ACOG Recommends OTC Access to Hormonal Contraception

The American College of Obstetricians and Gynecologists has published a new Committee Opinion in which they recommend that hormonal contraceptives, including pills, patches, injections, and vaginal rings, should be available over the counter (OTC) and without age restriction.

“Barriers to access are one reason for inconsistent or nonuse of contraception. The requirement for a prescription can be an obstacle for some contraceptive users,” the group wrote.

The new recommendations expand upon a 2012 Committee Opinion that recommended that oral contraceptives be available OTC.

Among their recommendations and conclusions:

• Hormonal contraception should be available OTC without age restrictions.
• OTC access has comparable continuation rates as prescription-only access and could potentially decrease rates of unintended pregnancy.
• There is evidence that supports that progestin-only hormonal methods are generally safe and carry no or minimal risk of venous thromboembolism.
  Pelvic and breast exams, cervical cancer screening, and sexually transmitted infection screening are not required before initiating hormonal contraception.
• OTC access should improve availability but not at the cost of affordability.  
• Pharmacist-provided contraception may be necessary as an intermediate step, with OTC access as the ultimate goal.

—Michael Potts

Reference:

Over-the-counter access to hormonal contraception - ACOG committee opinion summary, Number 788. Obstet Gynecol. 2019. 134(4)886-887.