The World Health Organisation (WHO) has recommended mifepristone as an additional emergency contraceptive option for preventing pregnancy after unprotected sex, with the medicine advised for use as soon as possible and within five days of the sexual encounter.
The recommendation is part of the WHO’s new Guidelines on Expanding Contraceptive Options, released on Wednesday to help countries increase access to contraceptive methods supported by available scientific evidence.
Mifepristone is being recommended specifically for emergency contraception, rather than routine contraceptive use. WHO said doses ranging from 10mg to 50mg are likely to be as safe and effective as other emergency contraceptive methods.
Under the recommendation, mifepristone should be taken as soon as possible after unprotected sex and no later than five days afterwards.
The updated guidance also expands the recommended use of some existing contraceptive methods. Combined oral contraceptive pills, for instance, can be taken for extended periods of up to six months or continuously for up to one year, rather than being used only in cycles.
WHO also supports the use of contraceptive implants for up to five years, a change it said could reduce replacement procedures, clinic visits and related costs.
The recommendations are designed to widen contraceptive choices and give people greater flexibility in deciding whether to use contraception, which method to choose and when to change or stop using it.
WHO said an estimated 164 million women who want to delay or avoid pregnancy are currently not using contraception, highlighting the need to expand access to contraceptive options.
The Director of the WHO Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, Dr Pascale Allotey, said contraceptive choice should be viewed 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, WHO said evidence remains insufficient for some other contraceptive methods and called for further research before they are considered for inclusion in family planning programmes.
The organisation said more research is needed on ormeloxifene because available evidence on its safety remains limited.
WHO also recommended against including quinestrol-containing contraceptive pills in national contraceptive programmes, citing limited evidence and reports of serious adverse events.
Beyond expanding options for women, the new guidance also addresses the limited range of contraceptive methods available to men.
WHO noted that men currently have relatively few contraceptive options under their control, mainly condoms, withdrawal and vasectomy. Despite this, about 30 per cent of couples rely on a male contraceptive method.
The organisation said more than 75 per cent of couples surveyed 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.
To support the development of additional male contraceptive options, WHO has created its first Target Product Profile for male contraceptive methods, setting out characteristics such products should meet, including safety, effectiveness, acceptability and affordability.
Several hormonal and non-hormonal male contraceptives are currently under research, with several candidates in advanced clinical trials, according to the organisation.
WHO said new reversible male contraceptives could become available within the next five to 10 years.
The organisation said the broader recommendations are intended to help countries update their family planning policies and programmes in line with the best available scientific evidence.
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