Progesterone only pills, AKA mini-pill, AKA now approved for OTC use:
- Jeanette Thomas
- Mar 5, 2024
- 2 min read
Great news. As women in the US lose more bodily autonomy, this is a step forward.
Nothing is perfect. Some links below to help, both patient oriented and physician oriented. Because some people want the nitty gritty detail that their gyno reads and some want just the facts.
It must be taken at the same time every day. Not only on the days that you have sex. Every day. Taking it consistently will also decrease side effects like bleeding and spotting when you don’t expect it. Those side effects are generally minimal after 3 months of consistent use. Other than trying to get pregnant, unexpected side effects are the most common reason that women stop using their birth control.
Unless you are a robot who never misses a pill or takes it late, count on the real world use effectiveness for preventing pregnancy of 90-93%, not perfect user effectiveness of 99%.
The mini pill does not reliably keep you from releasing an egg each month, so real world use tends to be somewhat less effective than the combination pill (one that has both estrogen and progesterone. This combined hormone pill does prevent egg release).
I counseled patients that if they were off by an hour in taking the mini-pill, they should use a back-up method. Or take a prenatal vitamin. Condoms = almost never the wrong answer.
The mini-pill is safe for almost all women to use. The sources I use are:
Planned Parenthood
ACOG (American College of Obstetricians and Gynecologists)
CDC (Centers for Disease Control)
WHO (World Health Organization) An internet search for any of these + "mini pill" will give you essentially the same info, but in different forms. WHO geared toward choices in areas that may have fewer resources than in the US.
https://www.acog.org/womens-health/experts-and-stories/the-latest/over-the-counter-birth-control-pill-what-to-know --a great patient friendly resource by an OB/GYN.
Over the counter (OTC) doesn’t mean universal access to the mini-pill. OTC methods may or may not be covered by insurance. For many women, $10 to $20 per month means a choice between birth control and other daily needs.
In the category of did-we-really-need-a-study-to-prove-this, Affordable Care Act free access to birth control decreased both unplanned pregnancies and abortions. * Who knew? (even the title practically screams "Duh.")
*Preventing unintended pregnancies by providing no-cost contraception
Jeffrey F Peipert 1, Tessa Madden, Jenifer E Allsworth, Gina M Secura
From the update your gyno is reading:
"Historically, high out-of-pocket costs, deductibles, and copayments for contraception have limited contraceptive access, even for those with private health insurance. A switch to over-the-counter access should not add yet another barrier for someone who desires contraception."
ACOG Practice Advisory: “First Over the Counter Daily Contraceptive Pill Released”, March 2024.
And again, the link from the New York Times article:
Comments