The Opill: What to Know
You may have heard the news this past July that the FDA has approved the sale of a birth control pill that does not require a prescription. This is great news for folks seeking affordable and accessible contraceptives, and sales have already begun in Cortland pharmacies. It is known as the “Opill” and commonly nicknamed the “minipill,” but its generic name is norgestrel. You might be wondering why the Opill is able to be sold over the counter while all other versions of the birth control pill require a doctor’s prescription. First, it is important to understand the science behind how birth control pills work.
Most contraceptive pills use synthetic versions of two hormones: progesterone and estrogen. The primary function of both hormones are to prevent ovulation, or the release of the egg from the ovary each month. You cannot become pregnant without ovulating, and so the pill is highly effective at preventing pregnancy as long as it’s being taken consistently and as directed. In addition, progesterone (also known as “progestin,” which is the synthetic version), thickens cervical mucus, making it more difficult for sperm to enter the uterus. Generally speaking, estrogen poses riskier side effects than progesterone, as it can increase the risk of high blood pressure, blood clots, and certain cancers. Progesterone does not cause these side effects, which is why a progestin-only pill does not require a prescription. However, this does NOT mean the medication is free of side effects; it’s very important to talk to your doctor if you’re unsure of how the Opill may affect you. The most commonly reported side effects include cramps, bloating, headaches, and nausea.
It’s worth noting that because the Opill lacks estrogen, it is slightly less effective than “combined” contraceptive pills that use both hormones; that said, during trial runs of the Opill, only 6 out of 955 participants became pregnant - just a 0.6% fail rate!
The Opill is also taken a little differently than pills with estrogen. First, while combined pills allow for some leniency with timing - e.g., you could take it at 6am on Monday and then 9am on Tuesday with little issue – this is not the case for the Opill, as it must be taken within the same hour every day. This means that the Opill likely won’t offer any protection if you accidentally skip a day of taking it. Moreover, combined pills usually have a “placebo” week, usually in the last week of the month, where the pills lack any hormones (they are also called “sugar pills”). This triggers what’s known as “withdrawal bleeding,” which people often colloquially call a “period,” but is still distinct from regular menstruation. Withdrawal bleeding tends to be lighter and shorter than regular menstruation, and is used as a reassurance to know that the contraceptive is working as intended and that you are not pregnant. The Opill does not have any placebo pills, so there isn’t any withdrawal bleeding. For some people this is a positive factor, but for others it can be a negative. It is also worth mentioning that irregular bleeding or “spotting” is common when taking birth control pills, but even more so with the Opill.
The Opill can be a great option for individuals seeking a birth control option that does not require a prescription or use estrogen, but it’s vital to understand how it works, how to use it properly, and what side effects to expect. The Opill is currently available at pharmacies in Cortland, priced at $20 for a month’s supply. There is no age restriction for buying it.
Don’t hesitate to reach out to your doctor or our friends at the Family Planning Agency of South Central New York: fpscny.org if you’re interested in trying a new contraceptive.