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Decades ago, birth control was seldom discussed outside the bedroom. Over-the-counter (OTC) birth control options were minimal and hard to find. Now, the birth control section in stores is easy to find, and there’s a much larger variety of options available.

Most drugstores and grocery stores such as Walgreens, CVS, and Walmart offer OTC birth control in stores or online. If you’re looking for a particular brand and can’t find it in the store, try the store’s website where there’s often a larger selection.

OTC birth control options are nonhormonal. This means that they don’t rely on the hormones estrogen or progestin to prevent pregnancy. Instead, these methods rely on other means. Keep reading to learn more.

Male condoms are considered a barrier form of birth control. They’re made from latex, lambskin, or polyurethane. Male condoms are placed on an erect penis and prevent sperm from entering the vagina and reaching an unfertilized egg. The condoms may be lubricated or non-lubricated. They may also include spermicide for additional protection.

Because male condoms must be used on an erect penis, they can’t be put in place ahead of time. This may be an issue if you don’t like to interrupt an intimate moment.

When they’re used correctly, most male condoms help prevent sexually transmitted infections (STIs). Lambskin or other natural condoms don’t provide STI protection.

The Centers for Disease Control and Prevention (CDC) reports all OTC birth control effectiveness rates based on typical use, which means overall effectiveness during incorrect and correct use. Because it’s unlikely you’ll use OTC birth control perfectly every time, typical use is more accurate. The CDC reports male condoms have an 18 percent failure rate.

A female condom is a lubricated pouch designed to prevent sperm from entering the vagina. These also help protect against STDs.

Female condoms can be inserted into the vagina up to eight hours before intercourse. They’re less effective than male condoms. The CDC reports they have a 21 percent failure rate.

Any woman can use female condoms, but some may experience vaginal irritation or condom slippage during intercourse.

There are several types of spermicides available. The options include:

  • foams
  • suppositories
  • gels
  • creams
  • films

Most spermicides contain nonoxynol-9, a substance that essentially stops sperm in their tracks. This means that the substance prevents sperm from reaching an unfertilized egg. Spermicide may be used alone or with other types of birth control, such as condoms and diaphragms.

When it’s used alone, any type of spermicide should be placed in the vagina at least an hour before intercourse. The substance must also be left in place for six to eight hours after intercourse. Because of this, some people may find spermicides to be messy.

Nonoxynol-9 doesn’t prevent the spread of STIs. In fact, this substance may actually increase the risk of STIs, such as HIV, in some people. Research has shown that spermicide disrupts the wall of the vagina, which can make it easier for infection to get through. If spermicide is used multiple times per day, your risk for infection may increase even more.

The CDC lists the failure rate of spermicide at 28 percent.

The contraceptive sponge is about two inches in diameter, made of soft foam, and contains nonoxynol-9 spermicide. It has a loop on one end for easy removal. The sponge helps prevent pregnancy two ways. The sponge itself is a barrier, which prevents sperm from traveling through the cervix, and the spermicide prevents sperm from moving beyond the sponge.

Before you use the sponge, you must wet it with water and squeeze it to activate the spermicide. You then insert it into the vagina where it can remain for up to 24 hours. This is true regardless of how many times you have intercourse.

If you leave the sponge in for 30 or more hours, you’re at an increased risk of toxic shock syndrome (TSS). This is a serious and potentially life-threatening bacterial infection.

You shouldn’t use the sponge if you:

  • are allergic to sulfa drugs, polyurethane, or
  • have physical vaginal issues
  • have had a recent abortion
  • have recently miscarried
  • have recently given birth
  • have an infection in your reproductive tract
  • have a history of TSS

The sponge has a 91 percent success rate when it’s “always used as directed” by women who’ve never given birth. That number drops to 88 percent for women who’ve given birth.

Emergency contraception, or “the morning after pill,” helps prevent your ovary from releasing an egg. Emergency contraception can be used up to five days after unprotected sex. The longer you wait to take this, the higher your risk of pregnancy.

Depending on the brand you buy, this is 85 to 89 percent effective when used within three to five days of unprotected sex. Effectiveness decreases over time.

All women can use emergency contraception, although, it may not work if your body mass index is over 25.

When using OTC birth control, keep these tips in mind:

  • Follow product instructions carefully. Not using
    a product as instructed may increase your risk of becoming pregnant.
  • Using condoms and spermicide together is the
    most effective OTC birth control. Using condoms or spermicide alone isn’t as
    reliable, and you run a higher risk of pregnancy.
  • Avoid oil-based lubricants such as massage oil,
    baby oil, or petroleum jelly. These may cause holes in the condom or cause it
    to break. Instead, stick to water-based lubricants.
  • Don’t store condoms in warm places. You also
    shouldn’t open the package with your teeth or another sharp object.

No OTC birth control is perfect. Condoms can break on occasion, sponges may be removed too soon, and any other number of things may happen to disrupt protection. If this happens, what you do next can mean the difference between an unplanned pregnancy and effective prevention.

If your OTC birth control fails, it’s important that you remain calm. Carefully remove the sponge or condom if you’re using one, and urinate to help get rid of any sperm left behind. You should take OTC emergency contraception pills as soon as possible to prevent pregnancy.

You can also schedule an emergency appointment with your doctor to have an intrauterine device (IUD) inserted. If it’s inserted within five days of unprotected sex or contraceptive failure, the IUD is over 99 percent effective in preventing pregnancy.

Whether you choose OTC birth control or hormonal birth control is a decision best made by you, your partner, and your doctor. To help narrow your options, you should consider:

  • your future plans to have children
  • your medical conditions
  • how often you have sex
  • the ease of use
  • any out-of-pocket cost or insurance coverage
  • protection against STIs

If you decide that you may interested in hormonal birth control pills, you should know that they may be coming soon to a store near you. In 2015, legislation was introduced to allow hormonal birth control pills to be sold without a prescription. The American College of Gynecologists and Obstetricians support the legislation based on the proven safety and effectiveness of the pills. A survey published in Contraceptionshowed two-thirds of women agree.

Learn more: Which birth control is right for you? »

When it comes to birth control, the options for women have come a long way. Most OTC birth control options are readily available, relatively inexpensive, and effective when used as directed.

Talk to your doctor if you have any questions or concerns about birth control. If you believe hormonal birth control pills should be available over the counter, contact your state’s congressional delegation.