WHO expands contraceptive options for women, men

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The World Health Organization has recommended a wider range of safe and effective contraceptive options, including emergency contraception, longer-lasting implants and potential future methods for men, to expand informed reproductive choices globally.

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WHO said in a statement on Wednesday that the expanded options were needed because an estimated 164 million women seeking to delay or avoid pregnancy were not using contraception, highlighting access gaps worldwide.

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“The new publication, ‘WHO guidelines on expanding contraceptive options,’ is designed to help countries broaden access to contraceptive methods supported by the best available scientific evidence and enable informed choices globally.

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“The guideline provides alternative ways of using existing contraceptive methods, including allowing combined oral contraceptive pills to be taken continuously for up to one year or extended periods of six months.”

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According to WHO, the guideline also supports the use of contraceptive implants for up to five years, a recommendation that could significantly reduce replacement procedures, clinic visits and associated costs.

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“For emergency contraception, WHO recommends mifepristone as an additional option, to be taken as soon as possible and within five days after unprotected sex, based on evidence supporting safety and effectiveness.

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“Mifepristone at doses ranging from 10 to 50 milligrams is likely to be as safe and effective as other established emergency contraceptive methods when used for emergency contraception,” it said.

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WHO quoted Dr Pascale Allotey, Director of its Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, as saying that contraception should not be treated as a one-size-fits-all intervention.

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According to Allotey, expanded contraceptive choices should consider convenience, invasiveness, behaviour, reliability and accessibility, enabling people to choose a method, change it when necessary or discontinue its use freely.

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“Expanding contraceptive options also requires identifying methods for which available evidence remains insufficient, noting that further research is needed on the safety of ormeloxifene.

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“The guideline recommends against adding quinestrol-containing contraceptive pills to national family planning programmes, citing limited evidence and reports of serious adverse events associated with the method.

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“Beyond existing methods, WHO is working to expand contraceptive choices for men, who currently have relatively few methods under their control, principally condoms, withdrawal and vasectomy.

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“In spite of the limited number of male-controlled methods, WHO noted that about 30 per cent of couples globally rely on a male method, underscoring the potential importance of expanding options.”

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According to the statement, WHO research also challenges assumptions about willingness to use male contraception, with more than 75 per cent of surveyed couples saying they would consider it.

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“More than 85 per cent of women surveyed said they would trust their male partners to take responsibility for contraception, according to findings from a cross-sectional study conducted globally.

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“To support development of new male contraceptives, WHO has developed its first Target Product Profile, outlining characteristics future methods should meet, including safety, effectiveness, acceptability and affordability,” it said.

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According to WHO, the product profile would provide researchers, funders and developers with clearer direction while supporting the development of a contraceptive market reflecting people’s needs and preferences.

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“Several hormonal and non-hormonal male contraceptive methods are currently being researched, with promising candidates in advanced clinical trials, raising the possibility of new reversible male contraceptives becoming available soon.

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“We will continue supporting countries to update their policies and family planning programmes in line with the best available scientific evidence and expanded contraceptive options,” WHO said.

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