ACOG supports over-the-counter availability of hormonal contraceptives without age restrictions

American College of Obstetricians and Gynecologists (ACOG) committee opinion has released recommendations on over-the-counter access to hormonal contraception.

According to the recommendations published in the Obstetrics & Gynecology journal, all hormonal contraceptives — pills, patches, injections, and vaginal rings — should be available as over-the-counter (OTC) items and without age restrictions.

Other key recommendations include:

• Over-the-counter access has continuation rates of hormonal contraception comparable to prescription-only access and has the potential to decrease unintended pregnancy.


• Evidence demonstrates that women want over-the-counter access to hormonal contraception because it is easier to obtain.


• Data support that progestin-only hormonal methods are generally safe and carry no or minimal risk of venous thromboembolism (VTE).


• The VTE risk with combined oral contraceptive use is small compared with the increased risk of VTE during pregnancy and the postpartum period.


• Pelvic and breast examinations, cervical cancer screening, and sexually transmitted infection screening are not required before initiating hormonal contraception and should not be used as reasons to deny access to hormonal contraception.


• Several studies have demonstrated that women are capable of using self-screening tools to determine their eligibility for hormonal contraceptive use.


• The goal of over-the-counter access is to improve the availability of hormonal contraception, but not at the expense of affordability. Also, a plan to improve access to hormonal contraception should address cost issues.


• Pharmacist-provided contraception may be a necessary intermediate step to increase access to contraception, but over-the-counter access to hormonal contraception should be the ultimate goal.

"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. Several studies have demonstrated that women are capable of using self-screening tools to determine their eligibility for hormonal contraceptive use. Pelvic and breast examinations, cervical cancer screening, and sexually transmitted infection screening are not required before initiating hormonal contraception and should not be used as reasons to deny access to hormonal contraception, wrote the authors.

To read full recommendations follow the link: doi: 10.1097/AOG.0000000000003474