What Are the Best Over-the-Counter Options for Birth Control?
Key takeaways:
There are several over-the-counter (OTC) birth control options available. These can be helpful if you’re unable to see a healthcare professional and want to prevent pregnancy.
External condoms are a great OTC birth control option. They’re typically about 85% effective for preventing pregnancy. They’re also the only OTC contraceptive that can protect against sexually transmitted infections (STIs).
Opill (norgestrel) is an OTC birth control pill that’s about 91% effective with typical use. This is the most effective OTC birth control choice for preventing pregnancy.
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Table of contents
When most people think of “birth control,” they likely think of oral contraceptives (also called “the pill”). But birth control covers a wide variety of products that can be used by both women and men. Often, the biggest barrier to accessing birth control is the fact that many contraceptives require a prescription.
Thankfully, there are several over-the-counter (OTC) birth control options available. These forms of contraception can vary in effectiveness. It’s important to know how well each one works before purchasing one. This information will allow you and your partner to make an informed decision.
Read on below to learn more about OTC birth control options and how effective they are.
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Can you prevent pregnancy with OTC products?
Yes. There are several ways to prevent pregnancy without visiting a medical office. While it’s always recommended to discuss your reproductive health with a healthcare professional, this can be easier said than done. Many people are uninsured or underinsured. And getting time off work to see a healthcare professional can be difficult for a lot of people.
So if one of these situations applies to you, know that OTC birth control options are available.
What OTC birth control options are available?
If you walk down the family planning aisle of a pharmacy, you’ll likely see a variety of contraception options. Some you’ve likely heard of or used before. But there may be a few that are new to you. Below, we discuss the details of seven OTC birth control options.
1. Opill (the OTC birth control pill)
In July 2023, Opill (norgestrel) made headlines when it became the first FDA-approved OTC birth control pill. It contains norgestrel, a type of progestin (a lab-made form of the sex hormone progesterone). It’s a pill you take by mouth once a day at the same time every day. And it’s the most effective OTC birth control method for preventing pregnancy. But keep in mind that it doesn’t protect you against sexually transmitted infections (STIs).
Opill is similarly effective to prescription birth control pills. With perfect use (meaning no missed or late doses), Opill is up to 98% effective. With typical use, it’s about 91% effective.
The main way Opill helps prevent pregnancy is by thickening your cervical mucus (the fluid around the opening of your uterus). This makes it harder for sperm to enter your uterus and fertilize an egg. Opill may also prevent ovulation (the release of an egg in the body). But it may not prevent ovulation every menstrual cycle.
Good to know: Opill has a few warnings to know about before taking it. For instance, you shouldn’t take it if you have a history of breast cancer. You can find these warnings on Opill’s OTC label. But if you’ve never taken birth control pills before, consider speaking with your pharmacist about whether it’s safe for you.
2. External condoms
Condoms are one of the most well-known contraception options available. External condoms (link contains explicit content) are those that fit over a penis during sex. While many people think of them as being for penis-in-vagina sex, they can be used during oral or anal sex, too.
When used to prevent pregnancy, condoms can be up to 98% effective if used perfectly. But perfect use doesn’t always happen. With typical use, condoms are about 85% effective for preventing pregnancy.
The biggest advantage condoms offer over other OTC birth control options is that they can also help protect you from STIs. No other contraceptives discussed here offer this benefit.
Most external condoms are made of latex. But there are options for people who are allergic to latex. There are condoms made of polyurethane (a type of plastic), polyisoprene (a lab-made form of rubber), and animal membranes (e.g., lambskin). Keep in mind that animal membrane condoms can prevent pregnancy, but they don’t protect you from STIs.
Be sure to check which lubricant you should use with the condom you’re purchasing. Each condom is compatible with different types of lubricants.
3. Spermicide
Spermicide is a product that works by killing sperm. This helps lower the number of sperm that can reach and fertilize an egg. It’s placed in the vagina before you have sex. Be sure to read the directions for your spermicide carefully. Some have to be applied a certain amount of time before sex. Others only last for so long before needing to be applied again.
Spermicide comes in several forms. A commonly-used spermicide is a gel that’s applied inside the vagina. Spermicide foams and dissolving spermicide films are also available. You may also find condoms that come pre-lubricated with spermicide. This can offer extra protection by combining two birth control methods.
When used by itself, spermicide is one of the least effective birth control options. With perfect use, these products are 82% effective. But with typical use, this effectiveness drops to 72%. That means that, on average, 28 out of every 100 women get pregnant when using spermicide by itself.
4. Contraceptive sponges
Contraceptive sponges are disc-shaped devices that are placed over the cervix before having sex. The cervix is the small opening that separates the vagina from the uterus. Contraceptive sponges typically contain spermicide. This OTC birth control option kills and absorbs some sperm during sex. This helps lower the number of sperm that can reach an egg.
Contraceptive sponges are less effective than most other birth control methods. Their effectiveness also depends on whether you’ve given birth before. If you’ve never given birth, they’re about 91% effective with perfect use and 88% effective with typical use. In women who’ve given birth before, they’re around 80% effective with perfect use and 76% effective with typical use.
5. Natural Cycles app
The Natural Cycles app was the first mobile device app to be FDA-cleared for birth control in 2018. This digital health tool uses your menstrual cycle information and daily temperature readings to predict when you’ll ovulate. This app is a form of “fertility awareness” birth control.
Shortly after you ovulate, your body temperature rises slightly. But in order to detect this small change, you’ll need a basal thermometer. These thermometers are more sensitive than those found in the cough and cold aisle.
Using a basal thermometer and tracking your temperature daily in the Natural Cycles app can help the app predict ovulation. During your fertile window, Natural Cycles will recommend avoiding sex or using a back-up method of protection, like condoms.
In order to be effective, Natural Cycles must be used every day. So it takes a lot of dedication and may not be the right OTC birth control option for everyone.
With perfect use, Natural Cycles can be up to 98% effective. With typical use, the FDA states it’s about 93% effective. But it’s important to note that, overall, fertility awareness methods are only about 76% effective.
6. Pharmacist-provided birth control pills or patches
In many U.S. states, prescription-only birth control pills and patches can be accessed just by talking to your pharmacist. States that have this option allow pharmacists to dispense a prescription for contraceptive pills and patches without you needing to see a prescriber beforehand.
Various state laws have been enacted over the past decade to help expand birth control access. This practice keeps growing, providing access to some of the most effective contraceptives. Birth control pills and patches are similarly effective. With perfect use, they’re up to 99% effective. With typical use, they’re about 91% effective.
Getting pharmacist-provided birth control is similar to getting a flu shot. You’ll fill out a form at the pharmacy and answer some questions about your medical history. Your pharmacist will also take your blood pressure. Based on the questionnaire and your blood pressure, your pharmacist can determine if birth control pills or patches would be safe. After that, they process a prescription for birth control just like they would for any other medication.
Keep in mind that pharmacist-provided birth control isn’t available in all 50 states. And not all pharmacies in those states may be set up to provide this service.
7. Emergency contraception
Emergency contraception (EC) is a type of birth control you use shortly after having unprotected sex. There are a few EC options, but only levonorgestrel (Plan B One-Step) is available OTC.
This OTC birth control option should be used as soon as possible after unprotected sex. But it can be taken within 72 hours (3 days) and still work well. Levonorgestrel is up to 89% effective when taken within this time frame. It can also be used multiple times during a menstrual cycle if needed.
Keep in mind that levonorgestrel is less effective than many prescription birth control methods. It can also cause a number of mild, uncomfortable side effects. So while it’s a great resource to have in case you need it, it shouldn’t replace regular, preventative birth control.
Is one OTC birth control better than the others?
Yes. If you’re looking for the best way to protect yourself from both pregnancy and STIs, latex or polyurethane condoms are your best bet. Their effectiveness is higher than many other OTC birth control options. They don’t require the same daily dedication that the Natural Cycles app does. And they're the only OTC contraceptives that offer protection against STIs.
If you’re just looking at pregnancy prevention, Opill or pharmacist-provided birth control (if available in your state) would be the best options. Hormonal birth control methods are among the most effective contraceptives for preventing pregnancy.
Good to know: For added protection, you can combine these two birth control methods. Using a condom and taking birth control pills is more effective than either is alone.
When should you see a prescriber for birth control?
If you’re looking for a birth control method that’s close to 100% effective with typical use, you’ll want to see a prescriber. The most effective reversible options, like the arm implant and intrauterine devices (IUDs), have to be placed at a prescriber’s office. These contraceptives also provide long-term pregnancy prevention.
Keep in mind that these birth control options still don’t protect against STIs. You’ll want to continue using condoms to protect yourself.
The bottom line
It’s important to have access to birth control and know how to properly use it. But not everyone is able to get to a healthcare professional for prescription contraceptives. Thankfully, over-the-counter (OTC) birth control options are available to help prevent pregnancy, regardless of whether you're insured or able to see a prescriber.
Condoms are an effective OTC contraceptive and are available in all U.S. states. They’re also the only OTC birth control method that also protects against sexually transmitted infections. Opill (norgestrel) is an OTC birth control pill that’s similarly effective to prescription contraceptive pills and patches. Speak with your prescriber or pharmacist if you’re not sure which OTC birth control option is right for you.
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References
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Centers for Disease Control and Prevention. (2023). Introduction.
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Planned Parenthood. (n.d.). How effective are condoms?
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