Could OTC Birth Control Be Available at Pharmacies Soon?

Regular birth control pills are already available over the counter in many countries including Turkey, Mexico, and South Korea. In the U.S., we are slowly but surely starting to provide women with greater access to birth control products without requiring a prescription.

In 2013, Plan B One-Step, the emergency contraceptive that can prevent pregnancy, was made available without a prescription (“over-the-counter” or OTC) without an ID or age restriction.

It was a step in the right direction for the OTC approval of other birth control products (the pill many women take monthly, for example). This is because Plan B One-Step contains levonorgestrel, the same hormone used in many birth controls — just at a higher dose.

How can birth control become available over the counter?

In general, OTC contraceptives can become available if they meet the following FDA conditions:

• You can properly figure out why you need to use the OTC product without a healthcare provider's assistance.

• You can safely and effectively use the OTC product without a healthcare provider’s assistance.

• The OTC product has a low chance of being misused or abused. 

The barriers to OTC birth control pills likely include the pills’ contraindications. Contraindications are reasons you shouldn’t use a particular medication. 

For example, you shouldn’t use combination hormonal birth control if you have uncontrolled hypertension (high blood pressure) or if you’re a smoker who is over 35 years of age. Other reasons to not use combination hormonal birth control may include a history of clots or breast cancer. You should also avoid progestin-only hormonal pills if you have a history of breast cancer.

While contraindications exist, birth control pills are well known for their safety and effectiveness. By using a checklist, women can also safely recognize contraindications on their own. This supports women’s access to OTC birth control pills.

Is there anywhere in the U.S. I can get birth control pills over the counter?

In Oregon, California, and Washington, D.C. women can get access to birth control just by visiting their local pharmacy. There are also 17 other states that give women this access.

In these states, birth control pills do not have OTC status yet. But, you do not need to go to the doctor to get or renew your prescription. A short questionnaire and consultation with your pharmacist will have you out the door with oral contraceptives in hand in no time.

Many other states, including Kansas and Missouri, are following suit by creating and/or passing bills to give women greater access to birth control pills. These bills allow your pharmacist to directly dispense your medication without needing a prescription from you.

Over-the-counter birth control options

While hormonal birth control pills aren’t truly available over the counter yet, there are other OTC contraceptive options. These include:

• Condoms

• Spermicide

• Contraceptive sponges

• Natural Cycles phone app

• Emergency contraception, like Plan B One-Step

Getting birth control pills online

Getting your birth control online is another possible option for you. You will still need a prescription, but you can get one in an online visit with a healthcare provider. GoodRx and Planned Parenthood offer this type of service. 

Are there any drawbacks to pharmacist-prescribed birth control?

Some have expressed concern that pharmacist-prescribed birth control could mean that some women will skip important tests and screenings. But studies show that giving women more access to birth control doesn’t steer them away from screenings. And in California and Oregon, roughly 90% of women using pharmacist-prescribed birth control saw their primary care provider (PCP) within the previous year.

Pharmacist-prescribed birth control, however, may still limit access for some women because of age restrictions and regular PCP requirements.

What type of birth control pill could be available without a prescription?

One pharmaceutical company, HRA Pharma, has been working with Ibis Reproductive Health to perform the necessary research to get birth control OTC.

In July 2022, HRA Pharma requested the FDA to review an application for an OTC birth control pill. This is a progestin-only birth control pill called Opill. Since Opill’s FDA approval in 1973, millions of women in the U.S. have used this progestin-only birth control pill. It also has decades of data to support its safe and effective use for preventing pregnancy.

If this Rx-to-OTC switch is approved, Opill will be the first daily OTC birth control pill in the U.S.

Are there advantages to a progestin-only pill?

Yes, progestin-only pills have several advantages. Some of these benefits may include:

• They’re not linked to a greater risk of high blood pressure or heart disease.

• People with a history of clots or uncontrolled high blood pressure may use progestin-only pills.

• Breastfeeding women can use progestin-only pills right away after giving birth.

• You might have lighter or no monthly menstrual periods.

Why trust our experts?

Written by:

Ross Phan, PharmD, BCACP, BCGP, BCPS

Ross Phan is a board-certified clinical pharmacist. She has roughly two decades of healthcare experience — with most of her experience being pharmacy related.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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