The World Health Organization (WHO) has updated its guidelines to include mifepristone as an emergency contraceptive option for preventing pregnancy after unprotected sex. This recommendation is part of the WHO's new Guidelines on Expanding Contraceptive Options, which aims to increase access to contraceptive methods supported by scientific evidence. Mifepristone is advised for use as soon as possible and within five days of the sexual encounter.
The recommended dosage of mifepristone for emergency contraception ranges from 10mg to 50mg, which is likely to be as safe and effective as other emergency contraceptive methods. This new guideline expands the options available for emergency contraception, providing individuals with more choices for preventing unintended pregnancies. The WHO emphasizes that mifepristone is specifically recommended for emergency contraception, rather than routine contraceptive use.
The updated guidance also expands the recommended use of some existing contraceptive methods. For instance, combined oral contraceptive pills can now be taken for extended periods of up to six months or continuously for up to one year, rather than being used only in cycles. Additionally, the WHO supports the use of contraceptive implants for up to five years, which could reduce the need for replacement procedures, clinic visits, and related costs.
According to the WHO, an estimated 164 million women who want to delay or avoid pregnancy are currently not using contraception, highlighting the need to expand access to contraceptive options. The organization's Director of the Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, Dr. Pascale Allotey, emphasizes that contraceptive choice is a gender equality issue. She notes that men and women both need a range of options that reflect what science and innovation can offer.
The WHO also acknowledges that evidence remains insufficient for some other contraceptive methods, such as ormeloxifene, and calls for further research before they are considered for inclusion in family planning programs. In contrast, the organization recommends against including quinestrol-containing contraceptive pills in national contraceptive programs due to limited evidence and reports of serious adverse events.
The new guidance also addresses the limited range of contraceptive methods available to men. Currently, men have relatively few contraceptive options under their control, mainly condoms, withdrawal, and vasectomy. However, about 30% of couples rely on a male contraceptive method, and more than 75% of couples surveyed would be willing to use a new male contraceptive.
To support the development of additional male contraceptive options, the WHO has created its first Target Product Profile for male contraceptive methods. Several hormonal and non-hormonal male contraceptives are currently under research, with several candidates in advanced clinical trials. The WHO estimates that new reversible male contraceptives could become available within the next five to 10 years.
Key points
- WHO recommends mifepristone for emergency contraception within five days of unprotected sex
- Updated guidelines expand use of existing contraceptive methods, including combined oral contraceptive pills and implants
- WHO calls for further research on certain contraceptive methods, including ormeloxifene
