Is Over-the-Counter Birth Control the Best Bet for Women?

Is Over-the-Counter Birth Control the Best Bet for Women?

It’s always been easy to pop into your local pharmacy to pick up things like cosmetics, cotton balls and first aid supplies.

And now, thanks to laws pioneered in Oregon and California, getting your monthly birth control prescription there may be just as easy.

Birth control without a prescription (sort of)
The new laws, in effect in January 2016 in Oregon and March 2016 in California, allow women in these states to go to a pharmacy and receive hormonal contraceptives (the pill, patch or rings) over-the-counter (OTC)—sort of. A prescription is still required, but women would be able to get it straight from qualified pharmacists, rather than having to get one from their physician.

Here’s how it works: A woman goes to her local pharmacy and completes a self-screening risk assessment that she gives to the licensed pharmacist. The pharmacist then writes a prescription and dispenses the type of birth control he or she deems appropriate.

The pharmacist would also refer the woman to her primary physician for follow-up care, and provide her with a written record of the type of birth control prescribed.

In California, where the law was originally signed in 2013, women would have to fill out a health questionnaire and also have their blood pressure taken at the pharmacy before getting the prescription.

Is OTC birth control right for women?
This improved access to birth control certainly has its benefits. It makes it easier to get if you were to accidentally run out and need a refill quickly, for one. And studies have found that women are more likely to use contraceptives when there are fewer obstacles to go through in obtaining them.

Research published in the journal Contraception also found that 21 percent of women would be “very likely” to use hormonal birth control if no prescription was required and an additional 11 to 21percent would use it if there were no out-of-pocket costs—such as an insurance copay.

But the new laws have also raised a few questions from experts like OBGYN Steven Edmondson, MD, of Medical City Alliance in Fort Worth, Texas.

“A birth control pill is not a medication without risks,” says Dr. Edmondson. “So one concern is the quality of the risk assessment. An individual may not know that they’re at risk for a particular complication. And are pharmacists the ideal individuals to be assessing the gynecologic risks related to these hormones?”

“The information that the pharmacist is using to make a decision is based entirely on the patient’s input,” Edmondson goes on to say. “What if I have high blood pressure and don’t know it? What if I’m unknowingly pregnant or have a family history of breast cancer? I would assume a person would know that, but they might not. That’s something we really have to refine so we’re making sure we’re not solving one problem and creating more.”

The importance of continued health screening
Another worry among experts like Edmondson is that by allowing women to bypass their gynecologists for birth control prescriptions, the new laws might also indirectly encourage women to bypass other important preventative screenings and exams, too.

“If [women] are able to access birth control pills without a prescription [from the doctor], is she less likely to go get her Pap smear or breast exam?” Edmondson says. “I think there’s a potential there that could adversely affect other healthcare screenings such as Pap smears, mammograms, immunizations and blood pressure checks.”

While the jury may still be out on whether or not over-the-counter birth control is the best bet for women’s health, Edmondson says one thing is certain: “You still need continued health surveillance for gynecologic problems irrespective of birth control.”

And those are issues better served between the physician and the patient.

Medically reviewed in August 2019.

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