Over the counter contraception is a step in the right direction

For World Contraception Day, Brook’s Head of Nursing explores what it means now that the progesterone only pill is available to purchase over the counter from pharmacies.

Earlier this year the progesterone only pill (POP) became available to purchase over the counter in pharmacies. This was a long overdue step – and it will improve access to contraception and help prevent unplanned pregnancies. 

In my role, I get questions about the safety of this medicine being provided over the counter as for years the oral contraceptive pill has only been available on prescription or patient group direction. 

The truth is these pills are extremely safe and there are very few conditions that contraindicate the use of this form of contraception.

There are few risks or side effects from using it but the most common ones are a change in bleeding pattern, mood and skin. It is worth noting that one of the brands now available over the counter – Lovima – contains soya, and so isn’t suitable for people with that allergy.

The hormone dose in the POP is tiny – only 75 micrograms per day. Compare this with the emergency contraceptive pill, Levonorgestrel which has a dose 20 times higher and is the equivalent of taking three weeks of POP at once. The emergency contraceptive pill has been available to purchase over the counter from pharmacists since 2001 and so it is appropriate that some forms of oral contraceptive pills should also be available this way. 

In terms of effectiveness, the POP works quickly, providing contraceptive cover within 48 hours of taking it, and is quickly reversed, with cover lost 36 hours after taking it.

Because of this, a LARC method (such as the IUD, IUS, injection or implant) always tops the pill in terms of effectiveness. But the important thing is that people remember to take the POP everyday, so I recommend setting an alarm on your phone as a reminder.

It’s worth noting that if you are purchasing the pill over the counter you will have to pay for it, whereas if you get it from sexual health service like Brook or your GP it’s free. In some area’s you can also get it for free from an online provider. It is likely that you will only be able to buy it from pharmacies if you are over 18. If you are under 18 you can still get it from Brook, a sexual health service or your GP.   

The pill becoming available over the counter may not be a revolutionary moment in the history of sexual and reproductive health but it is huge progress in making contraception more readily available for those who need it.