New guidelines from the World Health Organisation aim to help countries broaden access to contraception methods supported by the best available evidence, the agency has said.
From emergency contraception to longer-lasting implants and future contraceptives for men, the agency – with its new publication – offers a range of options so people can choose what best meets their needs.
Around 164m women who actually want to delay or avoid pregnancy are not using contraception, underscoring the urgent need for better and expanded access to contraceptives.
The WHO recommends that combined oral contraceptive pills can be taken for extended periods of up to six months or continuously for up to one year, as alternatives to cyclical use. It also supports the use of contraceptive implants for up to five years, potentially reducing the need for replacement procedures, clinic visits and associated costs.
Mifepristone is recommended as an additional emergency contraception option, taken as soon as possible and within five days of unprotected sex, with evidence showing that doses of 10mg-50mg are likely to be as safe and effective as other emergency contraceptive methods.
“Choice is a gender equality issue,” said Pascale Allotey, director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing.
“Contraception isn’t one-size-fits-all. Men and women both need a range of options reflecting what science and innovation can now offer, weighed against convenience, invasiveness, behaviour, reliability and accessibility. Real choice means the confidence and control to choose a method, change it, or stop it.”
Expanding access also means being clear about which methods are not yet supported by sufficient evidence, and the WHO has called for more research on ormeloxifene before inclusion in family planning programmes – because the current evidence on safety is limited.
The new guideline further recommends against adding quinestrol-containing contraceptive pills to national contraceptive programmes, due to limited evidence and reports of serious adverse events.
The agency is also working to broaden the range of choices available in the future. Today, men have relatively few methods under their control – principally condoms, withdrawal and vasectomy. Yet even with those limited choices, around 30% of couples rely on a male method.
Its research challenges a long-standing assumption that men would not use new contraceptives. More than 75% of couples surveyed said they would be willing to use a new male contraceptive, while more than 85% of women said they would trust their male partners to take responsibility for birth control.
To help turn that demand into new products, the WHO has developed its first Target Product Profile for male contraceptive methods, setting out the characteristics future methods should aim to meet, including safety, effectiveness, acceptability and affordability.
Several hormonal and non-hormonal male methods are being researched, and some promising candidates are in advanced clinical trials, suggesting that new reversible male contraceptives may be in the market within the next five-10 years.
The global study on male contraception was published in the journal Contraception.
See more from MedicalBrief archives:
Future of male contraception under spotlight at French congress
Male birth control gel shows promise in US trial