{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T07:18:45Z","timestamp":1768720725387,"version":"3.49.0"},"reference-count":22,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100014848","name":"Arnold Ventures","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100014848","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Collaborative for Gender + Reproductive Equity","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/100000008","name":"David and Lucile Packard Foundation","doi-asserted-by":"publisher","award":["2015-63012"],"award-info":[{"award-number":["2015-63012"]}],"id":[{"id":"10.13039\/100000008","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2022,10,6]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Efforts are underway to make a progestin-only pill (POP) over the counter (OTC) in the United States (US); however, little is known about POP user experiences, which could impact uptake and continuation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From January 2020\u2013September 2021, we conducted a cross-sectional online survey with individuals who used OTC POPs in a US trial. We calculated descriptive statistics and Pearson chi-square and Fisher\u2019s exact tests to assess menstrual bleeding acceptability, how OTC POP experiences compared with prior contraceptive methods, and preferred ways to get answers to questions during OTC POP use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 550 adult and 115 adolescent participants, 80% (n=531) felt their menstrual bleeding was acceptable. Participants reported a range of menstrual bleeding experiences compared with prior long-acting or hormonal methods used; 58% (n=84) said the POP bleeding was similar or better and 36% (n=53) said it was worse. Among participants who used contraception in the month prior to the trial, 77% (n=201) said their overall OTC POP experience was similar or better. Top benefits compared with prior methods included less worry about pregnancy, ease of access, fewer side effects, and greater decision-making power. Adults preferred to get answers about OTC POPs via webpage or app, whereas teens preferred asking pharmacists or other healthcare providers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, OTC POP users in a trial setting found the menstrual bleeding acceptable and the method similar to or better than previous methods. POP labelling should provide clear messaging about bleeding changes users may experience.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2022-201637","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T08:27:07Z","timestamp":1667204827000},"page":"27-34","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Experiences using a progestin-only pill in an over-the-counter environment in the United States: a cross-sectional survey"],"prefix":"10.1136","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-3710","authenticated-orcid":false,"given":"Kate","family":"Grindlay","sequence":"first","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Key","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-1568","authenticated-orcid":false,"given":"Carmela","family":"Zuniga","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Wollum","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Oakland, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-9368","authenticated-orcid":false,"given":"Daniel","family":"Grossman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California San Francisco, Oakland, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9691-0700","authenticated-orcid":false,"given":"Kelly","family":"Blanchard","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"2025090510111635000_49.1.27.1","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1097\/AOG.0000000000003473","article-title":"Over-the-counter access to hormonal contraception: ACOG Committee opinion, number 788","volume":"134","year":"2019","journal-title":"Obstet Gynecol"},{"key":"2025090510111635000_49.1.27.2","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.contraception.2021.01.010","article-title":"Prevalence of contraindications to progestin-only contraceptive pills in a multi-institution patient database","volume":"103","author":"Dutton","year":"2021","journal-title":"Contraception"},{"key":"2025090510111635000_49.1.27.3","unstructured":"Raymond EG , Grossman D . Progestin-Only Pills. In: Hatcher RA , Nelson AL , Trussell J , et al , eds. Contraceptive technology. 21 Edition. New York, NY: Ayer Company Publishers, Inc, 2018: 317\u201326."},{"key":"2025090510111635000_49.1.27.4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"2025090510111635000_49.1.27.5","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.contraception.2012.01.008","article-title":"Contraindications to progestin-only oral contraceptive pills among reproductive-aged women","volume":"86","author":"White","year":"2012","journal-title":"Contraception"},{"key":"2025090510111635000_49.1.27.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.contraception.2021.08.016","article-title":"A review of the effectiveness of a progestogen-only pill containing norgestrel 75 \u00b5g\/day","volume":"105","author":"Glasier","year":"2022","journal-title":"Contraception"},{"key":"2025090510111635000_49.1.27.7","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.ogc.2015.07.002","article-title":"Over-the-counter access to oral contraceptives","volume":"42","author":"Grossman","year":"2015","journal-title":"Obstet Gynecol Clin North Am"},{"key":"2025090510111635000_49.1.27.8","unstructured":"Crockett E . The first steps toward over-the-counter birth control in the U.S. are finally underway. Available: https:\/\/www.vox.com\/2016\/12\/30\/14120874\/birth-control-over-the-counter-fda-ibis-hra-pharma [Accessed 07 July 2022]."},{"key":"2025090510111635000_49.1.27.9","unstructured":"Clinicaltrials.gov . Adherence with Continuous-Dose Oral Contraceptive: Evaluation of Self-Selection and Use (ACCESS). Available: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04112095 [Accessed 07 July 2022]."},{"key":"2025090510111635000_49.1.27.10","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.whi.2017.11.006","article-title":"Interest in over-the-counter access to a progestin-only pill among women in the United States","volume":"28","author":"Grindlay","year":"2018","journal-title":"Womens Health Issues"},{"key":"2025090510111635000_49.1.27.11","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.contraception.2012.05.018","article-title":"User characteristics and out-of-pocket expenditures for progestin-only versus combined oral contraceptives","volume":"86","author":"Liang","year":"2012","journal-title":"Contraception"},{"key":"2025090510111635000_49.1.27.12","unstructured":"Bartz D , Goldberg A . Injectable Contraceptives. In: Hatcher RA , Trussell J , Nelson AL , et al , eds. Contraceptive technology. 20th Edition. New York: Ardent Media, Inc, 2011."},{"key":"2025090510111635000_49.1.27.13","unstructured":"Dean G , Schwarz EB . Intrauterine Contraceptives (IUCs). In: Hatcher RA , Trussell J , Nelson AL , et al , eds. Contraceptive technology. 20th Edition. New York: Ardent Media, Inc, 2011."},{"key":"2025090510111635000_49.1.27.14","unstructured":"Raymond EG . Contraceptive Implants. In: Hatcher RA , Trussell J , Nelson AL , et al , eds. Contraceptive technology. 20 Edition. New York: Ardent Media, Inc, 2011."},{"key":"2025090510111635000_49.1.27.15","unstructured":"U.S. Department of Health and Human Services, Office for Human Research Protections . 45 CFR 46: \u00a746.408 requirements for permission by parents or guardians and for assent by children. Available: https:\/\/www.hhs.gov\/ohrp\/regulations-and-policy\/regulations\/45-cfr-46\/common-rule-subpart-d\/index.html#46.408 [Accessed 07 July 2022]."},{"key":"2025090510111635000_49.1.27.16","unstructured":"Trussell J , Aiken ARA , Micks E . Efficacy, Safety, and Personal Considerations. In: Hatcher RA , Nelson AL , Trussell J , et al , eds. Contraceptive technology. 21st Edition. New York, NY: Ayer Company Publishers, Inc, 2018."},{"key":"2025090510111635000_49.1.27.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025090510111635000_49.1.27.18","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jadohealth.2016.12.024","article-title":"Over-the-counter access to oral contraceptives for adolescents","volume":"60","author":"Upadhya","year":"2017","journal-title":"J Adolesc Health"},{"key":"2025090510111635000_49.1.27.19","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jadohealth.2019.05.013","article-title":"Youth perspectives on pharmacists' provision of birth control: findings from a focus group study","volume":"65","author":"Zuniga","year":"2019","journal-title":"J Adolesc Health"},{"key":"2025090510111635000_49.1.27.20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jadohealth.2017.10.011","article-title":"Adolescents' and young adults' reports of barriers to confidential health care and receipt of contraceptive services","volume":"62","author":"Fuentes","year":"2018","journal-title":"J Adolesc Health"},{"key":"2025090510111635000_49.1.27.21","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.contraception.2017.11.008","article-title":"Older teen attitudes toward birth control access in pharmacies: a qualitative study","volume":"97","author":"Wilkinson","year":"2018","journal-title":"Contraception"},{"key":"2025090510111635000_49.1.27.22","doi-asserted-by":"crossref","first-page":"S85","DOI":"10.1016\/j.amepre.2015.04.001","article-title":"Confidentiality in family planning services for young people: a systematic review","volume":"49","author":"Brittain","year":"2015","journal-title":"Am J Prev Med"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2022-201637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:14:45Z","timestamp":1757092485000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2022-201637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,10]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/bmjsrh-2022-201637"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2022-201637","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]}}}