Future developments in hormonal contraception

The range of contraception options has recently increased to include long-term, reversible, and highly effective methods. Several new oral contraceptive (OC) formulations are now available in the United States, where OCs are the most popular reversible method. Long-term contraceptive systems that deliver hormones via subdermal implants, vaginal ring, intrauterine system, and transdermal patch afford convenient and effective alternatives to OCs. Contraceptives using hormone combinations appear to be especially effective with safety profiles comparable to OCs. All recently approved in the United States, the transdermal contraceptive patch offers once-weekly dosing with an improved compliance profile, the monthly vaginal ring has the convenient advantage of being user-controlled; a monthly combination injectable provides good pregnancy protection and improved bleeding control compared with the progestin-only formulatin; and the 5-year the levonorgestrel-releasing intrauterine system significantly diminishes menstrual blood loss. A single subdermal implant has been approved for use in Europe. With 60% of all unintended pregnancies occurring in women using birth control, it is anticipated that this increasing range of options will enhance compliance and provide more effective contraception suitable for the individual user. (C) 2004 Elsevier Inc. All rights reserved.