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

There are several birth control options that you can buy over-the-counter (OTC), including birth control pills and pills for emergency contraception.

In July 2023, the Food and Drug Administration (FDA) approved Opill (norgestrel), a progestin-only oral contraceptive, to be sold over the counter (OTC). Opill is the first and only birth control pill available without a prescription. 

Birth control pills would be hard to access for over half a million women and girls if Planned Parenthood is defunded.
Jonathan Nourok/Getty Images

How to Get Birth Control Pills

You need a healthcare provider's prescription for combination pills or extended-cycle pills. Progestin-only pills are available by prescription and OTC.

In order to get a prescription for birth control pills, you will need to talk to your healthcare provider about your medical history and get your blood pressure checked. Your practitioner may also require you to have a pelvic exam and a breast exam, but this is not a universal requirement.

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

There is a lot of debate on this topic, and there are many reasons why the pill isn't available OTC, as well as many potential benefits if they were available OTC.

Pros of OTC Availability

Proponents of OTC availability argue that menstruation and preventing pregnancy are not diseases. Furthermore, the birth control pill is not a dangerous medicine, and 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.

In fact, The American College of Obstetricians and Gynecologists supports over-the-counter access to hormonal contraception without age restrictions.

Requiring medical exams in order to get the pill could be difficult for people who work long hours and are not able to take time off. Some people might want a degree of anonymity when using the pill, and might not want it listed in their health records.

Pros of Prescription-Only Availability

Some people should not use the pill due to health risks, so it is important that you see a healthcare provider when you're using the pill. And some healthcare providers argue that if people could get over-the-counter birth control pills, they would never come in for their yearly wellness exams.

With several different hormone combinations, you might switch from one to another, and you would benefit substantially from having a doctor guide this process.

Furthermore, the pills can cause some side effects and complications and can interact with certain OTC and prescription medications, so having a doctor to manage these issues can be safer for you.

Having a doctor's prescription is often a prerequisite for health insurance coverage, so getting the birth control as a prescription can reduce your out-of-pocket cost.

Guidelines on How to Get the Pill

General medical guidelines and research suggest that hormonal contraception (like the pill) can be safely prescribed based on a careful medical history.

Some people should not take the pill. Talking with your healthcare provider before starting or switching pills is important. Combined pills can increase your blood pressure, so you should have your blood pressure checked regularly for the first few months after you start using the pill. They can also increase the risk of blood clots for some people, especially smokers or people who have a medical condition that causes blood clotting abnormalities.

Breast exams, pelvic exams, Pap smears, and sexually transmitted infection (STI) screenings are important for detecting and preventing cancer and for family planning and reproductive health care. Even though these tests may be uncomfortable (and are not something most people look forward to), they are an important part of your overall health care.

Routine STI screenings are recommended because people who use birth control pills are less likely to use internal or external condoms that protect against these infections.

These exams are essential for early detection of many diseases—some of which can be life-threatening. That being said, the information that healthcare providers get from these exams does not indicate whether a person can or cannot safely use birth control pills.

Requesting a Pill Prescription Without a Pelvic Exam

You may be like many other people out there—you want to use the pill, but you are not seeking a prescription because you're afraid to have a pelvic exam and Pap smear. If that's the case, you should know that 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 people, no further exams are necessary.

Current guidelines created by the Centers for Disease Control and Prevention suggest that birth control pills can be safely prescribed without a pelvic exam.

If your healthcare provider insists that you must have a breast exam, pelvic exam, Pap test, or STI screening in order to give you your pill prescription, explain your concerns and/or fears, and request not to have these exams done. They might hesitate out of concern that you could have an undiagnosed medical issue if you don't have these screening tests, or they might agree to prescribe the pill for you without the screening tests.

You can also call around and find a different medical professional who does not require these tests as a prerequisite for prescribing birth control pills. Planned Parenthood may be an option that doesn't require a pelvic exam to get hormonal birth control.

A Word From Verywell

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.

Consider your birth control options and choose the one that will work best for you. But don't avoid seeing your healthcare provider to get your routine gynecologic checks. This is also a chance to discuss your options with your medical professional privately and get a prescription if that is what you decide is best.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Over-the-counter access to hormonal contraception: ACOG Committee Opinion, Number 788. Obstet Gynecol. 2019;134(4):e96-e105. doi:10.1097/AOG.0000000000003473

  2. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep. 2016;65(4):1-66. doi:10.15585/mmwr.rr6504a1

  3. Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol. 2012;120(6):1291-1297.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.