
https://www.unfpa.org/sites/default/files/resource-
pdf/Safe%20Disposal%20and%20Management%20of%20Unused%20Unwanted%20Co
ntraceptives_2.pdf
8. NNA Environmental Health Committee. Nevada rnformation [Internet]. Nevada Nurses
Association. 2016 [cited 2017 Jul 11]; 25(3): 1 24. Available from:
http://nursingald.com/uploads/publication/pdf/1374/NEVADA_RN_8_16.pdf

Contraception/Hormonal
Replacement Therapy

Soil Receiving Water

Urination/Defecation