WHO Broadens Contraceptive Options, Recommends More Choices for Women and Men.
Geneva:
The World Health Organization (WHO) has issued new guidance aimed at expanding access to safe and effective contraceptive methods, giving people more options to choose, change or discontinue contraception according to their individual needs.
The new publication, “WHO guidelines on expanding contraceptive options,” comes as an estimated 164 million women who want to delay or avoid pregnancy are not currently using contraception, highlighting the continuing need for wider access to family-planning services and a broader range of methods.
WHO said the guidelines are intended to help countries expand contraceptive programmes based on the best available scientific evidence and ensure people can make informed decisions about whether to use contraception and which method is most appropriate for them.
Wider Use of Existing Contraceptive Methods
The updated recommendations include alternative ways of using some existing contraceptive methods.
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, providing alternatives to traditional cyclical use.
The organization also supports the use of contraceptive implants for up to five years. Longer use could reduce the need for replacement procedures, repeated clinic visits and associated costs for users.
For emergency contraception, WHO recommends mifepristone as an additional option. It should be taken as soon as possible and within five days of unprotected sex. According to WHO, available evidence indicates that mifepristone at doses of 10–50 milligrams is 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.
Allotey said contraception is not a “one-size-fits-all” issue and that people need a range of options that take into account factors including convenience, invasiveness, behaviour, reliability and accessibility.
WHO Flags Methods Where Evidence Remains Limited
While expanding available choices, WHO also emphasized the importance of distinguishing between methods supported by sufficient evidence and those that require further research.
The organization has called for additional research on ormeloxifene before it is included in family-planning programmes, citing limited evidence on its safety.
WHO also recommends against adding quinestrol-containing contraceptive pills to national contraceptive programmes, because of limited evidence and reports of serious adverse events.
The recommendations reflect WHO’s effort to ensure that expanded contraceptive access is based not only on increasing the number of available methods but also on evidence concerning their safety and effectiveness.
Focus Shifts Toward Male Contraception
The new guidance also highlights the need to expand contraceptive options controlled by men.
At present, men have relatively few contraceptive methods under their direct control, principally condoms, withdrawal and vasectomy. Despite the limited range, WHO estimates that around 30% of couples rely on a male contraceptive method.
WHO research challenges the long-standing assumption that men would not be interested in new contraceptive options. More than 75% of couples surveyed said they would be willing to use a new male contraceptive, while more than 85% of women surveyed said they would trust their male partners to take responsibility for contraception.
New WHO Framework for Future Male Contraceptives
To encourage the development of new products, WHO has developed its first Target Product Profile for male contraceptive methods.
The framework outlines characteristics that future male contraceptives should aim to meet, including safety, effectiveness, acceptability and affordability. WHO said the profile is intended to give researchers, funders and product developers clearer direction while helping shape a market around the needs and preferences of users.
Several hormonal and non-hormonal male contraceptive methods are currently being researched, with a number of promising candidates in advanced clinical trials.
WHO said this research raises the possibility that new reversible male contraceptives could reach the market within the next five to 10 years, although their availability will depend on successful clinical development, regulatory review and other factors.
Expanding Access Through Evidence-Based Policies
WHO said the broader goal is to support countries in updating their family-planning policies and programmes using the best available scientific evidence.
The organization emphasized that expanding contraceptive choice is not simply about introducing new products. It also involves ensuring that people have accurate information, access to appropriate services and the freedom to choose whether to use contraception, which method to use, and when to change or stop it.
The new recommendations therefore combine updated guidance on existing contraceptive methods with efforts to encourage the development of future options, including reversible methods for men.
