Get to Know Opill!

Most birth control in the United States is only accessed through a prescription given by a doctor. However, seeing a doctor can be a challenge for many due to not having the time, insurance to help pay for the visit, or even transportation to get to their appointment. Luckily, this past year, the first ever over-the-counter birth control pill was approved by the FDA and distributed throughout the country. Meet Opill, the first and only daily oral contraceptive pill that can be purchased over the counter at any pharmacy without a prescription and is effective as prescription birth control pills when taken correctly. Read on to learn more about Opill from our Adolescent Medicine residents at the Ybor Youth Clinic! 

Q: What is Opill, and how does it work?   

A: Opill® is a progestin-only pill (POP) and is estrogen-free. It is also sometimes referred to as the "mini-pill." It contains a synthetic version of the naturally produced hormone progesterone (aka, a "progestin") called norgestrel. Opill® works by thickening the cervical mucus, which helps block sperm from reaching the egg and prevents the ovaries from releasing eggs in some cycles. It is a convenient, daily over-the-counter birth control pill that you use every day to prevent pregnancy. The best part is you don't need a prescription from your doctor to purchase it! It's been approved by the FDA as a non-prescription daily oral birth control pill.   

Q: Is Opill different from other birth control pills?   

A: In terms of composition, most birth control pills contain a combination of either natural or synthetic forms of estrogen and progesterone, which are hormones that normally help regulate your menstrual cycles. Some may only contain estrogen or artificial forms of estrogen. Opill®, on the other hand, is a progestin-only pill and is therefore estrogen-free. With regards to their function, despite their individual differences in composition, all birth control pills work similarly, with the goal of preventing pregnancy.   

Q: How effective is Opill at preventing pregnancy?  

A: Opill® is quite effective at preventing pregnancy. Studies have demonstrated that Opill® is up to 98% effective with perfect use and about 91% effective with typical use. Missing doses of the pill lowers its effectiveness and raises the risk of getting pregnant.   

Q: How do I take Opill correctly?   

A: For Opill® to be most effective, take one tablet at the same time every day, and no later than 3 hours from the time you took your tablet the day before. You should never skip a tablet or take a break between packs. Start the next pack the following day when you finish one pack of 28 tablets. It's essential to take Opill® every day, even if you're on your period or have some spotting or bleeding between periods.   

Q: What are the common side effects of Opill?   

A: The most common side effects are related to changes in bleeding patterns. Some people may find their period becomes less or more frequent, shorter or longer, lighter or heavier than before starting Opill®. Some people may also have some spotting or bleeding between periods or stop having periods while taking Opill®. Less common side effects include headaches, dizziness, nausea, increased appetite, abdominal pain, cramps, or bloating. Most side effects are mild and often resolve on their own. However, if the side effects are severe or persistent, it is essential to talk to a doctor.  

Q: Are there any serious risks or health concerns with Opill?   

A: Opill® is generally safe to take in most pre-menopausal women, including those with a history of migraines (without aura), high blood pressure, HIV/AIDS, diabetes, and/or blood clots. Exceptions include women with current or prior breast cancer, as certain breast cancers may be hormonally responsive to the hormone found in Opill®, which can cause these cancers to grow and metastasize (spread throughout the body), liver cancer or liver disease, migraines with aura, or who are allergic to Opill® or any of its ingredients, including FD&C yellow No.5 (also known as tartrazine).   

Q: Will Opill affect my weight or mood?   

A: Progestin-only pills like Opill® have not been shown to cause weight gain. A systematic review of the published literature found that the preponderance of evidence does not support an association between progestin-only contraception and depression.   

Q: Does Opill affect my period or menstrual cycle?  

A: Yes, Opill® can cause changes to your typical periods (aka, menstrual cycles). This may include spotting between periods as well as the potential for missed or stopped periods. It may also make your periods less or more frequent, shorter or longer in duration, and/or lighter or heavier than before starting Opill®.  

Q: Can I drink alcohol or smoke while taking Opill?  

A: While there are no direct contraindications to drinking alcohol and/or smoking while taking Opill®, it is generally advisable to refrain from drinking heavily or smoking due to their negative health effects. Drinking alcohol in large amounts can lead to missing or forgetting to take doses, which in turn decreases the effectiveness of Opill® in preventing pregnancy.  

Q: Can Opill be used as emergency contraception?  

A: Opill® is NOT an emergency contraceptive (morning-after pill) and won't prevent pregnancy when used after unprotected sex. Opill® and emergency contraceptives serve different purposes. Opill® is a birth control pill that you take every day to prevent pregnancy. Emergency contraceptives are used as a one-time option and should be taken after having unprotected sex to reduce the risk of pregnancy. 

If you're interested in learning more about birth control and how to access it, make sure to visit our contraceptive access toolkit on our website!  Look out for our next blog post for more information regarding Opill! 👀 

John Wiegand, MD   

PGY-2 USF Pediatrics   

Ybor Youth Clinic  - You can learn more information about making an appointment here!