Medically reviewed by Dr. Betty Acker, MD on September 17, 2020
When most people hear “birth control” they think of prescription pills, but in fact over-the-counter birth control is commonly used to lower the risk of an unwanted pregnancy or spread of sexually transmitted diseases (STDs). CDC research estimates that around two-thirds of all adult women use at least one form of birth control.
Though many people connect with their medical providers about the possibility of using a prescription birth control product such as the pill or intrauterine device (IUD), others prefer to buy over-the-counter (OTC) birth control products.
What Are Some Frequently Seen Types of Over-the-Counter Birth Control?
Several OTC birth control methods are so common that plenty of teens have heard about them since they first had reproductive health class in school. Other OTC birth control products may be less well known to the masses. Below are a few of the more popular types.
Male and Female Condoms
Condoms are a barrier form of birth control that stops semen from entering the vagina. Condoms are available in a variety of materials and styles, including:
- Non-lubricated latex — This is a standard condom with no lubricant applied to the outside before packaging.
- Lubricated latex — This is a standard condom with lubricant applied to the outside before packaging.
- Polyisoprene — This would be a condom made from an alternative material often used by men and women with a latex allergy.
- Hexagonal — This type of condom is designed with a geometric, hexagonal style to improve strength.
- Female or internal — This female version of a condom is designed to be inserted into the vagina up to eight hours before sex.
- Spermicidal — This is a standard condom lubricated with spermicide (to kill sperm) as an extra line of defense.
Condoms can be used with other forms of OTC and prescription birth control. Some couples like to use condoms in tandem with the birth control pill or IUD, especially if a partner’s STI status is known.
Vaginal contraceptives come in sponges, creams, gels, and tabs all designed for insertion into the vagina before sex. Consequently, users of this kind of OTC birth control must be comfortable inserting it into the vagina to ensure that the contraception is properly positioned in the vaginal canal.
A few of the various vaginal contraception options include:
- Gel — A pre-filled applicator containing spermicide is injected into the vagina.
- Film — This square piece of dissolving film is laced with nonoxynol-9. When inserted into the vagina before sex, the film provides pregnancy protection for up to three hours.
- Cream — Like gels, this form of vaginal contraception is inserted into the vagina before sex.
- Foam — Like gels and creams, a foam is inserted into the vagina to reduce the chance of unwanted pregnancy.
- Diaphragm – A dome-shaped cup that covers the cervix. It is inserted into the vagina with spermicide before sex to prevent pregnancy.
All vaginal contraceptives rely upon a spermicide to prevent pregnancy. According to the American Pregnancy Association, spermicide use has a failure rate of up to 28%. As a result, vaginal contraception may be best used in conjunction with condoms, the pill, an IUD, or the shot to boost effectiveness.
Remember that spermicide-based contraception is meant to prevent pregnancy, but does not offer the STI protection that condoms do, so you should use condoms if you are uncertain of a partner’s STI status.
If a couple has unprotected sex or believes that the OTC birth control method used did not work to prevent pregnancy, emergency contraception is an option. Emergency contraception, like Plan B One-Step, can be used for up to three days following unprotected sex.
How well does Plan B work? If taken within 24 hours, the effectiveness is about 95%. At 72 hours, the efficiency drops to about 89%. The efficacy of Plan B depends on a variety of factors, including weight. For women weighing more than 165 pounds or with a body mass index (BMI) over 25, Plan B may be less effective.
What Are the Advantages and Disadvantages to Over-the-Counter Birth Control?
OTC birth control has a few key pros and cons that can make it the right choice for certain people in certain situations at certain times of their lives. Some of the biggest benefits to purchasing OTC birth control methods include:
- They are easily accessible. Most drug stores, big box stores, and even grocery stores sell OTC birth control such as male condoms and spermicide film. You can also find OTC birth control products online from trusted websites.
- They don’t require a visit to a doctor’s office. Ideally, patients will feel comfortable speaking with their physicians about reproductive health. However, some patients would rather not bring up the subject. OTC options allow those people to be discreet.
- They are highly affordable. In some situations, such as students at some colleges, OTC birth control may be offered at a free or reduced cost through condom availability programs. Condoms may also be an eligible expense for Flexible Spending Accounts offered by employers. Of course, depending on your situation, certain prescription birth control can be inexpensive, too.
What are the downsides to OTC birth control? The biggest issues are as follows:
- OTC birth control doesn’t always work as predictably as prescription counterparts. For example, If condoms are used perfectly every single time you have sex, they’re 98% effective at preventing pregnancy. But in real life condoms are about 85% effective — meaning about 15 out of 100 people who use condoms as their only birth control method will get pregnant each year.
- OTC birth control isn’t spontaneous. You must take proper steps to insert spermicide or put on a condom, which may be unappealing for some people. .
- OTC birth control products vary widely. Few stores carry a wide selection, so people looking for a particular brand or item may have to experiment with something different.
It’s worth noting that every person should look at both the positives and negatives of birth control through the lens of their own experiences and needs. What works for one person won’t necessarily work for another, and that’s okay. Part of the appeal of OTC birth control is that there are a variety of types to appeal to a large number of people.
Tips to Improve Peace of Mind When Using Over-the-Counter Birth Control
Like all birth control, OTC products work best when you follow certain guidelines.
- You should always follow the best-practice directions for any contraceptive. When trying a new OTC contraceptive, partners should spend the time understanding how to give themselves the widest safety net and lowered possibility of unwanted pregnancy or STI risk by taking their time in putting the contraceptive in place.
- Any OTC birth control that seems to be out-of-date or questionable should be thrown away. Male and female condoms may lose their elasticity over time and be more likely to break during intercourse.
- When trying spermicides, be on the lookout for any allergic reactions. The same holds true for partners using latex condoms, as some people are sensitive to latex and may have adverse reactions.
- Those who find it difficult to remember to use OTC birth control should always speak with their physician about an alternative, prescription-based method of birth control that allows for more spontaneity.
Above all else, responsibility is a key component of having a healthy sex life and taking care of reproductive needs. Whether you choose OTC or prescription-based birth control, you should feel comfortable doing what’s right for you, your body, and your partner.