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What contraceptive pills can you get over the counter (OTC)?

What contraceptive pills can you get over the counter (OTC)?

If you’re thinking about contraception for the first time, you might have wondered whether it’s possible to buy birth control over the counter in the UK. Over the counter contraceptive pills are not widely available in the UK. Typically, a GP, prescriber or sexual health expert will have to prescribe them.

But you still have options. We’ll explain the types of contraception you can get over the counter, and how to access the right type for you.

Daniel  Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical Lead
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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on November 18, 2022.
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Can you buy any contraceptive pills over the counter at a pharmacy?

To understand how you can access contraception in the UK and whether over the counter contraceptive pills are available to you, it helps to know some key prescribing definitions:

Pharmacy status What it means Includes
Prescription-only medication (POM) Refers to medication that only a highly-qualified medical professional, such as a GMC-registered doctor, can prescribe. A prescription is when a clinician signs off on you receiving a medication or other treatment, because it's right for you. Doctors can also e-prescribe, which is more commonly practiced today. The vast majority of contraceptive pills.
Pharmacy-only medicines (P), or P-line medication Refers to medication that you must buy in the presence of a pharmacist. Not usually displayed on open shelves. Typically, a pharmacist may ask you some questions about your health and symptoms before selling you P-line medication. These can be issued long-term and renewed. Some mini pills.
Over the counter medication (OTC), or general sales list (GSL) medication. Refers to medication you can easily buy in a pharmacy as an ordinary retail purchase, no prescription or licence is required. Paracetamol, condoms.

It’s important to understand the distinction between pharmacy-only medicines (P) and over the counter, or general sales list (GSL) medicines.

Even though you can access P-line medication at a counter, a pharmacist still has to ask some questions about your health to make sure what they issue is suitable. When it comes to GSL medication (OTC medication), these rules don’t apply. You can buy them ‘no questions asked.’

Until recently, all oral contraceptives were prescription only medications (POM) in the UK.

However, in 2021 it was announced that certain mini pills (progesterone-only pills) would be available to purchase from pharmacies as P-line medications.

‘The MHRA said it had consulted patients, pharmacists, prescribers and a wide range of stakeholders including the Royal College of Gynaecologists, Royal Pharmaceutical Society, Faculty of Sexual and Reproductive Healthcare and British Pregnancy Advisory Service, as part of the decision-making process.’

What contraceptive pills don’t need a prescription?

At the time of writing, two mini pills are currently approved as P-line medications which are Lovima and Hana. You can’t buy contraception, like Cerazette, for example, over-the-counter in the UK.

Being P-line medications, you don’t need a prescription to buy either the Lovima or Hana. But a pharmacist will still need to perform a quick consultation to ensure they’re safe and suitable for you.

What birth control do I need a prescription for?

All hormonal contraception, excluding the mini pills Lovima and Hana, are prescription-only medications. This means all combined pills, the patch, the contraceptive ring and the majority of mini pills will require a prescription.

You can buy non-hormonal methods of contraception over the counter in UK pharmacies, such as condoms.

Can you buy the contraceptive patch or the ring over the counter?

Both the contraceptive ring and patch require a prescription. They contain two synthetic female hormones to help prevent pregnancy. Because of this, and because of the potential for side effects, you’ll need to have a consultation with a doctor or prescriber before they can issue a prescription.

Nuvaring is the main contraceptive ring used in the UK, and Evra is the most commonly prescribed birth control patch. Both are prescription only medications (POM).

A doctor or prescriber will need to demonstrate how to use the contraceptive ring the first time you use it. After this, it can be self applied.

Can pharmacists prescribe birth control?

Since 2006, certain medical professionals who are not doctors have been allowed to prescribe medication in the UK. Nurses, pharmacists, dentists and certain other medical professionals can now train and register as independent prescribers.

So, yes, pharmacists can prescribe birth control and you can get the pill at the pharmacy – providing a healthcare professional who works there who is qualified to write prescriptions.

Why do most contraceptive pills need a prescription?

Contraceptive pills contain synthetic female sex hormones called oestrogen and progesterone. Sometimes, they contain both (combined pills) and others only contain one hormone (mini pills). Introducing additional hormones into the body can carry some risk. Taking contraception has the ability to cause side effects, and it’s not safe for everyone to take oral birth control. Each pill comes with a number of warnings and contraindications.

It is mainly for this reason that the majority of contraceptive pills are prescription-only medications (POM). It’s currently not permitted to buy most birth control pills over the counter in the UK (except Lovima and Hana), or as general sales list (GSL) items. You’ll need a prescription to buy most contraception, or at the very least certain mini pills can be issued as pharmacy medicines (P).

Risks of hormonal contraception

Hormonal contraception has helped many women since it was first introduced on the NHS in 1960, and roughly 70% of all living women in the UK will have used birth control at some point. 

But hormonal contraception can also carry risks when taken, namely as side effects. Common side effects of hormonal contraception can include, but are not limited to, headaches, spotting or period changes, nausea, breast tenderness, weight gain, mood changes, decreased libido and vaginal discharge. Contraceptives which contain hormones as their active ingredients have an increased risk association with blood clots. 

While contraception can be highly effective, as much as 99% with perfect use, there is always a small risk that an unintended pregnancy may occur while taking hormonal contraceptives. 

Hormonal contraception also isn’t suitable for everyone to take. For example, contraception which contains oestrogen cannot be taken by women who are over 35 and smoke, are very overweight and who take certain medications. For these women, the mini pill is likely a more suitable option as it only contains progesterone but works just as well as the combined pill. 

If you have certain health conditions, birth control may not be safe for you to take. For example, with reference to combination contraceptives, you should not take these if you have any of the following conditions: 

  • Migraines accompanied by aura
  • Lupus
  • Uncontrolled high blood pressure
  • Diabetes
  • Smoke and have high blood pressure
  • Liver tumour
  • Jaundice
  • Unexplained vaginal bleeding
  • Cancers affecting the breasts, vagina, cervix or uterus
  • Coronary artery disease
  • History of stroke or heart attack
  • Blood clots or history of blood clots.

Choosing the best contraceptive for you

Different hormonal contraceptives may be suitable for different people, and certain pills might be more preferable to you than others in terms of side effects.

Things to consider when thinking about contraception include: 

  • Effectiveness
  • Whether they need to be taken daily
  • Whether you’re prone to forgetfulness or not remembering 
  • Are you comfortable inserting something into your vagina? 
  • Do you mind if contraception impacts your period? 

If you respond more adversely to hormonal contraception in terms of side effects, you might want to try ‘low-dose’ contraceptives, which contain lower amounts of hormones than older, more traditional pills. 

If you experience oestrogenic side effects, those caused by the introduction of synthetic oestrogen, you might want to try the mini pill (which contains progesterone only).

Monitoring your use

Particularly if you’re taking contraception for the first time, a doctor or prescriber will want to monitor how you respond to it and whether it still seems suitable after a certain period of time. They may ask questions about any side effects you’ve noticed and whether you feel comfortable to continue taking the particular contraceptive they prescribed. They may also check your blood pressure regularly.

Why do most contraceptive pills need a prescription?

If you’re thinking about taking contraception, you can expect to undertake a quick consultation with your doctor or prescriber. They’ll want to ask a number of questions to ensure that hormonal birth control is safe and suitable for you. Examples of what they may ask can include: 

  • Have you ever taken hormonal contraception before? 
  • Do you know if your blood pressure is low, normal or high? 
  • Do you suffer from any medical conditions? 
  • Do you smoke? 
  • How is your mental health? 
  • When was the last time you had a smear test? 
  • When was the last time you had a period?
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