Abstract
Oral contraceptives (OCs) are used by millions of women in the U.S. The requirement
to obtain OCs by prescription from a clinician may serve as a barrier to contraceptive
initiation and continuation for women, in particular adolescents. Over-the-counter
(OTC) availability would reduce this barrier and could further reduce unintended pregnancy
rates. This review explores the scientific issues and regulatory processes involved
in switching OCs to OTC status for minor adolescents. We review: (1) the regulatory
criteria for switching a drug to OTC status; (2) risk of pregnancy and safety during
use of OCs including combined oral contraceptives and progestin-only pills for adolescents;
(3) the ability of adolescents to use OCs consistently and correctly; (4) OTC access
to OCs and potential effect on sexual risk behaviors; and (5) the potential for reduced
opportunities for clinicians to counsel and provide recommended reproductive health
care to adolescents. We find strong scientific rationale for including adolescents
in any regulatory change to switch OCs to OTC status. OCs are safe and highly effective
among adolescents; contraindications are rarer among adolescents compared to adult
women. Ready access to OCs, condoms, and emergency contraception increases their use
without increasing sexual risk behaviors.
Keywords
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Article info
Publication history
Published online: March 14, 2017
Accepted:
December 30,
2016
Received:
October 21,
2016
Footnotes
Conflicts of Interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2017 Society for Adolescent Health and Medicine. All rights reserved.
