Hormonal Contraception: New long-acting methods

 Before the year 2000 women around the world may have up to 5 new family planning methods to choose from.  All will be very effective, convenient to use, and long-acting -- from 1 month to 5 years.  All use a progestin, a type of female hormone that is also used in birth control pills.  Norplant implants which have already been approved in 7 countries, are placed just under the skin on the inside of a woman's arm.  6 capsules release the progestin levonorgestrel at a slow, steady rate.  For 5 years they prevent nearly all pregnancies.  Biodegradable implants also are placed under the skin, but they eventually dissolve and disappear.  Injectable microspheres and microcapsules, suspended in a solution, are given with a hypodermic needle.  The tiny particles of different sizes, consisting of hormone in a polymer carrier, dissolve and release hormone at various rates, providing a nearly constant dose that prevents pregnancy for 1 to 6 months.  Monthly injectables add an estrogen to a progestin to minimize menstrual changes.  The vaginal ring is placed by the woman in her vagina, where it gradually releases hormone.  When new long-acting methods become available, marketing and program development are essential.  Production must be arranged; providers trained; logistics systems in place; and supplies available.  The media, the health care professions, and other opinion leaders must be thoroughly briefed in advance.  Couples must learn about the new methods.  If these are properly introduced and made continuously available, there will soon be a much broader choice of contraceptives for women.  Effective, reversible, long-acting hormonal contraception will be available for nearly every couple, whatever their plans and needs.

Johns Hopkins Bloomberg School of Public Health,Center for Communication Programs,Population Information Program