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How Over the Counter Birth Control Pills Are Changing Access to Contraception

Conditions and Management

Raleigh Gynecology · May 26, 2025 ·

contraception and pregnancy concept asian young woman, girl hand opening birth control pillsFinding the right birth control method is a personal decision and often guided by a combination of convenience, safety, and individual health needs. Yet, for many women, accessing contraceptive care has long meant frequent doctor’s appointments, insurance hurdles, and pharmacy delays.

In fact, nearly one in three women between the ages of 18 and 49 report facing challenges when trying to obtain birth control prescriptions or refills. With the introduction of over the counter (OTC) birth control pills, acquiring contraception is becoming simpler, faster, and within reach for women of all backgrounds.

Find out how this new development is breaking down long-standing barriers and giving women more freedom to take control of their reproductive health.

Brief History of Birth Control Access in the United States

Access to birth control in the United States has evolved significantly over the past century. In 1960, the first oral contraceptive pill was approved by the FDA, offering women a new level of control over their reproductive health. However, early access was limited by state laws, marital status requirements, and social stigma.

It wasn’t until the 1970s that birth control became more widely available to unmarried women following Supreme Court decisions like Eisenstadt v. Baird. Despite these advancements, barriers, such as prescription requirements, cost, and provider availability have continued to impact contraceptive care for many women, especially those in underserved communities.

A Look at OTC Birth Control Pills

On July 13, 2023, the FDA approved Opill (norgestrel), making it the first daily oral contraceptive available OTC in the United States. Opill is a progestin-only pill, often referred to as the “mini pill,” and has been shown to be safe and effective when used as directed.

This historic approval allows individuals to purchase Opill at pharmacies, grocery stores, convenience stores, and online, eliminating the need for a visit to a healthcare provider. The FDA’s decision reflects decades of research supporting the safety of progestin-only pills and aims to reduce barriers to contraceptive access, particularly for those who face challenges such as cost, lack of insurance, or limited access to healthcare providers.

How OTC Birth Control is Improving Access

The approval of OTC birth control marks a major step forward in expanding access to contraceptive care. By removing the need for a doctor’s prescription, women can now obtain birth control more quickly, easily, and privately.

Some studies suggest that OTC access to birth control could increase the overall use of contraception, encourage ongoing use of contraceptives, and reduce the risk of unplanned pregnancies.

Potential Challenges & Considerations

women taking contraceptive pills While OTC birth control greatly improves access, it also presents new challenges. Without insurance coverage, the cost of OTC pills may still be a barrier for some individuals. Another concern is that easier access could lead to missed opportunities for preventive healthcare visits, such as pap smears and breast exams, which often accompany prescription renewals.

In addition, individuals may need better education about proper pill use and managing potential side effects. As access expands, making sure that women receive the information and support they need will be essential to promote safe and effective contraceptive care.

Role of Healthcare Providers in the OTC Era

Even as birth control becomes available OTC, healthcare providers remain an important part of managing women’s health. Providers can offer personalized guidance on selecting the most appropriate birth control method, help manage side effects, and address broader reproductive health needs.

Regular gynecological visits continue to be necessary for screenings, preventive care, and discussions about long-term health goals. Even with the advent of OTC birth control, providers still play a significant role in educating patients on proper pill use and encouraging ongoing communication to make sure that access to contraception remains both safe and effective.

What OTC Birth Control Means for Women’s Health

The availability of OTC birth control represents a major shift in women’s health, offering greater autonomy and convenience. Easier access to contraception can help reduce unintended pregnancies, promote reproductive freedom, and support broader health equity, especially for women who have historically faced barriers to care.

Going forward, continued education, affordability, and support from healthcare providers will be essential to help all women benefit from this progress. As options expand, women will have more opportunities to make informed decisions about their reproductive health, on their own terms and timelines.

Trust Raleigh Gynecology and Wellness for Compassionate Contraceptive Care

woman hands opening birth control pills in handThe approval of OTC birth control pills, such as Opill, is reshaping access to contraceptive care, offering women greater flexibility, independence, and control over their reproductive health. While challenges remain, this shift represents an important step toward a future where care is more accessible for all.

At Raleigh Gynecology & Wellness in Raleigh, NC, we are here to support you with professional gynecological and contraceptive care. Contact us today to schedule an appointment and receive the compassionate care you need to make informed decisions about your health.

Raleigh Gynecology · May 12, 2025 ·

doctor analyzing a mammogram on a computer screenStarting around age 40, the American Cancer Society recommends women begin getting mammograms once a year. Mammograms are low-dose X-rays of the breast that can help detect breast cancer at an early age when treatment is most likely to be successful. If you’ve recently had a mammogram, you may be anxiously waiting for your results.

Knowing your mammogram results is just as important as the screening itself. When terms like “BI-RADS scores” and “follow-up imaging” come up in conversation, you may be confused about what it all means. By learning what different results indicate, you can take informed steps toward managing your breast health.

Find out what your mammogram results really mean, why these screenings are important for overall health, and when you should consult a specialist for further guidance.

The Mammogram Screening Process

A mammogram is a specialized X-ray imaging test used to examine breast tissue for early signs of cancer or other abnormalities. It is one of the most effective tools for detecting breast cancer in its earliest stages, often before a lump can be felt.

During a mammogram, a technologist positions your breast between two plates, which gently compresses the tissue to capture clear images. The process typically takes about 20 minutes, with the imaging itself lasting just a few seconds per breast.

Two main types of mammograms are used for screening and diagnosis. Screening mammography is performed on women with no symptoms as part of routine breast cancer screening. Diagnostic mammograms are recommended when a suspicious finding occurs during a screening or when a woman has symptoms, such as a lump.

Breaking Down BI-RADS Scores

The Breast Imaging Reporting and Data System (BI-RADS) is a standardized classification system developed by the American College of Radiology to help interpret and report mammogram results. Each mammogram is assigned a BI-RADS score ranging from 0 to 6 and includes:

  • BI-RADS 0 – Incomplete. This score typically indicates that additional imaging is needed, such as additional mammogram images or an ultrasound or MRI.
  • BI-RADS 1 – Normal. A score of 1 means no signs of cancer or abnormalities were found.
  • BI-RADS 2 – Benign Findings. This is a non-cancerous result that involves benign conditions, such as cysts, calcifications, or fibroadenomas.
  • BI-RADS 3 – Probably Benign. This finding indicates a low likelihood (less than 2%) of cancer, and a short-term follow-up is recommended.
  • BI-RADS 4 – Suspicious Abnormality. A score of 4 means that the finding was concerning but is not definitive of cancer, and a biopsy may be needed.
  • BI-RADS 5 – Highly Suggestive of Malignancy. This indicates a greater than 95% chance that the abnormality is cancerous. An immediate biopsy is recommended.
  • BI-RADS 6 – Known Cancer Diagnosis. This category is for patients who have already been diagnosed with breast cancer through a prior biopsy.

Common Concerns and Misconceptions

female doctor examines breast scan on monitor while patient in blue gown undergoes mammogram screening in the backgroundMany women worry when they receive BI-RADS results that indicate something may be wrong. However, this doesn’t necessarily mean cancer. Differences in breast density can affect the results of the screening. For example, dense breast tissue can make it harder to find abnormalities on a standard mammogram.

Women with dense breasts may benefit from an ultrasound or MRI for clearer imaging. When more detailed images of the breast are needed, 3D mammography is often recommended.

The Genius 3D Mammography exam is the latest advancement in breast cancer screening, providing a more accurate screening compared to traditional 2D mammograms. What makes The Genius 3D test unique is that doctors can view breast tissue layer by layer to find abnormalities that may be hidden in flat 2D images.

The Importance of Regular Screenings

Regular mammograms help detect breast cancer early when treatment is most effective. You can also support breast health by maintaining a healthy weight, exercising, eating a balanced diet, limiting alcohol, and avoiding smoking. Being proactive with screenings and self-awareness empowers women to take control of their health and well-being.

When to Consult a Specialist

Seek an immediate follow-up with your provider if you notice any concerning symptoms, such as a new lump, nipple discharge (especially bloody), persistent breast pain, skin changes (redness or dimpling), or swelling. If your mammogram results are unclear, don’t hesitate to ask questions or request clarification.

Advocate for your health by discussing family history, risk factors, and additional imaging options when needed. If recommended for a biopsy, understand the procedure and results thoroughly. Trusting your instincts and working with a specialist can get you the best care and a personalized approach to your breast health.

Call Raleigh Gynecology & Wellness Today

Raleigh, NC OBGYN explaining mammogram results

Staying proactive leads to early detection and better outcomes in breast health. Regular breast cancer screenings, along with a healthy lifestyle, can make a significant difference in managing your well-being.

At Raleigh Gynecology & Wellness, we are committed to supporting women through every step of their screening and follow-up journey. Whether you need a mammogram, further testing, or guidance, our team is here to help. Schedule an appointment today to take charge of your breast health or contact us to learn more about our services.

Raleigh Gynecology · May 5, 2025 ·

supporting breast cancer awareness conceptEarly detection of breast cancer can make a huge difference in treatment outcome. Mammograms remain the gold standard in breast cancer screening, but they don’t always tell the whole story, especially for women with dense breast tissue or higher risk factors.

Ultrasounds and magnetic resonance imaging (MRI) can offer a clearer picture when traditional imaging falls short. These advanced imaging tools can reliably identify cancers that might otherwise go undetected, giving patients and doctors the best chance at early intervention.

This blog takes a closer look at how ultrasounds and MRIs can complement mammograms, providing a more thorough and effective strategy for breast cancer detection, especially for women at high risk.

Breast Ultrasound and MRI for Cancer Screening

Breast ultrasound and MRI offer enhanced imaging capabilities, providing more detailed views of breast tissue that can improve diagnostic accuracy, detect abnormalities that may have been previously missed, and reduce unnecessary biopsies.

By providing complementary views beyond standard mammography, these modalities improve early detection and serve as valuable tools in an exhaustive screening strategy.

Ultrasound Technology

Breast ultrasounds use high-frequency sound waves to gain a more detailed view of the breast’s structure. This technology is commonly used as a supplemental screening tool for women who are at a higher risk of breast cancer.

For instance, your provider may recommend an ultrasound if a mammogram suggests a change in the breast tissue, or a potential abnormality is discovered during a breast exam. Ultrasounds may also be recommended for women with dense breasts and those who are under 30 years old or pregnant.

What makes breast ultrasounds particularly useful is their ability to distinguish between fluid-filled cysts and solid masses. However, ultrasound technology does have its limitations. It is not adept at identifying microcalcifications, or tiny calcium deposits, which can be an early sign of breast cancer.

MRI

A breast MRI is a highly sensitive imaging test that generates 3D images of the breast using powerful magnets and radio waves. Unlike mammograms, this technology does not use radiation, making it a potentially safe option for monitoring high-risk patients who require frequent scans. The American Cancer Society recommends that women with a high risk of breast cancer get an MRI annually, often starting at age 30.

closeup of skilled female doctor in glasses carrying out ultrasound examination breast of unrecognizable young woman patient in medical clinicBreast MRIs can be especially useful for finding small or hidden tumors that might be overlooked on a mammogram, especially those in dense breast tissue. They can also be used to evaluate the extent of cancer in patients who have already been diagnosed.

However, breast MRIs are extremely sensitive and can sometimes produce false positives, meaning they may detect abnormalities that are not cancerous. There is also emerging data that suggests repetitive use of contrast dye for MRIs may lead to harmful effects in some patients.

Effectiveness of Ultrasounds and MRIs

While women’s health technologies have come a long way over the last decade, no tool is infallible. The overall effectiveness of ultrasounds and MRIs can differ based on a variety of factors. When used in conjunction with a mammogram, supplemental imaging techniques, such as ultrasounds and MRIs, can provide additional layers of detection that improve accuracy and facilitate early diagnosis.

Ultrasound Effectiveness

Regular breast cancer screening helps identify cancer earlier, helping to significantly reduce breast cancer deaths. Some studies suggest that early screening can reduce deaths up to 40%. Ultrasound can serve as a valuable tool for breast cancer detection, especially when used as a supplemental tool to evaluate suspicious areas found on mammograms or in dense breast tissue.

A systematic review found ultrasounds detect breast cancer with a sensitivity of around 80%. They are also particularly useful for guiding biopsies by pinpointing abnormal areas with high precision, as well as evaluating palpable lumps that don’t show up clearly on mammograms.

MRI Effectiveness

Breast MRIs are considered one of the most sensitive imaging methods, capable of detecting smaller and more aggressive cancers that may not be visible on mammograms or ultrasounds. They can be especially effective for women at high risk of breast cancer, such as those with BRCA1 or BRCA2 gene mutations. A breast MRI may also be recommended for women with a history of breast cancer to detect recurrences.

While MRIs are highly sensitive for detecting breast cancer, they should not be used as a sole screening tool. This technology can miss certain cancers that a mammogram would find and is also more likely to result in false positives that can lead to costly additional testing and unnecessary biopsies.

Improving Outcomes with Ultrasound and MRI

Combining ultrasounds and/or MRIs with mammograms offers a more thorough evaluation of breast tissue, increasing the likelihood of detecting abnormalities early. This is especially valuable for women at high risk, as these tools provide enhanced sensitivity and deeper insights for a more detailed and proactive approach to breast cancer screening.

Schedule Your Next Breast Cancer Screening

malignant tumor that forms in breast cells, often detectable by lumps, changes in shape, or other noticeable abnormalitiesCaring for your breast health is necessary for overall wellness, and early detection offers you the best chance for effective treatment and a positive outcome. Mammograms, ultrasounds, and MRIs each play an important role in keeping you informed and empowered. Take time to discuss your risk factors with your healthcare provider to determine the best diagnostic equipment for you.

If you’re due for a screening or have concerns about your breast health, contact Raleigh Gynecology & Wellness. We have an all-women team that focuses on patient comfort and privacy, and we understand the personal nature of gynecological care.

Our long-standing gynecological expertise and compassionate, patient-centered approach make us a trusted partner in your breast health journey for all stages of life. Early detection can save lives, and we’re here to provide the care and support you deserve.

Raleigh Gynecology · April 28, 2025 ·

women holding condom and birth control pills in both handsBirth control is one of the most common medical interventions that women around the world receive. Depending on the geographic area, as many as 18% of all women are currently taking oral contraception, with another 10% relying on IUDs and implants.

About 24% choose sterilization as their pregnancy prevention method of choice. Contraceptive care accounts for a significant portion of women’s healthcare from their OB-GYN. Still, most women do not settle on just one method for their entire lives.

It is common to switch among forms of birth control depending on the desired effects, potential side effects, and long-term need. Making the switch can present its share of challenges, and women should understand ahead of time how their bodies may respond and what to expect.

Here is some guidance for managing the adjustment period after switching birth control and some methods for making the transition as seamless as possible.

How to Make the Switch

There are multiple ways to switch to a new type of birth control. The right one for any woman will depend on the current method and what the patient wants to switch to, the evaluation of any existing medical conditions, and whether she is at risk of becoming pregnant during the switch.

In most cases, a woman may be able to stop using their previous birth control and begin using a new one right away. In other cases a woman may do better with an overlapping transition. In this scenario, she may be using two contraceptives at once. An example would be starting a birth control pill with an IUD still in place with a plan to remove the IUD once she is well established on the birth control pill.

The overlap method may help the body achieve a smoother transition in women for whom hormonal fluctuations cause significant side effects; however, , it is not always possible to transition in this way..

As-Needed

Some women elect to stop birth control for longer periods of time, such as when they do not actively have a partner. During this window, they may choose to switch their birth control method to condoms or another alternative. Some women benefit from this more drawn-out switching method, as it allows the body to fully return to its no-contraceptive homeostasis before trying a new product later. However, pregnancy risk is higher during this time if, for example, a condom breaks.

Adjusting After a Birth Control Switch

Regardless of which type of birth control switching process a woman chooses, she may experience some minor side effects. These can include:

  • women taking birth control pillMood changes
  • Libido changes
  • Changes to the menstrual cycle
  • Spotting
  • Tender breasts
  • Headaches
  • Nausea

While some adjustment period is normal, women should pay attention to their side effects. For most women, side effects from changing birth control methods can last a few months. It can be helpful to keep a journal detailing how the patient feels emotionally and physically at the end of each day, which helps to track side effects as they change over time.

In general, women should expect that the side effects gradually decrease in severity as they adjust to their new contraception. If side effects worsen or do not resolve within a few months, a gynecologist can help the patient understand their options.

For many women, their bodies respond best to certain brands or types of contraception. There is usually no need to remain beholden to a specific brand; instead, women should listen to their bodies and work with their GYN team to find a solution that fits them.

Talk to Your Gynecologist About Switching Birth Control

birth control pills and injectionChoosing (and using) birth control is one of the biggest decisions a woman may make in her lifetime. However, in the quest to find the right fit, many women will need to switch between birth control methods. The women at Raleigh Gynecology & Wellness want to make this switch as easy as possible so you can flourish!

We have been there and understand the relief of finding an option that works well with your body. Contact Raleigh Gynecology & Wellness today to schedule your contraceptive appointment, discuss switching, and learn more about how to manage this switch comfortably.

Raleigh Gynecology · April 7, 2025 ·

doctor examines mammogram snapshot of breast of female patient on the monitorsThe possibility of a breast cancer diagnosis can be overwhelming and bring a wave of uncertainty about what the future might hold. You may wonder: Am I at risk? Should I get a breast cancer screening earlier? These are not easy questions, but they are important ones. The good news is that early detection saves lives, and knowing your personal risk can empower you to take control of your health.

Some women face a higher risk of breast cancer due to factors such as family history, genetics, certain health conditions, and lifestyle choices. Determining your personal risk level starts with knowing these factors and talking to your healthcare provider about early screening.

In this blog, we’ll help you make informed decisions about your health by looking at common risk factors of breast cancer, how to determine your personal risk, and what steps to take if you’re considered high risk.

Common Risk Factors of Breast Cancer

Aside from skin cancers, breast cancer is the most common form of cancer in women, accounting for approximately 30% of all new female cancers annually. While all women should be mindful of their breast health, some face a higher risk often due to factors beyond their control. Recognizing these risk factors is the first step in determining whether early screening may be necessary.

Risk factors include:

  • Family History of Breast Cancer – Having a sister, mother, or other close relative with breast cancer can significantly elevate your risk.
  • Genetic Mutations – Inherited mutations in genes, such as BRCA1 and BRCA2, can greatly raise your likelihood of developing breast cancer.
  • Personal History of Breast Abnormalities – If you’ve been diagnosed with atypical cells or had other non-cancerous breast conditions, your risk may be higher.
  • Radiation Exposure at Young Age – Women who received radiation therapy to the chest before age 30 are at an increased risk.
  • Lifestyle Factors – Obesity, lack of exercise, excessive alcohol consumption, and smoking can all contribute to a higher breast cancer risk.
  • Hormonal Influences – Factors such as early menstruation (before age 12), late menopause (after age 55), hormone replacement therapy, or having children later in life can all increase your risk.

If one or more of these risk factors pertains to you, discuss your concerns with your healthcare provider. They can help assess your individual risk and determine whether earlier screening is right for you.

How to Determine Your Personal Risk

The American Cancer Society recommends that women at average risk for breast cancer get annual mammograms starting at age 40. Women ages 55 and older can choose to get a mammogram every other year or continue with annual mammograms. However, those at higher risk may need earlier or more frequent screenings.

Some proactive steps to take when assessing your risk include:

woman with pink ribbon on color background1. Speak with Your Healthcare Provider

A conversation with your healthcare provider is the best place to start. Your doctor can review your personal and family medical history, discuss any concerns, and help determine whether additional tests or screenings are necessary.

2. Consider Genetic Testing

If you have a strong family history of breast cancer, especially if a close relative was diagnosed at a young age, your healthcare provider may recommend genetic testing. This test looks for mutations in genes, such as BRCA1 and BRCA2, which significantly increase breast cancer risk. Other gene mutations, such as PALB2, CHEK2, and ATM, may also be evaluated.

3. Utilize Breast Cancer Assessment Tools

Healthcare providers often use various methods to estimate a person’s lifetime risk of developing breast cancer, such as The Gail Model, The Tyrer-Cuzick Model, and The Claus Model.

The Genius 3D Mammography is one of the latest advancements in breast cancer screening, offering state-of-the-art technology that provides greater accuracy and detects abnormalities that may go unseen in flat 2D images. The exam finds 20 to 65% more invasive breast cancers than traditional 2D mammograms and reduces unnecessary callbacks by up to 40%.

If your calculated risk of breast cancer is high, your healthcare provider may recommend earlier mammograms, breast ultrasounds, breast MRIs, and/or other preventive strategies.

Steps to Take If You’re Considered High Risk

If you’re at a high risk for breast cancer, taking proactive steps can make a significant difference in early detection and prevention. Work with your healthcare provider to develop a personalized screening plan, which may include earlier or more frequent imaging.

Additionally, adopting a healthy lifestyle, such as eating healthy, staying physically active, limiting alcohol consumption, and avoiding smoking, can help lower your risk. For those at very high risk, preventative options such as risk-reducing medications (e.g. tamoxifen) or preventive surgery (e.g. mastectomy) may be considered. Knowing your options can help you make an informed decision and take control of your health.

Trust Raleigh Gynecology & Wellness for Your Breast Cancer Screening

close-up of woman doing breast cancer self checkThe prospect of a breast cancer diagnosis can be frightening, especially if you’re at high risk. Fortunately, knowledge is power, and early detection can save lives. If you’re at high risk of breast cancer, our team’s long-standing experience and expertise is here to support you with compassionate, patient-centered and evidence-based care.

Our all-women team understands the importance of privacy in gynecological care, and we are here to listen and help address your individual needs at any stage of life. Schedule your breast cancer screening today with Raleigh Gynecology & Wellness for peace of mind.

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Conditions & Management

  • Abnormal PAP Smears
  • Endometriosis
  • Initial Evaluation of Infertility
  • Menopause & Peri-Menopause Care
  • Menstrual Disorders
  • PCOS
  • Pelvic Relaxation & Prolapse
  • Sexual Health & Sexual Dysfunction
  • Urinary Problems
  • Vaginal Dryness & Painful Sex
  • Vaginitis Care

Procedures

  • Colposcopy
  • Endometrial Biopsy
  • IUD Insertion
  • LEEP
  • MonaLisa Touch
  • Nexplanon
  • Pelvic Floor Therapy
  • Pessary Fitting
  • Sonohysterography & Ultrasound

Routine Care

  • Breast Care
  • Contraceptive Care
  • Emergency Contraception
  • Gardasil Vaccination
  • GYN Wellness Screening
  • HPV Counseling
  • Mammography
  • PAP Test
  • STD Testing

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