Contraception has evolved significantly over the past few decades, with newer methods offering improved efficacy, fewer side effects, and greater convenience. This article describes the most recent advancements in contraception.

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Contraception: Most recent advancements

Here's an overview of some of the most recent advancements in contraception:

1. Long-Acting Reversible Contraceptives (LARCs)

1. Hormonal IUDs (e.g., Mirena, Kyleena)

• Releases levonorgestrel, a type of progestin.
• Effective for 3-7 year
• Reduces menstrual bleeding and cramping

2. Copper IUDs (e.g., ParaGard)

• Non-hormonal uses copper to create an inhospitable environment for sperm.
• Effective for up to 10 years.
• It can increase menstrual bleeding and cramping initially.

3. Contraceptive Implants (e.g., Nexplanon)

• A small rod is inserted under the skin of the upper arm, releasing etonogestrel.
• Effective for up to 3 years.
• Can cause irregular bleeding.

2. Hormonal contraceptives

1. Contraceptive patch (e.g., Xulane, Twirla)

• A patch is worn on the skin that releases estrogen and progestin.
• Changed weekly for three weeks, with a patch-free week.
• Effective and convenient, but can cause skin irritation.

2. Vaginal ring (e.g., NuvaRing, Annovera)

• A flexible ring is inserted into the vagina, releasing estrogen and progestin.
• NuvaRing is used monthly, and Annovera is used for a year. (three weeks in, one week out)
• Offers steady hormone release, reducing side effects.

3. Progestin-only options

Suitable for those who cannot use estrogen.

1. Progestin-Only Pills (POPs)

• Also known as the "mini-pill"
• It must be taken at the same time every day.
• Lower risk of blood clots compared to combined pills.

2. Progestin-only Injection (e.g., Depo-Provera)

• An injection is given every three months
• Highly effective, but can cause weight gain and bone density loss with long-term use

4. Non-hormonal methods

For those who prefer to avoid hormones.

1. Phexxi

• A vaginal gel containing lactic acid, citric acid, and potassium bitartrate
• Used before intercourse to maintain an acidic vaginal environment, reducing sperm motility
• Offers an on-demand, hormone-free option

5. Emergency contraception

Used in the event of unprotected sex or contraceptive failure to avoid pregnancy.

1. Levonorgestrel pills (e.g., Plan B One-Step)

• Effective if taken within 72 hours of unprotected sex
• Available over-the-counter

2. Ulipristal acetate (e.g., Ella)

• Effective if taken within 120 hours of unprotected sex
•  Requires a prescription

3. Copper IUD

• It can be inserted up to five days after unprotected sex
• Offers long-term contraception post-insertion

6. Male contraception

New methods are being researched to provide more options for men.

1. Vasalgel

• A polymer gel is injected into the vas deferens, blocking sperm.
• Reversible with another injection to dissolve the gel.
• Currently in clinical trials.

2. Hormonal methods

• Research is ongoing for a male contraceptive pill or injection that combines testosterone and progestin to reduce sperm production.
• Aim to offer a reversible and reliable option for men.

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Considerations for choosing contraception

1. Efficacy: Higher efficacy methods like LARCs are preferred for those seeking long-term protection. 
2. Side effects: Hormonal methods may cause side effects like weight gain, mood changes, and menstrual irregularities.
3. Convenience: Methods requiring less frequent attention (e.g., implants, IUDs) are convenient for those with busy lifestyles.
4. Health conditions: Certain health conditions may limit options, e.g., smokers over 35 should avoid estrogen-containing methods.
5. Cost and accessibility: Availability and cost may influence the choice of contraception.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Archana Jha is an Associate Professor & Unit Head of the Department of OBGY- at Jawaharlal Nehru Medical College & Hospital in Bhagalpur.