Last year, Daily NK reported that black market merchants in Chongjin, North Hamgyong province, were secretly selling expired Chinese-made contraceptives to teenagers and young adults. Our follow-up investigation reveals that high demand has prompted merchants to import fresher contraceptive pills and expand their product offerings.
Back in July 2024, Chongjin merchants were selling contraceptive pills that had expired 3-4 years earlier, packaging them in sets of two for 10,000 won (about $0.70). By September 2024, Radio Free Asia reported that merchants were selling a once-monthly contraceptive pill called “Lebono” for 20,000 won per pill (roughly $1.24).
What’s available today
Nearly a year later, medicine peddlers in North Hamgyong province are now selling two main types of contraceptives, both smuggled from China: a pink pill taken once monthly and a morning-after emergency contraceptive consisting of two white pills.
The pink pill is marketed as a monthly pregnancy prevention method, selling for 8 RMB (approximately $1.10 or 25,000 KPW at current exchange rates). This aligns with earlier RFA reporting when accounting for the changing exchange rate. However, our source in North Hamgyong also found vendors charging double that amount (15 RMB, roughly $2.10 or 47,000 KPW) for a single pill. These dramatic price differences stem from arbitrary markups by vendors who know customers can’t easily comparison shop due to the secretive nature of birth control sales.
The white pills serve as morning-after emergency contraceptives, meant to be taken within days of unprotected sex. A set of two white pills (one complete dose) sells for 5 RMB ($0.70 or 15,500 KPW) in North Hamgyong province. While the won-based price appears higher than before, the RMB price has actually dropped slightly, suggesting better availability and competition among vendors. The fact that merchants now sell non-expired pills represents genuine improvement for consumers.
Either option works independently, but some businesspeople push customers to use both together. While the pink pill alone generally prevents pregnancy, one vendor told our source that taking the two white pills after each sexual encounter provided the best protection. At a combined minimum cost of 13 RMB ($1.84), this recommendation isn’t cheap—equivalent to over 4 kilograms of rice at current prices. Based on 2021 U.N. FAO grain consumption estimates, that’s more than a week’s worth of meals for one adult.
The hidden risks
Beyond the financial burden, using these pills together could be genuinely dangerous. Based on product descriptions, Daily NK identified the pink pill as a 6mg Levonorgestrel, 3mg Quinestrol tablet made by China Resource Zizhu Pharmaceuticals and sold under the brand names “Yue Ke Ting” or “Ai Yue.” The North Korean nickname “Lebono” likely comes from “Levonorgestrel,” the first English word on the package—everything else is written in Chinese.
According to Zizhu Pharm’s website, this pill contains high progestogen-estrogen doses that fatty tissue absorbs and slowly releases over a month. While once-monthly pills have existed in Chinese markets since the 1960s, Zizhu Pharm’s version appears to be the only one still widely produced and available.
The white pills most closely resemble levonorgestrel-only morning-after contraceptives like “Next Choice.” Since middlemen repackage products for smuggling, Daily NK couldn’t obtain original packaging to confirm origins, though they’re known to be Chinese-made. Given that Zizhu Pharmaceutical products have entered the country, these white pills might be Zizhu Pharm’s equivalent product, Yu Ting (毓婷). Online instructions tell users to take both pills at once or within 12 hours of each other, within 72 hours of unprotected sex—matching the instructions given by black market sellers.
These identifications are deeply concerning. The pink pill (Yue Ke Ting/Ai Yue) is banned in multiple countries including Uganda, Kenya, Lesotho, and Zambia. The manufacturer (Qinhuangdao Zizhu) has been red-listed by the US FDA for questionable quality control practices. A 2007 study in the journal Contraception warned about risks associated with once-monthly formulations, leading Beijing family planning clinics to discontinue these pills. While removed from Chinese government procurement lists, the pills spread across Southeast Asia, the Pacific, and Eastern Africa.
In Kenya, the pink pill (locally called “Sophia”) has been banned since 2012 after investigations found that a single pill contained over 40 times the recommended safe dose of levonorgestrel. African media reports describe several women suffering severe, sometimes life-threatening blood clots, with at least one Ugandan woman’s death in March 2023 attributed to the pill.
The problem becomes worse when vendors recommend combining the pink pill with the white morning-after pills. Both contain levonorgestrel, meaning women who take both face massive hormone exposure far exceeding safe levels. One Daily NK source reported that rumors about infertility risks are already circulating: “It’s true that even girls under 20 are taking these pills, but there are rumors that they’re bad for your health and, in severe cases, can make it difficult to get pregnant later on.”
The bigger picture
Fortunately, contraceptive pills aren’t North Korean women’s only or most common birth control option. According to 2014 U.N. contraception data, 78% of North Korean women using birth control rely on IUDs. These implanted devices were initially popular mainly among married women, but younger women are increasingly getting them as parents seek to protect daughters deployed far from home. In one revealing 2023 incident, a recruitment officer in North Pyongan province who rejected female candidates with IUDs ended up delaying his recruitment timeline after failing to find enough women to meet his quotas.
A 2013 study by the Citizens’ Alliance for North Korean Human Rights found that most interviewed women only learned about contraception after giving birth and becoming “desperate” to avoid more children. Participants indicated that while birth control pills were available in North Korea by the early 2010s, they were far less common than IUDs. Reports of teenagers using birth control suggest that contraception awareness is starting younger and that more secretive, self-administered options are becoming available.
Despite the potential benefits of increased contraception awareness, improperly prescribed birth control pills pose serious dangers to vulnerable young women. Government bans on contraception and strong social stigma around premarital sex make it difficult for young women to share information or seek help if complications arise. Parents often have no idea their daughters are taking birth control medication, meaning young women potentially face complications completely alone.
As seen worldwide, outlawing contraceptive practices doesn’t increase birth rates—it only drives reproductive health services underground and increases maternal mortality. Limited access to safer daily combined pills and lack of medical information about the risks of combining hormonal contraceptives may well cause long-term, population-wide fertility problems. This runs directly counter to North Korea’s pronatalist policies while needlessly endangering thousands of women’s lives.
