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Over-the-counter oral contraceptive use among women in Mexico: results from a national survey
  1. Kate Grindlay1,
  2. Alexandra Wollum1,
  3. Jonathan Karver2,
  4. Daniel Grossman3
  1. 1Ibis Reproductive Health, Cambridge, Massachusetts, USA
  2. 2Poverty & Equity Global Practice, The World Bank, Washington, District of Columbia, USA
  3. 3Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California, USA
  1. Correspondence to Dr Daniel Grossman, Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, Oakland, CA 94612, USA; Daniel.Grossman{at}


Aim In Mexico, many pharmacies sell oral contraceptives (OCs) over the counter (OTC); however, little is known about the background characteristics of OTC pill users. The primary objective of this study was to understand the characteristics of OTC OC users in Mexico, including whether there were differences by age, urbanicity, and insurance status. This information is instructive as other countries explore allowing OTC access to OCs.

Methods We analysed the nationally representative 2014 Mexican National Survey of Demographic Dynamics (ENADID) among a sample of OC users aged 15–54 years (n=1970). We performed multivariable logistic models to understand the characteristics associated with OTC access, with age, urbanicity, and insurance status as our primary predictors of interest. Additionally, we descriptively explored knowledge of how frequently to take OCs by pill source and age.

Results Some 54% of pill users, including 66% of those aged 15–17 years, obtained their OCs OTC. In multivariable regression we found no differences in OTC access by age. However, being uninsured (adjusted odds ratio (AOR) 1.86, 95% CI 1.23 to 2.82) (compared with employer-based public insurance) and living in an urban area (AOR 4.73, 95% CI 3.37 to 6.66) (compared with rural area) were associated with a higher odds of OTC access among pill users. Women’s knowledge of how frequently to take OCs was similar between OTC and prescription users within age groups.

Conclusions These findings point to the importance of OTC availability of OCs for pill users of all ages and uninsured and urban women in Mexico in particular.

  • contraceptives
  • oral
  • adolescent
  • hormonal contraception
  • health policy

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  • Contributors All authors contributed to the planning of the study. AW and JK coded and analysed the data. KG and AW drafted the manuscript. All authors contributed to the review and revising of the manuscript.

  • Funding This study was funded by a grant from The David and Lucile Packard Foundation.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. The data for this analysis are available here:

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