Abstract
Steady progress in contraception research has been achieved over the past 50 years.
Hormonal and nonhormonal modern contraceptives have improved women's lives by reducing
different health conditions that contributed to considerable morbidity. However, the
contraceptives available today are not suitable to all users, and the need to expand
contraceptive choices still exists. Novel products such as new implants, contraceptive
vaginal rings, transdermal patches and newer combinations of oral contraceptives have
recently been introduced in family planning programs, and hormonal contraception is
widely used for spacing and limiting births. Concerns over the adverse effects of
hormonal contraceptives have led to research and development of new combinations with
improved metabolic profile. Recent developments include use of natural compounds such
as estradiol and estradiol valerate with the hope to decrease thrombotic risk, in
combination with newer progestins derived from the progesterone structure or from
spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and
progesterone receptor modulators are highly effective in blocking ovulation and preventing
follicular rupture and are undergoing investigations in the form of oral pills and
in semi-long-acting delivery systems. Future developments also include the combination
of a contraceptive with an antiretroviral agent for dual contraception and protection
against sexually transmitted diseases, to be used before intercourse or on demand,
as well as for continuous use in dual-protection rings. Although clinical trials of
male contraception have reflected promising results, limited involvement of industry
in that area of research has decreased the likelihood of having a male method available
in the current decade. Development of nonhormonal methods is still at an early stage
of research, with the identification of specific targets within the reproductive system
in ovaries and testes, as well as interactions between spermatozoa and ova. It is
hoped that the introduction of new methods with additional health benefits would help
women and couples with unmet needs to obtain access to a wider range of contraceptives
with improved acceptability.
Keywords
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Article info
Publication history
Published online: September 19, 2012
Accepted:
August 6,
2012
Received:
July 31,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
