Fifty years after the Federal Drug Administration approved a prescription birth control pill, the first over-the-counter birth control pill is available to the public without a prescription at most pharmacies, convenience stores, and grocery stores, as well as online.

Opill’s availability starting Monday comes two years after the U.S. Supreme Court struck down the constitutional right to abortion in Roe vs. Wade, shining a spotlight on the heated debate over birth control and a woman’s right to choose. So far, no individual states or jurisdictions have proposed restrictions on the sale of Opill, although experts say age restrictions are likely to be imposed on sales.

Walgreens and CVS will soon carry Opill in stores once shipments arrive, but customers can already purchase the pill online at and Amazon. Perrigo, the pharmaceutical company that distributes Opill, cannot say how many purchases have already been made, but more than 1,700 orders for the 24- and 84-count supplies have already been sold on Amazon in two days.

“You don’t have to consult a doctor or undergo a physical exam from a health care provider, you can simply order delivery to your home, expanding access,” said Khiara M. Bridges, a law professor at UC Berkeley who studies reproductive rights.

Bridges said Opill’s online sales will help provide access to contraception for people living in remote or rural areas, as well as victims of domestic violence. “Any time travel is required, there is the potential for a barrier to entry.”

She pointed out that costs could be a prohibitive barrier for low-income people; A pack of 24 Opill costs $20 and a pack of 84 costs $50.

“Because these are not prescriptions, the user of the drug must cover the entire cost of the drug,” Bridges said. And that could limit access for people who rely on insurance to pay for their birth control medications. “This is not the final solution.”

Dr. Ashely Jeanlus, an obstetrician-gynecologist at UC San Francisco, said there may be health reasons why her patients would prefer the progestrin-only Opill over a prescription contraceptive that contains a combination of progestrin and estrogen.

“I would never offer it [medication containing estrogen] for someone who has had blood clots or strokes or … who has chronic high blood pressure that is not controlled,” Jeanlus said of the increased risk of adverse side effects for these populations. She said transgender patients undergoing hormone replacement therapy may also prefer to avoid medications with estrogen.

According to clinical studies, the pill was found to be 98% effective when taken within the same three-hour window every day. As with many other forms of contraception, birth control pills have common but mild side effects. the FDA announced online, such as “irregular vaginal bleeding, nausea, breast tenderness and headaches.” The FDA warns that Opill is not suitable for people who have had or have breast cancer.

Triona Schmelter, executive director of Perrigo, said Opill is safe for HIV-positive people to take, although its effectiveness can be reduced by HIV/AIDS medications and individuals should consult their doctor. Progestin pills already existed available in the UK As of 2021, the pill no longer requires a prescription, and the FDA approved norgestrel, a type of progestin, as a prescription drug in 1973. The approval process for this pill to become commercially available in the United States took 50 years.

In some parts of the country, challenges to reproductive resources have increased since the Roe and Wade reversal in 2022, and Jeanlus is concerned about what it all means for the quality of patient care she can provide.

“They limit people’s access to choice and self-determination and then actually cause chaos in the medical health care system,” Jeanlus said.

Last month, in vitro fertilization services in Alabama were thrown into disarray when the state Supreme Court ruled that frozen embryos counted as children before the state granted IVF immunity.

Bridges believes that the political backlash against abortion and birth control is because “large segments of the population strongly believe that sex is for procreation and should only occur within marriage” and do not want young people to have casual sex. This is because Americans are having less sex overall, and a UCLA study showed that Generation Z was averse to seeing sex on screen.

But Bridges said Opill could become as commonplace as condoms offered for free in a college campus restroom. During pop star Olivia Rodrigo’s “Guts” tour, abortion rights organizations gave her away emergency contraceptives and condoms until her team asked her to stop.

Bridges wants Opill to be accessible everywhere in public spaces in the future. “The easier it is to get medication, the better it is for everyone,” she said. “But certainly for people who haven’t had access to reproductive health care.”

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