Over-the-counter birth control: What you need to know

As of March 2024, over-the-counter birth control pills have been available without a prescription, offering an additional way for individuals to manage their reproductive health.

It’s a first in the U.S. and has expanded access to hormonal birth control.

“You can now buy oral contraceptives in the drug store or even online,” said Rachel Neal, MD, an OB-GYN with Endeavor Health. “It’s a safe, effective way to prevent unwanted pregnancy and manage painful periods.”

How does it work?

Opill, the birth control pill approved by the Food and Drug Administration as a nonprescription oral contraceptive, is a progestin-only pill. It works by thickening cervical mucus, making it more difficult for sperm to enter the uterus. It also thins the uterine lining and can stop ovulation.

When taken as directed — taking one pill at the same time every day — less than 1 in 100 women will get pregnant during the first year of use.

The most common side effect of the progestin-only pill is unpredictable bleeding, though it often lightens bleeding or stops periods altogether.

Who should use it?

“The progestin-only oral contraceptive can be an effective birth control when taken at the same time every day,” Dr. Neal said. “It can also help ease discomfort for people who have heavy or painful periods.”

People who have or have had breast cancer should not take progestin-only pills, as well as those with some forms of lupus. If you have questions, ask your physician before starting the pills.

This form of contraception doesn’t increase the risk of high blood pressure or cardiovascular disease like pills with estrogen do.

It’s important to note that oral contraceptives provide protection against pregnancy, but not against sexually transmitted infections (STI). Use an additional form of protection, such as a condom, to prevent infection.

Your doctor can answer questions about over-the-counter oral contraception. Even if you don’t have questions, continue to schedule your annual exam with your OB-GYN to keep your overall health on track.