Melissa May, Population Council

Table of Contents

• Summary
• Credits

1. The Long Road of Contraceptive Development
2. Vaginal Rings
3. Transdermal Contraception
4. Contraceptive Implants
5. Combined Injectables
6. Condoms
7. Fertility Awareness-Based Methods
8. Oral Contraceptives
9. Intrauterine Devices
10. Transcervical Female Sterilization
11. Male Hormonal Contraception
12. Bibliography
13. Web Supplements

• Clinical trials assess effectiveness and safety of new contraceptives
• New low-dose DMPA formulation
• More long-term choices for men

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New Contraceptive Choices

Family planning users and providers have been calling for more choices. They want contraceptive methods that provide highly effective protection and at the same time cause fewer side effects, cost less, and are easier to use. In response, researchers are improving existing contraceptives and developing new ways to deliver hormones.

Offering a wide range of safe, effective, and convenient family planning methods encourages more people to use contraception. Having more choices helps ensure that users are satisfied with their family planning method. Most new methods reaching the market today result from investments made years ago. Virtually all methods undergo a long process of research and rigorous testing for safety and effectiveness and must obtain regulatory approvals before becoming available.

This report focuses on selected innovations in contraceptives that are more effective, have fewer side effects, are less costly to manufacture, and are easier to deliver than many current options. A few of the new contraceptives discussed in this report are already available in some countries, others are on the brink of introduction, and still others are several years away from reaching the market. Among the improved contraceptives that have recently become available or are under development are the following:

Vaginal rings. Vaginal rings are a new way to deliver contraceptive hormones to the bloodstream. They are controlled by the user. Rings are easier to use correctly than oral contraceptives (OCs). Combined estrogen and progestin rings contain lower doses of hormones and cause fewer bleeding disturbances than combined OCs.

Transdermal patches. The contraceptive patch works by slowly releasing a combination of progestin and estrogen through the skin. The patch is safe, highly effective at preventing pregnancy, controlled by the user, and requires attention just once a week.

Implants. New research on implants has focused on different progestins that make it possible to reduce the number of rods or capsules from six to one or two. Also, the new implants produce fewer bleeding disturbances and ensure safety for use while breastfeeding.

Combined injectables. Combined injectables, compared with progestin-only injectables, disturb vaginal bleeding patterns less and allow earlier return to ovulation after women discontinue their use. Most combined injectables are injected once a month compared with once every two or three months for progestin-only injectables.

Condoms. New male condoms are being developed from nonlatex materials, while new female condoms are being developed in latex. Manufacturing condoms in different materials will expand variety, reduce cost, avoid allergic reactions, and so encourage condom use.

Fertility awareness-based methods. Two new fertility awareness-based family planning approaches—the Standard Days Method and the TwoDay Method—simplify older fertility awareness-based methods, making it easier for couples to track the woman’s fertile days and know when to avoid unprotected sexual intercourse.

Oral contraceptives. Pharmaceutical companies are introducing new hormonal formulations of OCs designed to reduce side effects, and thus encourage continuation.

IUDs. New IUDs in development contain hormones or are frameless. They may make insertion and removal easier and reduce expulsion, pain, and bleeding—innovations that could lead to greater acceptability and use.

Transcervical sterilization. Transcervical methods for women are nonsurgical. They result in contraceptive protection comparable to surgical sterilization but are safer and easier to provide. They reach the fallopian tubes through the vagina and uterus.

Male hormonal contraceptives. Hormonal contraception for men that could be as effective as OCs for women is in the clinical trial stages of development. Male hormonal contraception would offer men a reversible and convenient method to control their fertility.

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