New guidelines recommend longer-lasting implants, alternative emergency contraception as millions of women remain without access to family planning.
By Bunmi Yekini
The World Health Organization (WHO) has recommended an expanded range of contraceptive options, including longer-lasting implants and alternative emergency contraception, to improve access to family planning and give users greater control over reproductive health.
The recommendations, contained in new guidelines released on friday also support extended use of contraceptive pills and call for more research into new birth control methods for men.
WHO estimates that 164 million women who want to delay or avoid pregnancy are not using contraception, highlighting persistent gaps in access to family planning services.
Under the new guidelines, the agency recommends that combined oral contraceptive pills can be taken continuously for up to one year or for extended periods of up to six months, offering alternatives to the conventional monthly cycle.
It also recommends extending the use of contraceptive implants to five years, potentially reducing replacement procedures, clinic visits and associated costs.
For emergency contraception, WHO has recommended mifepristone, taken as soon as possible and within five days of unprotected sex, as an additional option. Evidence suggests that doses of 10 to 50 milligrams are likely to be as safe and effective as other emergency contraceptive methods.
Pascale Allotey, director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, said expanding contraceptive choices was also a gender equality issue.
“Contraception isn’t one-size-fits-all,” Allotey said, adding that people should have the freedom to choose, change or discontinue a method based on their needs and circumstances.
The guidelines also caution against introducing contraceptives with insufficient safety evidence into national family planning programmes.
WHO called for further research into ormeloxifene, citing limited safety evidence, and recommended against including quinestrol-containing contraceptive pills in national programmes because of inadequate evidence and reports of serious adverse effects.
Beyond existing methods, the agency is also pushing for the development of new male contraceptives, noting that men currently have relatively few options, mainly condoms, withdrawal and vasectomy.
Despite the limited choices, about 30% of couples worldwide rely on male contraceptive methods, according to WHO.
The agency cited a study across four low- and middle-income countries which found that more than 75% of couples surveyed were willing to use a new male contraceptive, while over 85% of women said they would trust their partners to take responsibility for contraception.
To support the development of new products, WHO has introduced its first Target Product Profile for male contraceptives, outlining the safety, effectiveness, affordability and acceptability standards that future methods should meet.
Several hormonal and non-hormonal male contraceptives are already in development, with some advanced candidates undergoing clinical trials. WHO said reversible male contraceptives could reach the market within the next five to 10 years.
The agency said the new guidelines would help countries update their family planning policies and programmes in line with the latest scientific evidence.