Should emergency hormonal contraception be available over the counter? — September 12, 2002

Research Triangle Park, NC -- The prescription requirement for emergency hormonal contraception should be dropped, and emergency contraceptive pills (ECPs) should be available over the counter in the United States, argues Dr. David Grimes of Family Health International in "Sounding Board" in the September 12, 2002 issue of the New England Journal of Medicine.

"The prescription requirement for emergency hormonal contraception jeopardizes women's health by decreasing or delaying use of this safe, effective prophylaxis," says Dr. Grimes.

Emergency contraceptive pills are hormone-containing tablets that can be taken orally as soon as possible after unprotected sexual intercourse, contraceptive failure, or contraceptive misuse to prevent pregnancy. Two ECP regimens — one containing a combination of estrogen and progestin, and the other only progestin — are approved by the U.S. Food and Drug Administration (FDA) for prescription-only use. The pills have no medical contraindications, and they can reduce the risk of pregnancy by 74% to 85% if taken within 72 hours of intercourse. According to Dr. Grimes, over-the-counter availability of ECPs could help reduce health risks and costs associated with unintended pregnancy in the United States, where nearly half of all women have at least one unintended pregnancy during their reproductive years.

Other arguments for switching ECPs to over-the-counter status are that they do not cause any serious adverse side effects; they do not harm a woman if used inappropriately; and they can be taken without medical supervision, since doses are the same for all women and women can independently determine when they are necessary.

In 2001, more than 70 organizations filed a petition with the FDA requesting that emergency contraception gain non-prescription status. No action has been taken yet. Emergency contraceptive pills are currently available over the counter in the United Kingdom, Morocco, Norway, Sweden, Finland, Israel, France, Belgium, Denmark, Portugal, South Africa, Albania, and some parts of Canada.

For more information, see http://content.nejm.org/current.shtml

To see Family Health International's online materials on emergency contraception, click here.