OTC Birth Control Pills - Your Guide to Women's Reproductive Choices

You’ve read that right. The FDA has approved the first OTC birth control pill, Opill, which requires no prescription. It is a progestin-only pill, taken daily. The goal is to increase the availability of oral contraceptives and allow birth control users more flexibility in how and where they get their medication. 

There are so many options for birth control in the US right now, and it can be a bit mystifying to figure out which one would be right for you. There are side effects and medication interactions for several types of birth control, and some may be better choices for different women.

Before you begin, remember that our professionals are always here to help

Women’s Mental Health and Reproductive Rights Go Hand in Hand

We want to empower you to make your own decisions, especially at a time when reproductive rights are not only under attack, but outright unavailable to so many American women. With the overturning of Roe v. Wade, 12 states have outright banned abortion and 12 states have or are in the process of significantly reducing availability of abortion services through changes in laws. Less than half of the 17 states where LunaJoy offers care have protected abortion access. 

At LunaJoy, we stand against this elimination of bodily autonomy. Women are losing access to care on many fronts, from lack of access to abortion services to lack of access to prenatal care too. We want you to have access to resources to support your mental health at any point in your life, and having control over what happens to your body is a key component of ensuring your mental health is supported. 

Birth Control: What are Your Options?

Here’s a rundown of a variety of birth control methods for you. This is not a comprehensive list of benefits and drawbacks, but an overview to give you a good idea of what options you have:

• Barrier methods and spermicides:

• Condoms, diaphragms, sponges and cervical caps all use physical barriers to prevent sperm from coming in contact with your cervix and thus making its way to any eggs that might have been recently released. Diaphragms, sponges, and cervical caps are typically used with spermicides, but spermicides can also be used on their own.
  
  These methods can be freeing for women who don’t want to deal with the side effects of hormonal birth control, but can also have a larger margin of error due to needing to be used every single time PIV sex happens. You’ll also need to be fitted for a diaphragm, and need a prescription for a cervical cap, so there are potential challenges with access to those options.

• IUDs:

• Intrauterine devices, or IUDs, place a small device inside the uterus. Some release hormones, and some rely on the chemistry of copper, to help prevent pregnancy. They are highly effective and can stay in place for 3-7 years depending on which type you get.
  
  IUD insertion requires a doctor's appointment, and often insurance to make it affordable. Depending on where you live, finding a doctor to insert an IUD may be difficult, especially as the legal fallout from Roe v. Wade being overturned continues to develop.
  
  You can advocate for yourself by requesting more pain management than is standard, as IUD insertion can be very painful, though some doctors still refuse. Copper IUDs can also worsen menstrual symptoms, which can be exhausting and difficult to deal with mentally. Hormonal IUDs, on the other hand, can sometimes lessen or eliminate menstrual periods, which can be appealing.

• Pills:

• Birth control pills are typically taken daily, and must be taken at the same time each day. These hormone-containing pills prevent ovulation.
  
  Pills are widely available and widely used, and now there are OTC birth control pills available even without insurance. However, there are a huge number of potential side effects for hormonal birth control, including depression, body shape changes, and more. These side effects can negatively impact both mental health and self-image. 

• Implants:

• Implants are small plastic rods with hormones that sit under the skin. They’re effective for up to 5 years, and once they’re removed, you can get pregnant right away if you choose. They’re inserted by a doctor and can require health insurance to be affordable, so access may not be feasible.
  
  Implants are known to have side effects including mood changes and weight gain, and you’ll need a doctor to remove it for you when you no longer want to use it, which is worth considering. 

• Short-term hormones: 

• The ring, the shot, and the patch all provide short-term hormonal birth control, for one or a few months at a time. There are advantages to not having to remember birth control daily, but a schedule over months must still be kept for these methods to remain effective.
  
  Hormonal birth control can cause mood changes that some women find intolerable, and the birth control shot can cause weight gain, which can compound mood changes by playing into the development of a negative self-image.

• Sterilization: 

• Tubal ligation (getting your “tubes tied”) or tube removal are the options for women for sterilization. These options involve surgery on your fallopian tubes, and it is considered permanent. It is a great option if you know you never want to be pregnant, though there are always risks with surgery.
  
  It’s sometimes difficult to find a doctor who will perform sterilization on women they think might regret the procedure, or that they’ll meet a partner someday who will be unhappy with their decision. This is unfortunate, as your autonomy should be the first consideration. Thankfully not all doctors assume this.

• Withdrawal, Fertility Awareness:

•  With each of these methods, sexual partners make sure that sperm does not enter a woman’s body. With withdrawal, each time a man ejaculates, he does so outside his partner’s body. With fertility awareness, a woman uses her body’s temperature, or tracking her cervical mucus, or tracking her menstrual cycle, as a way to predict when she is susceptible to pregnancy. At that time, barriers, withdrawal, or abstinence will be used to prevent sperm from coming in contact with any eggs released.
  
  For women who cannot tolerate hormones for any reason, and for couples that prefer not to use barriers, these methods at least provide some control over pregnancy. They have higher failure rates than a lot of other methods, with up to 1 in 5 couples who use these methods will end up with a pregnancy in a year of use. However, they can provide an option when other methods are not an option, and can free women up from the negative impacts of hormonal methods.

How Can Birth Control Affect Your Mental Health?

Hormones and Women’s Mental Health

When looking at how birth control can impact mental health, it’s important to recognize that hormones absolutely play a role in your mental health. We’ve written before about hormones and mental health, and shifting hormones through birth control can bring changes.

When we looked at the research available, we found studies showing that using hormonal birth control can cause mood disorders. Almost half of women on hormonal birth control stopped using it after a year, due to the emotional and mental health side-effects in one study. Otherwise healthy young women were also 50% more likely to be diagnosed with depression within 6 months of starting birth control than women of the same age who are not using hormonal birth control. There is also evidence that suicide attempts are more likely in women on hormonal birth control. 

These are all very serious considerations to take in when you’re looking at choosing birth control. We don’t want to overwhelm you, or sway your decisions away from hormones, because they can be a great option! It can be a tremendous load off your mind to be able to use hormones to prevent pregnancy. We simply want to give you a full picture of the possibilities.

Birth Control and Women’s Self-Image

Hormonal birth control can also change the way your body looks; your body fat can shift places over time to a more pear-shaped figure, you may bloat, and hormonal birth control can make it harder for you to put on muscle. The implant and the shot also have weight gain as a known side effect.

We are all for loving your body at any shape or size, but there are real frustrations that can come with unwanted weight gain, a body that is changing shape, and a body that has a harder time showing the rewards of exercise. It’s important to consider how you’ll cope with these changes if they happen to you from hormonal birth control. You deserve to love yourself, and planning ahead to love yourself even through changes is key.

Birth Control Access and Mental Health

As abortion access is shifting in America, so too is the ability to access things like prescriptions for birth control, appointments for IUD or implant insertion, and consistent insurance coverage to make sure your birth control method of choice can happen on schedule. Interruptions in access can be a source of stress and fear. We see you, and we know you need access to all the information possible.

As you mull over the birth control options you have, and consider which is right for you, know that LunaJoy is here for you. We want to make sure you have access to all the care you need, and want to support you in these highly uncertain times when it comes to reproductive rights. 

Therapy for Women at Any Stage of Life

We provide therapy for women who are dealing with the mental health effects of birth control, but also for women who are dealing with infertility, women who are pregnant or dealing with pregnancy loss, and women dealing with postpartum depression. We know that women’s mental health can be closely tied to where they are in their reproductive journey, including ensuring unwanted pregnancies are prevented through access to birth control. If you find yourself in need of support as you navigate mental health challenges from using or trying to find birth control, contact us at LunaJoy and see how we can help.