The World Health Organization has published new guidance widening the range of recommended contraceptive options, including longer use of some existing methods, the addition of mifepristone for emergency contraception and steps to accelerate development of male contraceptives, the WHO said in its guideline document reported by Premium Times.
The document, titled “WHO guidelines on expanding contraceptive options”, endorses taking combined oral contraceptive pills for extended periods, allowing use for up to six months or continuous use for as long as one year rather than the conventional cyclical schedule, the guidance says. The organisation also supports using contraceptive implants for up to five years to reduce replacement procedures and clinic visits.
WHO added mifepristone to the list of emergency contraceptive options. The organisation advised the drug should be taken as soon as possible and within five days of unprotected sex, and said available evidence indicates mifepristone at doses of 10 to 50 milligrams is likely to be as safe and effective as other emergency contraceptives.
The guidance includes a global estimate that 164 million women who want to delay or avoid pregnancy are not currently using contraception. WHO said expanding method choice is necessary so people can better decide whether to use contraception, which method to use and when to change or stop a method.
Pascale Allotey, director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, was quoted in Premium Times stressing that contraception should reflect people’s differing needs and circumstances. Ms Allotey said method choice should consider convenience, invasiveness, behaviour, reliability and accessibility, and added, “Choice is a gender equality issue,” noting contraception was not “one-size-fits-all”.
The WHO said it found insufficient evidence to include some products in national programmes. It called for more research into ormeloxifene before including it in family planning services, citing limited safety data, and recommended against adding quinestrol-containing contraceptive pills because of limited evidence and reports of serious adverse events.
WHO also urged greater development of male contraceptives. It noted that currently condoms, withdrawal and vasectomy are the main male-controlled methods and that about 30 per cent of couples rely on a male method. Citing survey results, WHO said more than 75 per cent of couples would be willing to use a new male contraceptive and more than 85 per cent of women would trust their male partners to take responsibility for contraception.
To guide research and product development, WHO has produced its first Target Product Profile for male contraceptives, listing desired characteristics such as safety, effectiveness, acceptability and affordability. The organisation said several hormonal and non-hormonal male contraceptive candidates are in development, some in advanced clinical trials, and that reversible male methods could reach the market within five to 10 years. WHO said it will continue supporting countries to update policies and family planning programmes in line with scientific evidence.
(Reporting is based on coverage of the WHO guidance by Premium Times.)
Featured image: Yann Forget via Wikimedia Commons, CC BY-SA 3.0.
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