Health
WHO recommends mifepristone to prevent pregnancy after unprotected sex
Iyanuoluwa Abiola
The World Health Organisation has recommended mifepristone as an additional emergency contraceptive option for preventing pregnancy after unprotected sex, saying it should be taken as soon as possible and within five days of the sexual encounter.
The recommendation is contained in the WHO’s new Guidelines on Expanding Contraceptive Options, released on Wednesday to help countries broaden access to contraceptive methods supported by the best available evidence.
Mifepristone is a medicine that WHO is recommending specifically for emergency contraception, which refers to methods used after unprotected sex to prevent pregnancy. At doses of 10mg to 50mg, mifepristone is likely to be as safe and effective as other emergency contraceptive methods, the organisation stated.
The recommendation is for emergency use after unprotected sex and not for routine contraceptive use, with WHO advising that mifepristone be taken as soon as possible and within five days.
The new guideline also recommends alternative ways of using some existing contraceptive methods, including allowing combined oral contraceptive pills to be taken for extended periods of up to six months or continuously for up to one year, instead of cyclical use.
It further supports the use of contraceptive implants for up to five years, potentially reducing the need for replacement procedures, clinic visits and associated costs, according to WHO.
The expanded recommendations are intended to give people a wider range of contraceptive choices and enable them to make informed decisions about whether to use contraception, which method is right for them, and when to change or stop using it, the organisation noted.
An estimated 164 million women who want to delay or avoid pregnancy are not using contraception, underscoring the need for better and expanded access to contraceptive methods, WHO disclosed.
The Director of the WHO Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, Dr Pascale Allotey, described contraceptive choice as a gender equality issue.
“Contraception isn’t one-size-fits-all. Men and women both need a range of options that reflect what science and innovation can now offer, weighed against convenience, invasiveness, behaviour, reliability and accessibility,” Allotey stated.
“Real choice means the confidence and control to choose a method, change it, or stop it,” she added.
However, while WHO has recommended mifepristone based on the available evidence, it said more research was needed on some other contraceptive methods before they could be included in family planning programmes.
The organisation called for more research on ormeloxifene before its inclusion in family planning programmes because current evidence on its safety is limited.
It also recommended against adding quinestrol-containing contraceptive pills to national contraceptive programmes because of limited evidence and reports of serious adverse events.
Meanwhile, WHO is working to broaden contraceptive choices available to men, who currently have relatively few methods under their control, principally condoms, withdrawal and vasectomy.
Despite the limited options, around 30 per cent of couples rely on a male method, the organisation noted.
More than 75 per cent of couples surveyed said they would be willing to use a new male contraceptive, while more than 85 per cent of women said they would trust their male partners to take responsibility for contraception, according to WHO.
To help develop new options, WHO has developed its first Target Product Profile for male contraceptive methods, outlining characteristics future methods should meet, including safety, effectiveness, acceptability and affordability.
Several hormonal and non-hormonal male contraceptive methods are being researched, with several promising candidates in advanced clinical trials, the organisation stated.
WHO said new reversible male contraceptives could become available within the next five to 10 years.
The organisation said the new guideline would support countries in updating their family planning policies and plans based on the best available scientific evidence.
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