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Can you get birth control over the counter (OTC)?

Can you get birth control over the counter (OTC)?

If you’re thinking about birth control for the first time, you might have wondered whether it’s possible to buy birth control over the counter in the US. Over the counter birth control pills are not available in the US; you need a prescription for all hormonal birth control. Typically, a doctor, prescriber or sexual health expert will have to prescribe them.

To understand how you can access contraception in the US and is available to you over the counter, it helps to know some key prescribing definitions:

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical lead
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Can you buy any birth control pills over the counter at a pharmacy?

All hormonal contraception, which includes birth control pills, requires a prescription in the US and so can’t be bought over the counter. Non hormonal contraceptives like condoms are available, though.

In recent years, some states have allowed pharmacists to prescribe hormonal birth control, including the pill. So while birth control pills aren’t available over the counter, you might be able to get them just by going to the pharmacy if you live in one of these states.

Prescription-only medication (POM)

Refers to medication that only a highly-qualified medical professional, such as a doctor or pharmacist, can prescribe.

Doctors can also e-prescribe, which is more commonly practiced today.

Example: All hormonal birth control

Over the counter medication (OTC)

Refers to medication you can easily buy in a pharmacy as an ordinary retail purchase, no prescription or license is required.

Example: Condoms

 

What birth control do I need a prescription for?

All hormonal contraception is prescription-only medications. This means all combined pills, mini pills, the patch and the contraceptive ring will require a prescription.

You can buy non-hormonal methods of contraception over the counter in US pharmacies, such as condoms.

Can you buy the contraceptive patch or the ring over the counter?

Both the contraceptive patch and ring contain hormones, so they can’t be purchased without a prescription.

NuvaRing is the main birth control ring used in the US. The most commonly prescribed birth control patch is known as Xulane. Both are prescription only medications (POM).

A doctor or prescriber will need to demonstrate how to use the contraceptive ring the first time you use it. After this, it can be self applied.

Can pharmacists prescribe birth control?

Since 2015, some states have been making it possible for pharmacists to prescribe hormonal birth control, including the pill. These include Arizona, Arkansas, California, Colorado, District of Columbia, Hawaii, Idaho, Maryland, Minnesota, Nevada, New Hampshire, New Mexico, Oregon, Utah, Vermont, Virginia, and West Virginia.

Why do birth control pills need a prescription?

Birth control pills contain synthetic versions of hormones called estrogen and progesterone. Sometimes, they contain both (combined pills) and others only contain one hormone (mini pills). Introducing additional hormones into the body can carry some risk. Taking contraception has the ability to cause side effects, and it’s not safe for everyone to take oral birth control. Each pill comes with a number of warnings and contraindications.

It is mainly for this reason that contraceptive pills are prescription-only medications (POM). It’s currently not possible to buy any birth control pills over the counter in the US. However, some states allow pharmacists to prescribe birth control pills, so you won’t need an additional doctor’s appointment.

Risks of hormonal contraception

Hormonal contraception has helped many women since it was first introduced in 1960, and roughly 98% of all women in the US will have used birth control at some point.

But hormonal contraception can also carry risks when taken, namely as side effects. Common side effects of hormonal contraception can include, but are not limited to, headaches, spotting or period changes, nausea, breast tenderness, weight gain, mood changes, decreased libido and vaginal discharge. Contraceptives which contain hormones as their active ingredients have an increased risk association with blood clots.

While contraception can be highly effective, as much as 99% with perfect use, there is always a small risk that an unintended pregnancy may occur while taking hormonal contraceptives.

Hormonal contraception also isn’t suitable for everyone to take. For example, contraception which contains estrogen cannot be taken by women who are over 35 and smoke, are very overweight and who take certain medications. For these women, the mini pill is likely a more suitable option as it only contains progestin but works just as well as the combined pill.

If you have certain health conditions, birth control may not be safe for you to take. For example, with reference to combined hormonal birth control, you should not take these if you have any of the following conditions:

  • Migraines accompanied by aura
  • Lupus
  • Uncontrolled high blood pressure
  • Diabetes
  • Smoke and have high blood pressure
  • Liver tumor
  • Jaundice
  • Unexplained vaginal bleeding
  • Cancers affecting the breasts, vagina, cervix or uterus
    Coronary artery disease
  • History of stroke or heart attack
  • Blood clots or history of blood clots.

Choosing the best contraceptive for you

Different hormonal contraceptives may be suitable for different people, and certain pills might be more preferable to you than others in terms of side effects.

Things to consider when thinking about contraception include:

  • Effectiveness
  • Whether they need to be taken daily
  • Whether you’re prone to forgetfulness or not remembering
  • Are you comfortable inserting something into your vagina?
  • Do you mind if contraception impacts your period?

If you respond more adversely to hormonal contraception in terms of side effects, you might want to try “low-dose” contraceptives, which contain lower amounts of hormones than older, more traditional pills.

If you experience oestrogenic side effects, those caused by the introduction of synthetic estrogen, you might want to try the mini pill (which contains progestin only)

Monitoring your use

Particularly if you’re taking birth control for the first time, a doctor or prescriber will want to monitor how you respond to it and whether it still seems suitable after a certain period of time. They may ask questions about any side effects you’ve noticed and whether you feel comfortable to continue taking the particular contraceptive they prescribed. They may also check your blood pressure regularly.

If you could benefit from a different contraceptive, they may prescribe you something else.

What happens at a birth control consultation?

If you’re thinking about taking contraception, particularly for the first time, you can expect to undertake a quick consultation with your doctor or prescriber. They’ll want to ask a number of questions to ensure that hormonal birth control is safe for you. Examples of what they may ask can include:

  • Have you ever taken hormonal contraception before?
  • Do you know if your blood pressure is low, normal or high?
  • Do you suffer from any medical conditions?
  • Do you smoke?
  • How is your mental health?
  • When was the last time you had a smear test?
  • When was the last time you had a period?

My pill isn’t working for me: Can I switch?

At Treated, it’s easy to switch your pill if it isn’t working for you. Answer some questions about your health and our clinicians will prescribe contraception if it’s safe and suitable for you. Once you subscribe you have easy access to our team, meaning if you have problems you can discuss them and find the best treatment for you. We’ll deliver your contraceptive pill regularly, in discreet packaging.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

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