Over‐the‐Counter Provision of Oral Contraceptive Pills for Patients With Dysmenorrhea, Suspected or Confirmed Endometriosis or Chronic Pelvic Pain: A Systematic Review and Evidence Gaps

ABSTRACT Objective To evaluate the effectiveness, values and preferences, and cost associated with over‐the‐counter oral contraceptive pills for self‐managing dysmenorrhea, including symptoms related to suspected or confirmed endometriosis or chronic pelvic pain. Methods Comprehensive searches of peer‐reviewed and grey literature were conducted across multiple databases (PubMed, CINAHL, LILACS and EMBASE) from inception through to April 2025 and screened using predefined eligibility criteria. Results No eligible studies were identified. We found no evidence evaluating the effectiveness, values and preferences, or cost of over‐the‐counter oral contraceptive pills compared to standard of care for managing dysmenorrhea. Conclusion The absence of evidence highlights an important research gap in the use of self‐management strategies for dysmenorrhea. Future studies could evaluate comparative outcomes, implementation models, and preferences of women affected by dysmenorrhea, including in low‐ and middle‐income settings and among underserved communities. A phased approach, such as pharmacist‐led over‐the‐counter access, could address current access barriers while providing critical data to guide future policy decisions. PROSPERO Registration Number CRD42024616792.