Buying medicines online, when you already have a prescription, has certainly become easier and more commonplace.

But a few websites are now offering both online prescriptions for and the delivery of the oral contraceptive pill (‘the pill’) — without an in-person doctor consultation.

You log on, answer a few questions about your health, and are assessed by a doctor remotely. Your pill is then delivered to your door.

Sounds simple enough, but is it safe?

Experts warn against online prescriptions

The Royal Australian College of General Practitioners (RACGP) is very concerned about “online business models that are seeking to prescribe online without seeing or knowing patients,” says RACGP President Dr Harry Nespolon. “[They] could be putting financial gains ahead of patient care and safety.”

There’s more to getting a prescription for the pill than showing up at a doctor’s office.

“Prescribing the oral contraceptive pill for the first time is complicated — it’s not ‘just a simple prescription’. A doctor needs to have a conversation with their patient to work out what the right type of contraceptive is for them,” says Dr Nespolon. “If a patient doesn’t get the opportunity to have this discussion with a GP they might not end up with the best form of contraceptive… and could put their health at risk.”

Why should you see a doctor in person to get the pill?

“If a patient sees their GP to discuss contraceptives, it’s also an opportunity to discuss a range of other sexual health issues, in a confidential and non-judgmental environment, which they otherwise miss out on,” says Dr Nespolon.

Dr Kerryn Rae, a GP and spokesperson for Jean Hailes for Women’s Health, agrees that women should see their doctor for a prescription, if possible. “The risks of online prescribing are concerns around safety of the OCP [oral contraceptive pill] for an individual woman, whether the woman is taking her OCP correctly, whether there have been any missed pills or whether she is having any problems with the OCP such as unscheduled bleeding,” explains Dr Rae.

“Blood pressure needs to be monitored. Sexually transmitted infection (STIs) education and screening and cervical screening should be performed as appropriate. The contraceptive method or OCP may need be changed due to side effects, compliance, reliability or cost.

“This is unable to be done online,” says Dr Rae.

Your GP might also talk to you about mental health and whether you’re planning a pregnancy in the future. They might ask if you would consider a different, more effective form of contraception such as a contraceptive implant or intra-uterine device (IUD).

Is it ever OK to get an online prescription for the pill?

Dr Rae believes it’s important for women to establish a relationship with a medical practitioner during their reproductive years. But if a woman needs a repeat prescription for her contraceptive pill, her health and STI screening is up to date and she has no concerns about her OCP, says Dr Rae, it may be appropriate to get repeat prescription online.

“It may also be appropriate if a woman is in a remote area without easy access to health services, or if she is away from home and lost her prescription or medication,” says Dr Rae.

Are there risks associated with the contraceptive pill?

The oral contraceptive pill is safe for most women and when taken correctly it is very effective. But like any medicine, it comes with risks and contraindications. Some women may be advised to use another form of contraception.

While it’s rare, the pill is associated with an increased risk of blood clots and stroke. It may not be suitable for women with hypertension, diabetes, certain heart diseases, migraine, a history of blood clotting, liver problems or unusual vaginal bleeding. Smoking can increase the risk of any harmful effects of the pill.

Less serious side effects can include tender breasts, nausea, headaches and weight gain. Of course, the contraceptive pill doesn’t protect against STIs.

If you’re considering the pill, it’s important to discuss these issues with your GP.

Tips for safer prescriptions

Whether it’s the pill or painkillers, statins or SSRIs, you have the right to ask your doctor or pharmacist questions about your prescription. For example:

• What side effects should I be aware of?
• What are the benefits of this medicine?
• What are the alternatives to this medicine?
• Are there treatment options besides medicine?
• What happens if I don’t have this medicine?
• How long will I need to have this medicine?
• What should I do if I have a problem with this medicine?