WASHINGTON — U.S. officials have approved the first over-the-counter birth control pill, which will let American women and girls buy contraceptive medication from the same aisle as aspirin and eyedrops.
The Food and Drug Administration said Thursday it cleared Perrigo’s once-a-day Opill to be sold without a prescription, making it the first such medication to be moved out from behind the pharmacy counter. The company won’t start shipping the pill until early next year, and there will be no age restrictions on sales.
Hormone-based pills have long been the most common form of birth control in the U.S., used by tens of millions of women since the 1960s. Until now, all of them required a prescription.
FILE - This illustration provided by Perrigo in May 2023, depicts proposed packaging for the company's birth control medication Opill. U.S. officials have approved the first over-the-counter birth control pill, a major change that will broaden access for women and teenagers. The Food and Drug Administration decision on Thursday, July 13, 2023 means drugmaker Perrigo can sell its once-a-day Opill without a prescription. (Perrigo via AP, File)
Medical societies and women’s health groups have pushed for wider access, noting that an estimated 45% of the 6 million annual pregnancies in the U.S. are unintended. Teens and girls, women of color and those with low incomes report greater hurdles in getting prescriptions and picking them up.
Some of the challenges can include paying for a doctor's visit, getting time off from work and finding child care.
“This is really a transformation in access to contraceptive care,” said Kelly Blanchard, president of Ibis Reproductive Health, a non-profit group that supported the approval. “Hopefully this will help people overcome those barriers that exist now.”
Ireland-based Perrigo did not announce a price. Over-the-counter medicines are generally much cheaper than prescriptions, but they typically aren’t covered by insurance.
Forcing insurers to cover over-the-counter birth control would require a regulatory change by the federal government, which women's advocates are urging the Biden administration to implement.
Many common medications have made the switch to non-prescription status in recent decades, including drugs for pain, heartburn and allergies. Birth control pills are available without a prescription across much of South America, Asia and Africa.
Perrigo submitted years of research to FDA to show that women could understand and follow instructions for using the pill. Thursday’s approval came despite some concerns by FDA scientists about the company's results, including whether women with certain underlying medical conditions would understand they shouldn't take the drug.
FDA’s action only applies to Opill. It’s in an older class of contraceptives, sometimes called minipills, that contain a single synthetic hormone and generally carry fewer side effects than more popular combination hormone pills.
But women’s health advocates hope the decision will pave the way for more over-the-counter birth control options and, eventually, for abortion pills to do the same.
That said, FDA’s decision has no relation to the ongoing court battles over the abortion pill mifepristone. The studies in Perrigo’s FDA application began years before the Supreme Court’s reversal of Roe v. Wade, which has upended abortion access across the U.S.
With some states curtailing women’s reproductive rights, the FDA has faced pressure from Democratic politicians, health advocates and medical professionals to ease access to birth control. The American Medical Association and the leading professional society for obstetricians and gynecologists backed Opill's application for over-the-counter status.
An outside panel of FDA advisers unanimously voted in favor of the switch at a hearing in May where dozens of public speakers called for Opill’s approval.
Dyvia Huitron was among those who presented, explaining how she has been unable to get prescription birth control more than three years after becoming sexually active. The 19-year-old University of Alabama student said she still isn’t comfortable getting a prescription because the school’s health system reports medical exams and medications to parents.
“My parents did not let me go on the pill,” Huitron said in a recent interview. “There was just a lot of cultural stigma around being sexually active before you’re married.”
While she uses other forms of contraception, “I would have much preferred to have birth control and use these additional methods to ensure that I was being as safe as possible.”
Huitron spoke on behalf of Advocates for Youth, one of the dozens of groups that have pushed to make prescription contraceptives more accessible.
The groups helped fund some of the studies submitted for Opill and they encouraged HRA Pharma, later acquired by Perrigo, to file its application with the FDA.
Advocates were particularly interested in Opill because it raised fewer safety concerns. The pill was first approved in the U.S. five decades ago but hasn’t been marketed here since 2005.
“It’s been around a long time and we have a large amount of data supporting that this pill is safe and effective for over-the-counter use,” said Blanchard, of Ibsis Reproductive Health.
Newer birth control pills typically combine two hormones, estrogen and progestin, which can help make periods lighter and more regular. But their use carries a heightened risk of blood clots and they shouldn't be used by women at risk for heart problems, such as those who smoke and are over 35.
Opill has only progestin, which prevents pregnancy by blocking sperm from reaching the cervix. It must be taken around the same time daily to be most effective.
In its internal review published in May, the FDA noted that some women in Perrigo’s study had trouble understanding the drug's labeling information. In particular, the instructions warn that women with a history of breast cancer should not take the pill because it could spur tumor growth. And women who have unusual vaginal bleeding are instructed to talk to a doctor first, because it could indicate a medical problem.
Common side effects of the pill include bleeding, headaches, dizziness, nausea and cramps, according to the FDA. The label also cautions that certain drugs can interfere with Opill's effectiveness, including medications for seizures, HIV and hypertension.
Perrigo executives said the company will spend the rest of the year manufacturing the pill and its packaging so it can be available in stores early next year.
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Best and worst states for women
Best and worst states for women
Updated
Note: This article contains discussion of domestic violence and rape.
The #MeToo movement ushered in a modern wave of feminism, with a new generation of activists building off work done by the feminists in previous waves to highlight long-standing issues while articulating structural solutions. Women's rights have come a long way since the suffragettes won women the right to vote in 1920, after 100 years of work, or when the second-wave feminist movement demanded and won the right to abortion after a decade of activism.
But while women won the right the vote, they remain underrepresented in the nation's halls of power: 24 women (24%) currently serve in the Senate, and 119 women (27.4%) currently serve in the House of Representatives. And those numbers are even more dire considering women of color. Of those 143 women currently serving in the 117th Congress, 51 are women of color—and despite the overall low numbers, Congress is the most diverse it's ever been. Still, when Kamala Harris became the first woman and person of color to win the vice presidency, her exit from the Senate left it without a single Black woman. Women won the right to vote more than 100 years ago, but we've never had a female president.
The COVID-19 pandemic has underscored the frail gains made by women, as the economic recession and job losses have primarily harmed women who have been forced out of jobs in order to take on the labor of childcare and as fathers fail to step up to perform an equal share of household work. Women also are more likely to work in low-wage and precarious jobs in the industries that have been hardest hit by the pandemic, including restaurants, retail, hospitality, and health care. This points to the fact that even before the pandemic, women overall are more impoverished than men. Nearly two-thirds of all minimum-wage workers in the U.S. are women. And while the Equal Pay Act federally mandates equal pay, the gender gap still exists, with women making 81 cents to every man’s dollar in 2020. When the wage gap incorporates race, Black and Latina women make only 75 cents on the dollar—25% less than what their white male counterpart makes.
Outside of the workplace, America remains a dangerous place for women. Intimate partner violence is a public health epidemic that accounts for 15% of all violent crime. One in five women women (and one in 71 men) in the U.S. has been raped in their lifetime. Transgender women are especially targeted with harassment and violence, making up the majority of the victims of hate violence homicides in 2020. States continue to make abortions restrictive and difficult for women to obtain. A study of 11 developed countries found the U.S. to have the highest maternal mortality rate, a dearth of maternity care providers, and the only country that doesn't mandate paid parental leave. Women are twice as likely to be diagnosed with depression than men.
With a myriad number of problems facing equality in mind, Stacker turned to WalletHub for a look at the best and worst states for women. By looking at socioeconomic factors (such as unemployment and poverty rates, attitudes towards women equality, and median earnings) and health care and safety (such as rates of violent acts against women, depression rates, and quality of women’s hospitals), WalletHub ranked states in order of their treatment of women. Socioeconomic factors were weighted at 60%, and health care and safety at 40%. A more detailed methodology can be found here.
If you or someone you know are currently experiencing domestic violence, you can call the National Domestic Violence Hotline 1-800-787-3224 or visit it online.
#51. Louisiana
Updated
- Total score: 36.26
- Economic and social well-being rank: #51
- Health and safety rank: #46
#50. Mississippi
Updated
- Total score: 36.63
- Economic and social well-being rank: #50
- Health and safety rank: #49
#49. Arkansas
Updated
- Total score: 37.13
- Economic and social well-being rank: #46
- Health and safety rank: #51
#48. Alabama
Updated
- Total score: 39.40
- Economic and social well-being rank: #48
- Health and safety rank: #44
#47. Oklahoma
Updated
- Total score: 40.20
- Economic and social well-being rank: #44
- Health and safety rank: #50
#46. South Carolina
Updated
- Total score: 40.34
- Economic and social well-being rank: #47
- Health and safety rank: #43
#45. Idaho
Updated
- Total score: 44.66
- Economic and social well-being rank: #49
- Health and safety rank: #28
#44. West Virginia
Updated
- Total score: 45.11
- Economic and social well-being rank: #39
- Health and safety rank: #47
#43. Texas
Updated
- Total score: 46.11
- Economic and social well-being rank: #42
- Health and safety rank: #39
#42. Georgia
Updated
- Total score: 46.68
- Economic and social well-being rank: #43
- Health and safety rank: #37
#41. Utah
Updated
- Total score: 48.51
- Economic and social well-being rank: #45
- Health and safety rank: #26
#40. Nevada
Updated
- Total score: 48.75
- Economic and social well-being rank: #28
- Health and safety rank: #48
#39. Kentucky
Updated
- Total score: 48.88
- Economic and social well-being rank: #36
- Health and safety rank: #40
#38. Wyoming
Updated
- Total score: 49.34
- Economic and social well-being rank: #41
- Health and safety rank: #32
#37. Tennessee
Updated
- Total score: 49.59
- Economic and social well-being rank: #29
- Health and safety rank: #45
#36. Alaska
Updated
- Total score: 50.03
- Economic and social well-being rank: #30
- Health and safety rank: #42
#35. Missouri
Updated
- Total score: 50.18
- Economic and social well-being rank: #33
- Health and safety rank: #38
#34. Florida
Updated
- Total score: 51.31
- Economic and social well-being rank: #38
- Health and safety rank: #29
#33. New Mexico
Updated
- Total score: 51.59
- Economic and social well-being rank: #27
- Health and safety rank: #41
#32. North Carolina
Updated
- Total score: 52.04
- Economic and social well-being rank: #35
- Health and safety rank: #31
#31. Kansas
Updated
- Total score: 52.37
- Economic and social well-being rank: #32
- Health and safety rank: #34
#30. Arizona
Updated
- Total score: 52.53
- Economic and social well-being rank: #31
- Health and safety rank: #35
#29. Illinois
Updated
- Total score: 54.26
- Economic and social well-being rank: #40
- Health and safety rank: #18
#28. Pennsylvania
Updated
- Total score: 55.21
- Economic and social well-being rank: #34
- Health and safety rank: #23
#27. Indiana
Updated
- Total score: 56.68
- Economic and social well-being rank: #20
- Health and safety rank: #33
#26. California
Updated
- Total score: 57.48
- Economic and social well-being rank: #37
- Health and safety rank: #9
#25. Oregon
Updated
- Total score: 57.57
- Economic and social well-being rank: #25
- Health and safety rank: #24
#24. Montana
Updated
- Total score: 58.08
- Economic and social well-being rank: #13
- Health and safety rank: #36
#23. South Dakota
Updated
- Total score: 58.33
- Economic and social well-being rank: #22
- Health and safety rank: #25
#22. Michigan
Updated
- Total score: 59.08
- Economic and social well-being rank: #14
- Health and safety rank: #30
#21. Virginia
Updated
- Total score: 59.24
- Economic and social well-being rank: #24
- Health and safety rank: #22
#20. Ohio
Updated
- Total score: 59.26
- Economic and social well-being rank: #19
- Health and safety rank: #27
#19. Nebraska
Updated
- Total score: 59.30
- Economic and social well-being rank: #26
- Health and safety rank: #19
#18. Maryland
Updated
- Total score: 61.40
- Economic and social well-being rank: #21
- Health and safety rank: #15
#17. New Jersey
Updated
- Total score: 64.24
- Economic and social well-being rank: #23
- Health and safety rank: #6
#16. Wisconsin
Updated
- Total score: 64.55
- Economic and social well-being rank: #11
- Health and safety rank: #14
#15. Washington
Updated
- Total score: 64.65
- Economic and social well-being rank: #10
- Health and safety rank: #16
#14. North Dakota
Updated
- Total score: 65.02
- Economic and social well-being rank: #12
- Health and safety rank: #12
#13. New Hampshire
Updated
- Total score: 65.23
- Economic and social well-being rank: #18
- Health and safety rank: #8
#12. New York
Updated
- Total score: 66.83
- Economic and social well-being rank: #17
- Health and safety rank: #5
#11. Delaware
Updated
- Total score: 67.22
- Economic and social well-being rank: #7
- Health and safety rank: #21
#10. Vermont
Updated
- Total score: 67.43
- Economic and social well-being rank: #8
- Health and safety rank: #13
#9. Rhode Island
Updated
- Total score: 67.51
- Economic and social well-being rank: #9
- Health and safety rank: #7
#8. Connecticut
Updated
- Total score: 67.92
- Economic and social well-being rank: #15
- Health and safety rank: #3
#7. Hawaii
Updated
- Total score: 68.13
- Economic and social well-being rank: #16
- Health and safety rank: #2
#6. District of Columbia
Updated
- Total score: 68.62
- Economic and social well-being rank: #2
- Health and safety rank: #20
#5. Colorado
Updated
- Total score: 69.17
- Economic and social well-being rank: #4
- Health and safety rank: #17
#4. Maine
Updated
- Total score: 70.60
- Economic and social well-being rank: #6
- Health and safety rank: #11
#3. Iowa
Updated
- Total score: 71.17
- Economic and social well-being rank: #3
- Health and safety rank: #10
#2. Minnesota
Updated
- Total score: 75.16
- Economic and social well-being rank: #1
- Health and safety rank: #4
#1. Massachusetts
Updated
- Total score: 75.66
- Economic and social well-being rank: #5
- Health and safety rank: #1



