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  • Title: [Future prospects in contraception].
    Author: Rabe T, Grunwald K, Runnebaum B.
    Journal: Arch Gynecol Obstet; 1995; 257(1-4):541-7. PubMed ID: 8579440.
    Abstract:
    Only 40% of the 1.2 billion couples in reproductive age have access to effective contraceptive methods, although only $3.0 per couple per year would suffice for contraception worldwide. Abortions are performed for 40-60 million women annually. More than 200,000 women die as a result of abortions, and another 500,000 die due to labor complications. Contraception for women comprises the following: 1) agents that prevent ovulation; prolonged breast feeding (98% safe contraception within the first 6 months); oral contraceptives containing estrogens and gestagens (60-80 million women use them worldwide; in 1968 the 50 g estrogen containing pill, in 1972 the micropill with 30 g of ethinyl estradiol [EE], and in 1992 the ultra-low-dose pill with 20 g of EE were introduced); and future developments (third generation progestagens, antigestagens, nonsteroidal natural substances, melatonin, the combination of gonadotropin-releasing hormone analogs and natural estrogens); 2) prevention of fertilization: mechanical methods (diaphragm, sterilization methods by laparoscopy or chemical means); chemical methods (spermicides such as nonoxynol); behavioral methods (temperature methods using refined measurement of the body temperature, cervical mucus resistance); hormonal methods (implants such as Norplant containing levonorgestrel [LNG], Implanon containing 3-ketodesogestrel, the vaginal ring [the WHO-ring and the Organon ring], the minipill with pure gestagen, one-month injection with Cyclofem), IUDs (copper-containing IUDs, LNG-containing IUDs with a Pearl Index of 0.2-0.5 and reduction of dysmenorrhea); and immunological contraception (ovum and spermatozoon antigens); 3) the prevention of implantation: hormonal methods (the morning-after pill with high-dose EE or the combination of estrogen and gestagen); insertion of an IUD up to the 6th day after coitus; immunological methods (human chorionic gonadotropin antibodies, antibodies against the zona pellucida glycoproteins, implantation inhibition through interaction with interleukin IL-1 receptor, and antibodies against specific proteins of the endometrium influencing implantation). Contraception for men consist of the condom, vasectomy, coitus interruptus, and medical inhibition of spermiogenesis (testosterone ester and gossypol).
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