By approving Opill, a progesterone-only birth control pill, for non prescription use, the FDA aims to make oral birth control more accessible to users in the U.S.

After being approved in July of 2023, Opill became the first over-the-counter birth control pill approved by the FDA in the U.S. 

According to University of Pennsylvania Associate Professor of Obstetrics and Gynecology Sarita Sonalkar, the FDA’s approval of Opill is “forward progress” and a “really great development.”

“It’s the kind of thing we’ve been wanting to see for decades,” Sonalkar said, “then all of a sudden we just heard the news and it was really exciting.” 

Opill is a daily use, progesterone-only oral birth control pill, rather than the more commonly used combined pills with both progesterone and estrogen hormones. Currently, there are two progesterone-only prescription birth control pills.

Progesterone works by thickening the cervical mucus to prevent sperm from fertilizing an egg, as well as altering the uterine lining to create an unfavorable environment for an embryo to take place. 

According to Sonalkar, Opill’s methods of preventing pregnancy as a progesterone-only pill makes it “highly efficacious.”

The efficacy of a birth control pill refers to how well the pill works in a perfect-use environment, such as in clinical trials where variables, such as when the pill is taken, are closely monitored. 

According to Opill’s website, it has an efficacy of 98%. Sonalkar says that, as long as people take Opill as directed, it will have the same efficacy as prescription birth control pills.

“ I think, if someone were to take a pill like this every single day, you’re actually going to achieve the same level of effectiveness as you see for pills that are already on the market,” Sonalkar said.

With its purely progesterone make-up, Opill also poses as a possibly more suitable option for most people in search of a birth control pill. 

According to Sonalkar, estrogen is often the part of birth control pills that makes it potentially risky for people to use with certain medical conditions, such as “high blood pressure, clots in the legs and lungs, cardiac conditions [and] migraines.” 

“[Progesterone-only] birth control is just extraordinarily safe,” Sonalkar said. “There are almost no restrictions to the use of progestin pills- really just breast cancer and most young people of reproductive age don’t have a history of breast cancer.”

According to a statement released by the FDA, common side effects of Opill include “irregular bleeding, headaches, dizziness, nausea, increased appetite, abdominal pain, cramps or bloating,” which are also side effects of prescription birth control pills.

To many, the increased accessibility to birth control pills that Opill provides is a positive, especially with restrictions to pregnancy prevention being established since the overturning of Roe v. Wade in 2022.