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The new over-the-counter birth control pill: is it right for me?

There are many types of contraception available to avoid pregnancy. Soon, there will be a new option without a prescription. For the first time, an over-the-counter birth control pill will be available in the U.S. starting in 2024.

What’s different about the new Opill® (norgestrel) birth control pill?

Most birth control pills contain the hormones estrogen and progestin. Opill, or norgestrel, contains only one hormone—progestin. Progestin-only pills prevent pregnancy by stopping sperm from entering the uterus. They may also prevent egg release from the ovary in some people. 

Progestin-only pills are not new and have been around since the 1970s. You can read more about the minipill here. What is new is that you don’t need a healthcare provider to prescribe Norgestrel. It will be available over-the-counter at drugstores and retailers or purchased online. Access to birth control may now be easier for millions. Especially for those with limited or no healthcare coverage and those who find it difficult to see a doctor due to barriers.

About half of all pregnancies in the United States are unintended, which can lead to negative maternal and child health outcomes. Making birth control available over the counter may make it easier for more people to avoid unintended pregnancy. 

Is a progestin-only pill right for me? 

Progestin-only pills are generally appropriate for most people with a menstrual cycle. They are also recommended for people who should avoid estrogen for some reason. For example, people who smoke, are breastfeeding, have migraines with aura, heart disease, or diabetes. 

There are other reasons why a progestin-only pill might be a good contraceptive option for you. The new birth control pill is now over-the-counter, so you won’t need a prescription, making it easier to get. 

Progestin-only pills are highly effective at preventing pregnancy. If taken as recommended, they work like other birth control pills. But, there are some differences between this birth control pill and other pills. Other pills allow more wiggle room between doses. In contrast, you must take the progestin-only pill around the same time each day to be effective. If you miss a dose by more than three hours, take it as soon as possible and use a backup birth control method, like condoms.

When choosing a contraceptive method, be honest with yourself. Consider whether you can follow the usage guidelines for that method. Suppose you have a hard time remembering to take or are unable to take the pill at the same time every day. In that case, it may lower the pill’s effectiveness in preventing pregnancy. You may want to explore other birth control options that are more suitable for your needs.

You should also consider your current health and the medications you take. If you are pregnant, have breast cancer, or have a history of breast cancer, progestin-only pills are not the right form of contraception for you. If you take antiseizure medications, antibiotics, or over-the-counter supplements, consult your provider before using progestin-only pills to make sure there are no drug interactions. 

It’s also important to note that, like all non-barrier methods of contraception, the progestin-only pill does not prevent sexually transmitted infections (STIs).

Always have a shared discussion with your provider about the best birth control for your reproductive health journey. The decision is yours – and this new over-the-counter pill gives you another option!

Reviewed by the Ovia Health Clinical Team

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