The World Health Organization has expanded its list of recommended contraceptive options for women and men. This move aims to provide informed reproductive choices globally. According to the WHO, an estimated 164 million women seeking to delay or avoid pregnancy are not using contraception. This highlights significant access gaps worldwide. The new guidelines are designed to help countries broaden access to contraceptive methods supported by scientific evidence.
The WHO's new publication, 'WHO guidelines on expanding contraceptive options,' provides alternative ways of using existing contraceptive methods. For instance, combined oral contraceptive pills can now be taken continuously for up to one year or extended periods of six months. The guideline also supports the use of contraceptive implants for up to five years. This recommendation could significantly reduce replacement procedures, clinic visits, and associated costs.
The WHO has also recommended mifepristone as an additional emergency contraception option. This can be taken as soon as possible and within five days after unprotected sex. The recommendation is based on evidence supporting its safety and effectiveness. Mifepristone at doses ranging from 10 to 50 milligrams is likely to be as safe and effective as other established emergency contraceptive methods.
According to Dr. Pascale Allotey, Director of WHO's Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, contraception should not be treated as a one-size-fits-all intervention. Expanded contraceptive choices should consider convenience, invasiveness, behavior, reliability, and accessibility. This enables people to choose a method, change it when necessary, or discontinue its use freely.
The WHO guideline recommends against adding quinestrol-containing contraceptive pills to national family planning programs. This is due to limited evidence and reports of serious adverse events associated with the method. The organization is working to expand contraceptive choices for men, who currently have relatively few methods under their control, principally condoms, withdrawal, and vasectomy.
Despite the limited number of male-controlled methods, about 30 percent of couples globally rely on a male method. This underscores the potential importance of expanding options. Research by the WHO challenges assumptions about willingness to use male contraception, with more than 75 percent of surveyed couples saying they would consider it. Additionally, over 85 percent of women surveyed said they would trust their male partners to take responsibility for contraception.
The WHO has developed its first Target Product Profile to support the development of new male contraceptives. This outlines characteristics future methods should meet, including safety, effectiveness, acceptability, and affordability. Several hormonal and non-hormonal male contraceptive methods are currently being researched, with promising candidates in advanced clinical trials. This raises the possibility of new reversible male contraceptives becoming available soon.
Key points
- The WHO recommends mifepristone as an additional emergency contraception option.
- The guideline supports the use of contraceptive implants for up to five years.
- The WHO is working to expand contraceptive choices for men.
