The value and use of different contraceptive methods

Abstract

Reductions in the rates of maternal and child mortality as well as in demographic growth are directly linked to contraceptive usage. The development and availability of safer, improved contraceptives which are convenient to use could be expected to be used by a larger group of individuals and thus make an impact on reproductive health as well as on population growth rates. Such arguments have been used to support contraceptive research. This article deals with some of the developments that have occurred as a consequence of such efforts.

PIP: Considerable research and development have been done to find new contraceptive modalities. Due to limited reproductive physiological events, however, few points of intervention exist. We have several decades of experience with barrier methods, sterilization, and steroidal contraceptives which disrupt the hypothalamo-hypophysio-gonadal axis and the local endometrial level. These methods are rather reliable. The newer synthetic steroids and drug delivery systems are not associated with the adverse side effects of the older generation of hormonal contraceptives. Developments in the synthesis of newer steroids may further reduce the adverse effects linked to today's generation of compounds. Contraceptive vaccines appear to provide as effective protection against pregnancy and to be more convenient than hormonal contraceptives. They do not induce a uniform response, however. Polyvaccines may overcome this. The emphasis on effecting complete azoospermia hinders development of male contraceptives. Intranasal administration of norethisterone and the FSH vaccine impair sperm function, and thus might be acceptable male contraceptives. Developed nations have been able to voluntarily limit family size and, in some cases, even achieve a negative growth rate with existing contraceptives. Economic development, adult literacy, and child welfare programs have also contributed to the decline in the birth rate. Considerable time is needed in developing countries to achieve the same state of economic development and optimal growth rates as those in developed countries. If population growth rates are not restrained in developing countries, abject poverty will be further entrenched. We really need to find newer, more safe and convenient contraception with fewer side effects. Thus, contraception research and development must continue with increased vitality. Such research often finds important medical uses for experimental contraceptives (e.g., contraceptive vaccines treat some types of cancer).