New OTC birth control pill raises questions, some concerns

Birth control is going to become much more accessible in 2024. The Food and Drug Administration recently approved the first over-the-counter non-prescription birth control pill, Opill.

It was approved for prescription use in the 1970s.

But the increased accessibility is raising some concerns.

Local OB-GYN Kelly Battoglia supports the decision to increase access to birth control, but says it needs to be done carefully.

“I have been a little concerned because the FDA has a history of letting things go over the counter without a full plan, and then the people trying to access it have problems,” said Battoglia.

For example, when emergency contraception stopped requiring a prescription, she said it wasn’t as affordable as anticipated.

“When it went over the counter it was about 60 dollars, which does not create great access for people who don’t have 60 dollars,” she said.

Typically, OTC pills are not covered by insurance, she said. And the price for Opill remains to be seen.

Battoglia is also concerned about patient education. She said women should discuss taking Opill with a professional. This includes why they’re choosing to take it, how to take it, and what side effects to expect. She said this product is going to be everyday use, and it is very different from the combined hormonal contraceptive pills that many women are used to.

Dr. Colt Wasserman, Chief Medical Officer for Rochester’s Planned Parenthood, said although the box will come with a detailed package insert, it’s important anyone taking it has a conversation with a medical professional. Especially younger patients.

“Younger patients do well when they are supported by parents, or people that they rely on in their lives as a source of adult support,” said Wasserman. “But I think we have good evidence that young people can make great contraceptive decisions for themselves.”

The general recommendation is to take the pill within the same three-hour window each day.

“So the over-the-counter contraception is going to be just a progesterone only pill,” said Wasserman. “And the main way that we understand it prevents pregnancy is by thickening the cervical mucous, which just makes it harder for sperm to fertilize an egg.”

“The good news about progesterone-only contraception is that they are really well tolerated,” they said.

Battoglia said the three-hour window may be standard. But women should also know that not taking the pill on time might lower its effectiveness.

Professionals do not recommend this pill for those with breast cancer, or a history of breast cancer. The reason has to do with a higher risk of clotting.

The pill is expected to hit store shelves in early 2024.