Some 27 years ago, in 1993, The Lancet published an editorial arguing the case for oral contraceptives over the counter (OTC).1 It opened by saying that the oral contraceptive pill (OCP) had helped women ‘escape from the confines of their own reproductive system’ but that ‘these ex-prisoners remain on probation’ because they still needed to see a doctor regularly for a repeat prescriptions. This month, almost 60 years after approval in the UK, at last an oral contraceptive has been approved here for initiation and use without a doctor’s prescription. Desogestrel 75 μg daily, a progestogen-only pill (POP) available in the UK for over 20 years, will be available as a pharmacy medicine for use by women of all ages wishing to prevent pregnancy. While a few countries, like the Netherlands and New Zealand,2 have arrangements which allow women to obtain repeat supplies from pharmacies without a prescription, this will be the first time that women living in the industrialised world will be able to buy the pill without ever consulting a doctor.

It has taken a long time. The pill is arguably one of the most widely used drugs in the world and one of the most intensively researched. In the UK, where almost one in three women currently using contraception choose the OCP,3 there must be very few women of reproductive age who have …