Can I Buy Over-the-Counter Birth Control Pills?

Over the Counter Birth Control Pills
Over-the-Counter Birth Control Pills?. Photo © 2016 Dawn Stacey

One of the most common questions that people ask is whether or not they can buy over-the-counter birth control pills. Although there are some great birth control options that you can buy over-the-counter,  unfortunately, birth control pills are not one of them. As of now, the only available over-the-counter birth control pills are for emergency contraception.

How to Get Birth Control Pills

To get birth control pills (either progestin-only pills, combination pills, or extended cycle pills), you do need a doctor’s prescription.

In order to write this prescription, you will need to talk with your doctor about your medical history and get your blood pressure checked. Your doctor may require a pelvic exam and a breast exam, but this is not universal.

Why Aren't There Over-The-Counter Birth Control Pills?

There is a lot of debate over this topic. Many women argue that menstruation and preventing pregnancy are not diseases. The birth control pill is not a dangerous medicine. Most of the pill's side effects are not very serious. There isn't a risk of addiction and they don't give you a high.

This leads many to wonder if the U.S. Food and Drug Administration (FDA) is taking the best stance on this issue. By not allowing for over-the-counter birth control pills, is the government making it more difficult for women to get and use the pill? Also, by requiring medical exams in order to get the pill, it makes it harder for women who work long hours and are not able to take time off.

On the other hand, some doctors argue that if women could get over-the-counter birth control pills, they would never come in for their yearly wellness exams. 

Guidelines for How to Get the Pill

General medical guidelines and research suggest that hormonal contraception (like the pill) can be safely prescribed just on the basis of obtaining a careful medical history and blood pressure measurement.

Breast and pelvic exams as well as pap smears and sexually transmitted disease screenings are important to have done as part of staying healthy. These are a necessary part of family planning and reproductive health care. Routine STD screenings are recommended because women who use birth control pills are less likely to also use condoms that protect against these infections. That being said, the information doctors get from these exams do not tell them if a woman can or cannot safely use birth control pills. 

It is important that you have an honest conversation with your doctor because there are some women who are not good candidates for the pill. This is why it is important that your doctor does a thorough medical history with you and that you are truthful about your history. Because the pill can increase your blood pressure, you should also have your blood pressure checked regularly for the first few months after you start using the pill.

Requesting a Pill Prescription Without a Pelvic Exam

You may be like so many other women out there—you want to use the pill, but are not because you're afraid to have a pelvic exam and pap smear. It seems that the general medical consensus supports a change in practice.

Research shows that birth control pills can be safely prescribed based on a careful review of your medical history and blood pressure measurement. For most women, no further exams are necessary. Current guidelines created by the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG) also suggest that birth control pills can be safely prescribed without a pelvic exam.

If your doctor insists that you must have a breast and pelvic exam in order to give you your pill prescription, explain your concerns and/or fears, and request not to have these exams done.

You can also call around and find a different doctor who follows WHO's and the ACOG's guidelines for prescribing birth control pills. Planned Parenthood may be an option to use as a healthcare provider that doesn't require a pelvic exam to get hormonal birth control.

Why You Should See Your Doctor for Birth Control Pills

The pill is an effective, discreet and convenient birth control method. It allows you to have control over your fertility, to manage your period and to prevent pregnancy, and its use probably results in fewer abortions. There are some good arguments that support purchasing over-the-counter birth control pills (without the need for a prescription). But since there are some women who should not use the pill, there are also reasons why it is important that you see a doctor in order to use the pill.

Even though routine pelvic and breast exams, pap smears, and STD testing may be uncomfortable (and are definitely not something most women look forward to doing), they are an important part of your overall health care. These screenings may not be effective for determining whether or not you are a good candidate for the pill, but they are essential for early detection of life-threatening diseases.

A Word From Verywell

Consider your birth control options and choose the one that will work best for you. But don't avoid seeing your doctor to get your routine well-woman checks because they may be uncomfortable. This is also a chance to discuss your options with your doctor privately and get a prescription if that is what you decide is best.

Sources:

American College of Obstetricians and Gynecologists. Over-the-Counter Access to Oral Contraceptives. Committee Opinion No. 544. Obstetrics & Gynecology. 2012;120(6):1527-1531. doi:10.1097/01.aog.0000423818.85283.bd.

Birth control pill FAQ: Benefits, risks and choices. Mayo Clinic. http://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136. Published May 4, 2016.

Tepper NK, Marchbanks PA, Curtis KM. U.S. Selected Practice Recommendations for Contraceptive Use, 2013. Journal of Women's Health. 2014;23(2):108-111. doi:10.1089/jwh.2013.4556.

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