New Over-the-Counter Contraceptive Pill Promises to Increase Access to Birth Control for Adolescents

The Food and Drug Administration (FDA) recently approved Opill (norgestrel), the first ever over-the-counter (OTC) contraceptive pill. It isn’t on the market yet, but it will be available for purchase soon at local pharmacies, convenience stores and grocery stores, as well as online.  

Opill is an OTC version of one type of prescription birth control pill. Some birth control pills contain two female hormones—estrogen and progesterone—while others contain progesterone only. Opill is a progesterone-only pill. As a result, Opill may have fewer side effects than pills containing estrogen and progesterone, according to the American Academy of Family Physicians. 

Dr. Julia Cron, Vice Chair and Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medicine and Site Chief for Obstetrics and Gynecology at NewYork-Presbyterian Lower Manhattan Hospital, says the new pill will improve adolescents’ access to contraception—and anything that improves access will give them greater autonomy and control over decision-making where their reproductive health is concerned. 

FDA guidelines 

  • Opill should be taken at the same time every day.  
  • It shouldn’t be combined with any other hormonal birth control product, such as another oral contraceptive pill, a vaginal ring, or a contraceptive patch, implant, injection or intrauterine device (IUD). 
  • Opill’s side effects may include irregular bleeding between periods, headaches, dizziness, nausea, increased appetite, cramps or bloating. 
  • Opill shouldn’t be used by people who have had breast cancer. If you’ve had any other form of cancer, ask your doctor whether it’s safe to use Opill. 
  • It isn’t intended for use as emergency contraception. Also known as the “morning after” pill, emergency contraception is a form of backup birth control that can be used up to several days after unprotected sex and still prevent a pregnancy.  
  • Opill won’t protect you from sexually transmitted infections (STIs). Condoms remain the only way to protect against them. Combine Opill with a condom to prevent both pregnancy and STIs. 

Safety profile 

As mentioned, many birth control pills contain a combination of two hormones—estrogen and progesterone—while Opill has just one—progesterone. A small number of girls and women can’t take estrogen, so Opill may be safer than the combined estrogen and progesterone pills, Dr. Cron says. 

Unintended pregnancies and their risks 

Nearly half of all pregnancies in the U.S. are unintended, but that doesn’t mean they’re always undesired. Some may wish to postpone pregnancy for 8 years, while others might prefer to wait for just a year or so. And, of course, some may decide not to have children at all.  

Approximately 80 percent of adolescent pregnancies are unintended, and the majority of these are also undesired. Having a discreet way to obtain The Pill without a prescription will help girls and young women under 20 take control of their health and their lives, she says. 

That’s especially important given the risks associated with unintended pregnancies. According to the Centers for Disease Control and Prevention (CDC), pregnant women who didn’t intend to conceive are less likely to seek early prenatal care. They’re also at higher risk for premature delivery. “Preemies” may be born with problems around the time of birth, and they may experience higher rates of developmental and health problems later on. 

Cost and insurance coverage 

We don’t know yet what Opill will cost, or whether it will be covered by insurance,” says Dr. Cron. We must recognize that some adolescents don’t have insurance, and some may choose not to use their insurance for privacy reasons 

She hopes it will be affordable. Otherwise, lower-income teens won’t be able to pay for it, andthat would be a shame. But it won’t be the first time that the most vulnerable among us might be excluded from an otherwise promising advance.” 

The right to privacy 

Clearly, caregivers—parents, grandparents or other designated adults—have a very important role to play, says Dr. Cron. However, there are certainly some instances where engaging a caregiver can be harmful, so we need to make sure that adolescent privacy is protected.” 

Adolescents have the same right to privacy as the rest of us. “The legal landscape is changing all the time, as we know, so it’s important to find out what’s protected in your particular state. But hopefully, the right to privacy—especially around contraception and STI testingwill stand. 

“With access to Opill, adolescents will be empowered to avoid unintended pregnancies,” she continues. “The new oral contraceptive may also help reduce geographic disparities, preventing unintended pregnancies in states where reproductive rights and access to health care are being taken away. Teens and young women have the potential to be the greatest beneficiaries.” 

Listen to Dr. Cron’s podcast, which includes an overview of the benefits and drawbacks of various contraceptive methods, here. 

Make an appointment with a gynecologist specializing in adolescent care at Weill Cornell Medicine here.