Oral contraceptives are one of the most common medications among women and the most popular method for birth control. But getting the pill usually requires a prescription and can’t be dispensed over-the-counter.
A new review of research, published earlier this week in the Journal of Adolescent Health, suggests that should change, especially for younger patients. According to doctors who authored the review, there aren’t any drawbacks to making birth control pills available over-the-counter for teenagers.
The review looked at several studies to see what risks for pregnancy might be among teenagers if different types of oral contraceptives became available over-the-counter. It also looked at how such a change might affect risky sexual activity.
The results, the authors wrote, were clear: “There is no scientific rationale for limiting access to a future over-the-counter oral contraceptive product by age.”
“The requirement to obtain OCs by prescription from a clinician may serve as a barrier to contraceptive initiation and continuation for women, in particular adolescents,” the review added. “Over-the-counter availability would reduce this barrier and could further reduce unintended pregnancy rates.”
Some states have looser regulations on dispensing birth control from pharmacies, like Oregon, Washington and California, which let patients get birth control after talking to a pharmacist, according to the Los Angeles Times. But neither is truly over-the-counter, since the pharmacist technically has to approve the medication.
The pill is available without a prescription in several other countries, including South Korea, China, Portugal and Greece, the Baltimore Sun reported.
In fact, birth control pills might be even safer for teenagers than for adults, they suggested. Some birth control pills might increase the risk of developing certain blood clots, the study’s lead author and Johns Hopkins University professor Krishna Upadhya told NPR. But those clotting risks are lower for younger women.
Those birth control pills could be “potentially safer the younger you are," she told the news organization.
Birth control pills are also prescribed for several reasons beyond preventing pregnancy — oral contraceptives can treat pain associated with endometriosis, regulate periods and treat hormone imbalances. According to the Guttmacher Institute, more than half of oral contraceptive users cite reasons other than pregnancy for taking them – and about a third of teenage users take the pill entirely for non-pregnancy reasons.
“There is a growing body of evidence that the safety risks are low and benefits are large,” Upadhya told NPR.
But making birth control pills over-the-counter might have an unintended consequence, NPR reported. The American Health Care Act, the current version of the GOP replacement bill, wouldn’t change the provision in the Affordable Care Act that requires requires insurance companies to fully cover contraceptive methods that require a prescription, like the pill. Making the pill available over-the-counter would mean insurers might no longer have to cover it.
Nor is it clear if such a change would happen soon. The Food and Drug Administration is responsible for approving drugs to be sold over-the-counter, either by ensuring they satisfy a set of regulations or by being submitted for individual review. According to the Sun, HRA Pharma, a pharmaceutical company in France, said in December it would apply for approval for a pill that could be sold over-the-counter in the United States.