World Population Awareness

Birth Control Choices

A Brief History of Contraception

February 18, 2015, Atlantic Monthly   By: Jackie Lay

The use of contraceptives dates all the way back to 1850 B.C., when women in ancient Egypt used honey, acacia leaves, and lint to block sperm. This two-minute animation traces the history of contraception through the centuries, from sea sponges (500 B.C.), linen sheath condoms (1564), lemon cervical caps (1700), and the "rhythm method" (1920) to modern advancements such as vaginal rings, hormone injections, IUDs, and patches. doclink

Birth Control Choices

Multipurpose Prevention Technologies for the Developing World: U.S. Investment is Critical

Guttmacher Institute   By: Heather D. Boonstra

There is a compelling need for new technologies that protect sexually active women against multiple sexual and reproductive health risks, especially in countries heavily burdened by HIV and by maternal and infant mortality.

Over the past 50 years, U.S. government investments in research and innovation have played a major role in improving the lives of women, children and families worldwide. Investments in sexual and reproductive health technologies, including contraceptives, vaccines, diagnostic tools and therapies, enable women and couples to have the number of children they want, when they want them; to deliver their babies safely and have healthy newborns; and to have healthy sexual lives.

Despite these remarkable gains, there is still much work to be done to provide essential health services to the poorest and most vulnerable people. Far too many women continue to have unintended pregnancies, STIs and pregnancy-related complications that could have been prevented.

In the face of these health challenges, the global community has been working toward better linkages between different types of sexual and reproductive health services in the developing world. As awareness of the need for linked services has increased, the need for new technologies that combine protection against unintended pregnancy, HIV and other STIs has become a research priority.

This drive-to develop new multipurpose prevention technologies (MPTs)-is now a rising priority on the health agenda of many of the leading government agencies and nongovernmental organizations (NGOs) worldwide; however, experts believe that these products may never reach the market without robust U.S. investment and intensified collaboration between government and the private sector. The U.S. government is the world's largest funder of global health research and development, and this leadership will be critical in pioneering and advancing MPTs.

Women who are sexually active may be exposed to multiple health risks, including unintended pregnancy, pregnancy- and childbirth-related complications, HIV and other STIs. The use of modern contraceptive methods has risen greatly in developing regions, from negligible levels 50 years ago to 57% among married women aged 15-49 in 2014.1 And yet, the level of unmet need for modern contraception is remarkable: An estimated 225 million women-or one in four of those living in developing regions who are at risk of pregnancy but want to delay or avoid having a child-are not using a modern contraceptive method.

An unplanned pregnancy can be an emotionally wrenching experience for any woman. In absolute numbers, an estimated 74 million women in the developing world experience an unintended pregnancy each year. These unintended pregnancies result in an estimated 28 million unplanned births, 36 million abortions (20 million of which are unsafe), eight million miscarriages and nearly one million stillbirths.

In many regions of the world, women of reproductive age are also at high risk of HIV. An estimated 37 million people are living with HIV worldwide,14 million of whom are women aged 15-49 in developing regions. Young women have been particularly hard hit by the epidemic: In Sub-Saharan Africa, 71% of all new infections among 15-19-year-olds are among women.2 HIV prevalence among adolescent women is two times that of their male peers across the region.

In many of the world's poorest countries, these health challenges are not independent problems. In Sub-Saharan Africa, where 12 million women aged 15-49 are living with HIV, millions of women lack essential sexual and reproductive health services. More than four in 10 reproductive-age women in the region want to avoid a pregnancy;4 however, more than half of these women-55 million-are not using an effective contraceptive method.

Condoms (both male and female) are currently the only methods that protect against both unintended pregnancy and STIs; however, for many men and women, condoms are less than ideal. One disadvantage to condoms is that women have to negotiate use with their partner. Even the female condom, which has been hailed as a female-initiated method, requires a woman to obtain her partner's cooperation to use it. In many societies, especially those with an unequal gender power balance, women are simply unable to control when condoms are used.

Condoms have other drawbacks as well. They are not an option for women who want to become pregnant while protecting themselves against infection. Moreover, men and women worldwide report having issues with the fit and feel of male and female condoms, and that condoms interfere with sexual pleasure and are a barrier to intimacy and trust. Although condoms may be seen as acceptable and even necessary in the early stages of a relationship, they are often abandoned over time as intimacy between a couple grows. This, too, can make it difficult for women to discuss condom use with their long-term partner without raising suspicions of infidelity.

While more should be done to increase access to condoms, scientists and advocates have long argued that new and especially female-controlled means of prevention are desperately needed.

An analysis by the Guttmacher Institute found that women in developing countries have unmet need for contraception because they lack access to supplies and services, but that is only one of the many reasons women give for not using a method. Women also frequently report nonuse because they are concerned about health risks or side effects, have sex infrequently (and, therefore, believe themselves unlikely to become pregnant) or have a partner who is opposed to contraceptive use.

One goal, therefore, is that MPTs would cause few or no systemic side effects. Another goal would involve having a suite of products to meet the differing needs of different women: Some could be used on-demand, around the time of sex, which may appeal to women who have sex infrequently; others could be long-acting for women who would rather not worry about remembering to use a method each time. MPTs would be within a woman's personal control and have the potential to be used without her partner's permission or knowledge. And most MPTs in development have the advantage over condoms of allowing for direct physical contact-and some may even enhance sexual pleasure.

USAID investments have contributed to the development of more than a dozen contraceptives on the market today, including copper and hormonal IUDs, implants, injectables, and new vasectomy and female sterilization techniques that have increased safety and accessibility worldwide.

In 2009, CAMI Health, a project of the Public Health Institute, founded the Initiative for Multipurpose Prevention Technologies to catalyze the field by bringing together scientists, product developers and advocacy groups on a regular basis to advance the MPT agenda. The initiative aims to promote collaboration across a broad cross-section of organizations and experts from around the world. These include agencies such as USAID, NIH, the World Health Organization and the United Nations Population Fund; foundations such as the Bill and Melinda Gates Foundation; research entities such as CONRAD, International Partnership for Microbicides, the Indian Council of Medical Research and the Population Council; and NGOs.

As one of its first priorities, the initiative led an assessment of the leading MPT products in development and prioritized the most promising candidates. It has also been working to galvanize political support for MPT research, with hope that this will eventually result in a significant infusion of new funding for MPT product development.

Imagine the impact on a woman's life if she could use one product that simultaneously prevented unintended pregnancy and disease. MPTs would be a true game-changer." doclink

Humanae Vitae

The Story Behind the Ban on Contraception
April 29, 2018, The Story Behind the Ban on Contraception

In 1968, Pope Paul VI went against the findings of his own Papal Birth Control Commission and rejected an opportunity to create a modern and compassionate doctrine on birth control which would appeal to its faithful.

Instead, he launched the church backwards toward staunch orthodoxy with his encyclical titled Humanae Vitae. "The urging men to the observance of the precepts of the natural law, which it interprets by its constant doctrine, teaches that each and every marital act must of necessity retain its intrinsic relationship to the procreation of human life." For the past 50 years these words have come to influence the church's stance on public health challenges that relate to sex, and have affected the way Catholics around the world view birth control.

How did the church come to reject modern contraception, and why does it continue to make it a central part of its theology? Five years before Humanae Vitae, the papal commission was examining its view on marriage and looking to update its teachings. At this time it was feared that the more liberal members of the commission would push to revisit the church's ban an "artificial" birth control that was established in the 1930 encyclical Casti Connubii. The birth control pill had been introduced and, because it used naturally occurring hormones, many conservative members were concerned that its use would be approved for Catholic couples. Instead of considering the issue, the Papal Birth Control Commission was established as a concession.

After much study, it was the commission's opinion that the prohibition of contraception was faulty and outdated. It found that in many cases it strained marriages instead of making them stronger. Contrary to the assertion of the hierarchy that natural family planning brought couples closer together, it was found that it drove them apart. Couples became obsessed with sex because of the unnatural restrictions placed upon spontaneous demonstrations of affection. Women spoke of the many roles they played as wives and of the importance of the non-procreative sexual bond to marriage.

Even though the commission overwhelmingly agreed to advise the church to change its stance on the matter, many within the church rejected the change because it would be an admission that the church had been wrong.

The church demoted the commission members and appointed 15 bishops to make a final report on the matter. The bishops were also convinced by the case for modern contraception. They argued that the interpretation of the biblical story of Onan and his spilled seed was fallible, birth control is necessary for responsible parenting, and marriage should be based on "mutual love within the totality of marriage." There was a report issued by the dissenting bishops, but its only basis for opposition was that if the church changed its view, it would have to admit that it was wrong. And if it was wrong, it would lead to questioning on all "moral matters."

Although the commission and bishops overwhelmingly advised the hierarchy to change its stance, Pope Paul ignored the recommendations. He declared that the findings were not unanimous, and that the the recommendation disagreed with previous teaching and could not be changed.

Reaction to Humanae Vitae was not favorable. Many Catholics had expected Pope Paul to rescind the ban and had already made up their minds about birth control. There was also dissent from inside the church and by the world's theologians, most of it asserting that Catholics were free to make their own decisions on the issue. The reaction was as described by Father Curran. "All the hope and enthusiasm, all the sense that things had changed and that birth control teaching could change were crushed by the document. In a sense, there was one positive outcome from the encyclical in that Catholics realized that they could disagree with the pope on non-fallible issues and still remain a good Catholic. However, the negative outcome was that it created a lot of tension regarding credibility of the church.”

In the face of much dissent and disobedience, the church refused to alter its stance, and many Catholics have made their own decisions on contraceptives, especially in developed countries. Of the sexually active Catholic women in the US, 99% have used a method of birth control other than natural family planning.

In developing countries Humanae Vitae still has an impact on health policies and foreign assistance for such. This has led to an unmet need for family planning, increased abortion, death and disability for women denied the ability to limit pregnancies, and has hurt efforts to stem the spread of HIV/AIDS. The Catholic hierarchy continues to oppose modern contraception in Africa, which has the world's lowest rate of contraceptive use. Bishops regularly mislead those in developing countries by telling them that contraception is harmful to women's health, it leads to higher levels of abortion, and that international family planning programs are western plots to destroy their society.

Some developing countries have had some success in overcoming the Catholic church. Despite its large Catholic population, Kenya has successfully promoted contraceptive use. By 2015 52% of married women were using contraceptives and it is on target to get to 60% by 2018.

In the Philippines, according to a 2014 poll, 68% of Catholics support contraceptive use, but have unmet need due to the rate of poverty. In 2017, however, the president of the Philippines issued an executive order calling for the full implementation of the Reproductive Health Law. The Catholic church responded by blocking the distribution of condoms in schools.

Over the last 50 years, the impact of Humanae Vitae has been immeasurable. Despite its existence, Catholics continue to use contraceptives, dismissing a central tenet of the church, and the divide between its doctrine and reality continues to widen. The ideology has also hampered women's health and family planning causes around the world. The need for a more modern sexual ethic is long overdue, and, in order for the church to move forward, a reexamination of Humanae Vitae is imperative. doclink

Contraception's Role in Fighting Poverty

August 20, 2016, Huffington Poast   By: Phil Harvey and Lisa Conyers

Providing poor unmarried women with free, Long Acting Reversible Contraceptives (LARCs - e.g., intrauterine devices and subdermal implants) is one effective means of reducing income inequality. Our interviews with welfare recipients across the country indicated that, if all young women had effective means to avoid unwanted pregnancies, single motherhood would decline sharply. And, since the poverty rate for families headed by single mothers is 40%, compared to 8% for two-parent families, providing contraception to potential single mothers would also result in fewer impoverished mothers and children.

We talked with unmarried mothers who had given birth in their teens. They paid predictable penalties for those pregnancies, e.g.: delayed graduation or no graduation from high school, no easy way to learn job skills, and no time to do paid work. These problems made them poor and dependent on welfare programs. "I used to have that American dream of having a nice house, a car, a career, my kids in a good school," Juakea, a young mother of two in Beacon, Georgia, told us. "Now all that is gone."

Studies have shown that LARCs give those most likely to end up on welfare a better way forward. Isabel Sawhill of the Brookings Institution has spent decades studying single mothers. Her recent study reveals that many young single women slide into unplanned parenthood, making them less able to finish school and start careers. Two Colorado studies confirm Sawhill's findings. The first provided LARCs to single mothers. Only 2.6% of them got pregnant again within a year, while 19% of those in the control group (without LARCs) got pregnant again in that time. A second 2009 state-run pilot study showed that when teenage girls had free access to LARCS, pregnancies fell by 26%. That helped reduce participation in the Women, Infants and Children (WIC) program by 23%, so every dollar the state spent on LARCs saved about six dollars in WIC costs.

All factors considered, LARCs are an effective anti-poverty tool. Our interviews, like Sawhill's research, show that many young women who become sexually active don't do as well using contraceptives that require repeated action, often in the heat of the moment. The LARC alternative provides long-lasting, effective contraception without requiring the girls to do anything. Like all FDA-approved contraceptives, LARCs are covered by medical insurance under the ACA, and by Medicaid. The device and its insertion requires a clinic visit and costs about $1,000, but LARCs have none of the continuing costs associated with other contraceptive devices. However, although they are safe and effective, LARCs won't prevent sexually transmitted diseases. doclink

Australia: New Morning After Pill Makes it Difficult to Choose Which to Take

June 28, 2016, The Conversation   By: Esther Lau, Greg Kyle, Jose Manuel Serrano Santos, Lisa Nissen and Yasmin Antwertinger

Almost 200,000 unplanned pregnancies occur in Australia each year. Safe and effective emergency contraception can help prevent unintended pregnancies.

Levonorgestrel, the "morning after pill" (Postinor©) was the only oral emergency contraception available in Australia until 2015. It is available from a pharmacist without a prescription from A$14.99.

Now EllaOne© (ulipristal), is available in Australia with a doctor's prescription.

Levonorgestrel is a synthetic progestogen, thought to work by inhibiting or delaying ovulation, and impeding transport of sperm and/or egg to prevent fertilization. It may also change the uterus environment to make it more difficult for a fertilized egg to attach to it.

EllaOne (ulipristal) is an oral tablet (30 mg) that is taken as a single dose. It does not yet have a recommended retail price (RRP) in Australia, however, its RRP in the United Kingdom is £34.95, or almost A$70.

Ulipristal blocks the effect of the body's progesterone, inhibiting or delaying ovulation. It may also make it more difficult for a fertilized egg to attach to the uterus.

While levonorgestrel should be taken within 72 hours, ulipristal can be taken up to 120 hours (five days) after unprotected sex or contraceptive failure. Contraceptive failure can be missing a regular active contraceptive pill, or having used a broken condom.

Both levonorgestrel and ulipristal have comparable side effects, which are mild to moderate in nature, short-lived and resolved on their own. The most common side effects reported were stomach aches, nausea, and headaches.

Levonorgestrel is most effective when taken within 24 hours after unprotected sex as it prevents 95% of expected pregnancies. After 24-48 hours, the effectiveness decreases to 85%, then 58% after 48-72 hours. Ideally it is taken within three days as the benefits after 96-120 hours are uncertain.

When used within 72 hours, ulipristal is linked to lower pregnancy rates compared to levonorgestrel. This effect is maintained up to 120 hours afterwards.

However, ulipristal is not effective after ovulation, which usually occurs in the middle of each menstrual cycle. And there is no easy test to determine if ovulation has already occurred, This means ulipristal could be a waste of time.

Also EllaOne's manufacturer recommends waiting at least five days before the regular contraceptive pill is restarted. During this time, barrier methods of contraception (such as condoms) are recommended until cover from the regular contraceptive pill is achieved, so this can be up to one week after recommencing, or almost two weeks after taking EllaOne.

Women need to weigh up all these factors to make a decision for their circumstances. These can include the slightly higher efficacy of ulipristal, whether or not they have ovulated, accessibility (without prescription from a pharmacy or needing to see their GP), the time elapsed since unprotected sex and cost. doclink

Fake Egg Cells Can Be Used as Contraception and to Treat Infertility

April 29, 2016, Inquisitr   By: Amy Schaeffer

The idea of an egg decoy that draws sperm away from a legitimate egg is being investigated by Matteo Avella, a lead researcher at the National Institutes of Health. Under normal conditions, sperm migrate to the female ovum, or egg by way of a chemical attraction and reaction that allows fertilization.

The fake ova are agarose beads, which are carbohydrate particles often used for lab testing in many different studies. Scientists coat the agarose beads with a peptide called zona pellucida glycoprotein 2, or ZP2 for short, a chemical that is known for binding a sperm to an egg, causing conception. After one sperm infiltrates the egg, a chemical reaction prevents other sperm from to penetrating the ovum due to a chemical reaction.

Trials are currently being done on live mice which have shown zero complications or side effects from the "decoy eggs" that have been implanted in them.

While it is unknown if this would work as effectively in human subjects, scientists believe it is a good possibility. Once the decoy eggs were removed, the mice were able to conceive healthy litters very quickly, which is a factor that many birth control methods today do not have. For many women, it takes months to regulate and ovulate again after being on contraceptive pills or Depo-Provera.

Oddly, the peptide decoy also helps with infertility. The peptide helps the technician select the healthiest sperm to use in vitro fertilization, saving that time-consuming step by attracting sperm that are capable of penetrating a real human egg, increasing the woman's chance of conceiving with IVF.

It will likely be many years before either the contraception or in vitro fertilization is an option for humans. doclink

The Science Behind Emergency Contraception and Abortion

March 21, 2016, Fusion   By: Katie McDonough

In the in Zubik v. Burwell case, the Supreme Court is hearing arguments in another challenge to the contraception mandate in the Affordable Care Act, which requires all insurance companies to cover contraception without a copay.

The ACA has an accommodation for religiously-affiliated employers who object to covering birth control to opt out of directly providing the coverage so that the Department of Health and Human Services can arrange it instead. They claim this accommodation is a violation of their core religious beliefs because employees can still access birth control.

Birth control is expensive, especially for women earning the minimum wage. An IUD can cost up to $1,000 - a month's pay for some women.

Priests for Life, one of the plaintiffs, claims contraceptive and abortion-causing drugs and devices covered by the mandate are counter to Catholic teaching. They also claim these drugs are harmful to women.

In addition, Priests for Life claim that emergency contraception is the same thing as medication that causes abortion.

Dr. Tracey Wilkinson, a pediatrician and reproductive health researcher explained that emergency contraception is birth control. In fact it can be one of several different kinds of birth control that you can take if your primary birth control method fails or if you just didn't use any to begin with.

Plan B One-Step (morning after pill), can be bought over-the-counter. It has a high dose of progesterone (as in the birth control pill) that can thicken the cervical mucus, which makes it harder for the sperm to get to the egg. And if you haven't ovulated -- when the ovary releases an egg -- it can delay the process, which is another way to keep sperm from reaching the egg.

Without ovulation, there can be no fertilization. Without fertilization, there can't be implantation in the uterus, which is the thing that triggers the hormones that let your body know you are pregnant. Nothing happens if you are already pregnant when you take Plan B.

Ella, another emergency contraception, is currently only available with a prescription. It contains the hormone ulipristal acetate and It works just as well on day one or day five after unprotected sex. Ella suppresses progesterone, which delays ovulation, giving the sperm enough time to allow the sperm to die -- sperm can survive for several days inside a woman's reproductive tract -- before it has a chance to meet with an egg.

A copper IUD kills the sperm before it has a chance to reach the egg. It is the most effective form of emergency contraception on the market. Since the timing is difficult with the insertion of an IUD, it's use as emergency contraception is rare. A woman would need to get an appointment to get an IUD placed within the five-day window needed to avoid pregnancy.

A copper IUD also "causes irritation to the uterine lining that makes implantation difficult," Wilkinson explains. "So there is a chance that if you have a fertilized egg coming down the fallopian tube that, if you insert a copper IUD, it would make it harder for that egg to implant."

None of these methods of emergency contraception will work after you're already pregnant. [A pregnancy is defined as when the fertilized egg implants in the uterus.]

If you're already pregnant and don't want to be, one of the ways you can end the pregnancy is through a medication abortion, which is sometimes called the abortion pill. There are two pills: mifepristone, which blocks progesterone and causes the pregnancy to end, and misoprostol which, taken 24 to 48 hours after the first pill, causes cervical dilation and contractions to expel that pregnancy. You can take it up to nine weeks into a pregnancy, and you can take the medicines at home.

So when someone claims that emergency contraception is an abortion-inducing drug... They're wrong. doclink

Struggling Colorado Birth Control Program Worked Even Better Than Thought, Says Health Department

October 22, 2015, Gazette, The   By: Jakob Rodgers

A program offering birth control to low-income teens and young women is more efficient than previously thought, Colorado's health department announced last Wednesday.

The initiative, which provided long-acting reversible contraceptives at little or no cost, dropped the state's teen birth and abortion rates by 48 percent from 2009 to 2014, the Colorado Department of Public Health and Environment found.

The intrauterine devices can prevent more than 99 percent of pregnancies within the first year of implantation. They should not affect fertility once removed, according to WebMD.

Previous data from the program's first four years found teen births had dropped 40 percent from 2009 through 2013, while abortions declined 35 percent, the department said.

The new data comes as the program faces several challenges.

A five-year, $25 million grant from the Susan Thompson Buffett Foundation ended in June, and legislation to continue funding failed in the Republican-held Senate.

Several Colorado foundations have since offered $2.2 million in bridge funding through June 30, 2016. The health department said Wednesday it is seeking more sustainable funding.

Unintended pregnancies are more likely to result in children lives and health being at risk, according to the health department.

The initiative also has been credited with saving Medicaid an estimated $79 million from 2010 through 2012, the health department said. doclink

How a Billionaire-Backed IUD is Fighting the GOP War on Women's Bodies

Republicans should love Liletta, but instead they're fighting it every step of the way
October 27, 2015, AlterNet   By: Kali Holloway

Liletta is a new intrauterine device which became available in April. It is affordable, safe, 99% effective, and widely accessible. Studies prove the IUD reduces rates of unplanned pregnancies, and it's been shown to decrease the number of teen abortions. Once Liletta is inserted by a healthcare professional, it can remain in place for up to three years without any patient intervention, effectively eliminating the kinds of user errors that lead to pregnancy.

In multiple studies, Liletta has been proven safe, placing it far outside the troubled history of IUDs.

Unfortunately the conservative response has been to obstruct the use and availability of Liletta and similar contraceptive methods at every opportunity. Their mission seems like one less focused on protecting the sanctity of human life than it is penalizing and stigmatizing women for having non-reproductive sex.

Most IUDs cost anywhere from $800 to $1,200 -- prohibitively priced for most family planning clinics, many of which are already severely underfunded. But with Liletta, its developer Medicines360 has capped out-of-pocket expenditures for insured women at $75, and in cases where patients qualify financially, even that cost can be subsidized. Medicines360 has made it a priority that public health care centers can purchase the IUD at just $50 a pop, allowing them to keep plenty in stock. Batches of Liletta have been recently shipped to 49 states, with more than half of the devices going to clinics that serve low-income patients.

The Susan Thompson Buffett Foundation, the philanthropic organization co-founded by Warren Buffett and his late wife, has recently focused on funding family planning work, spending an estimated $200 million to determine the best and most effective contraceptive methods, underwriting costs for product development, conducting clinical trials, and creating distribution channels that ensure affordability.

Judith DeSarno of the Buffett Foundation, said that Warren "thinks that unless women can control their fertility -- and that it's basically their right to control their fertility-that you are sort of wasting more than half of the brainpower in the United States."

In 2007, the Buffett Foundation gave approximately $20 million to fund the Contraceptive Choice Project, a three-year study involving more than 9,000 women of childbearing age in St. Louis, Missouri. Participants were given information about various types of birth control, with particular insights on IUDs, and offered the method of their choice for free. 56% ultimately opted for an IUD, proving women would be interested in the devices when armed with the right information.

Between 2008 and 2013, the Buffett Foundation spent over $50 million in Colorado on a project that offered free and reduced-cost IUDs to some 30,000 women through 68 family planning clinics statewide. Subsequently the teen birth rate in the state fell by 40% from 2009 to 2013, while their rate of abortions fell by 42%, according to the Colorado Department of Public Health and Environment. There was a similar decline in births for unmarried women under 25 who have not finished high school.

Colorado governor John Hickenlooper said that "Colorado moved from the 29th lowest teenage birth rate in the nation before the initiative began in 2008 to 19th lowest in 2012." The project saved the state "$42.5 million in public funds in 2010 alone."

In the 1970s and '80s, IUDs were synonymous with the Dalkon Shield, a brand that was recalled for causing septic abortions, infertility, and in rare cases, death. In 2000, the FDA-approved Mirena hit the market, followed in 2013 by pharmaceutical giant Bayer's Skyla, both of which helped revive interest in the IUD for a generation of women less familiar with its history.

To remedy the dark name of the IUD, the Buffett Foundation spent $74 million to launch Medicines360, which immediately set about creating a generic IUD. Liletta was the result.

There are nearly 3.4 million unintended pregnancies each year in America; many likely to end in abortion. Poor and low-income women, more specifically, are five times more likely than wealthier women to experience both unplanned pregnancies and unintended births, according to a Brookings Institute study.

Although conservatives often discuss the birth rate among women in underserved communities as if it points to some innate, class-based moral failing, Brookings notes that rates of premarital sex are not socioeconomically determined. "There is no 'sex gap' by income," researchers write.

A study by the Guttmacher Institute of women aged 18-34 with household incomes below $75,000 found that cost led many women to cut corners with their birth control, skipping pills, delaying prescriptions, or adopting a one-month-on, one-month-off approach to taking the pill. One in four women who struggle financially are forced to take such measures, compared to among women with financial stability, whose rate is roughly one in seventeen.

Because of the upfront cost of IUDs and hormonal implants, low-income women are less likely to access these most effective forms of birth control, which are 99% successful in preventing pregnancy.

Another Guttmacher survey finds that a "majority of respondents reported that birth control use had allowed them to take better care of themselves or their families (63%), support themselves financially (56%), complete their education (51%), or keep or get a job (50%). Young women, unmarried women, and those without children reported more reasons for using contraception than others: not being able to afford a baby, not being ready for children, feeling that having a baby would interrupt their goals, and wanting to maintain control in their lives were the most commonly reported reasons for using birth control.

Many conservatives might not be interested in the self-determination birth control provides for women. But as a measure that helps reduce abortions and unwanted births -- they should be all for it. In 2010, nearly 70% of unintended births were paid for by public insurance programs, especially Medicaid. The GOP, which supposedly values dollars and cents above all else, should appreciate any solution likely to send those numbers downward.

Early this summer, House Republicans voted to eliminate funding for Title X, the only federal program which specifically funds family planning and reproductive-health services, including birth control, for low-income women. Now they are currently trying to defund Planned Parenthood, which provides a long list of family planning services to millions of women. Abortions represent just 3% of the services Planned Parenthood offers, a figure Republicans might care about if any of this was actually about abortion.

Conservatives in Texas, Kansas, Utah, Arkansas, Louisiana and Alabama are trying to defund Planned Parenthood at the local level. Louisiana Planned Parenthood clinics don't even provide abortion services, "so defunding it would only keep low-income patients...from accessing cancer screenings and other preventative health-care." Across the country, health care clinics have been rapidly disappearing, thanks to Republican efforts.

In 2014 the Supreme Court's Hobby Lobby decision ruled in favor of a companies with closely held religious beliefs to opt out of providing women insurance that covers the cost of IUDs and some morning-after pills. (Hobby Lobby says IUDs are abortifacients; doctors and elementary school-level reproductive science say that's not true.)

Ann Friedman wrote of the decision: "The Supreme Court's decision -- and most reproductive-health restrictions passed by lawmakers across America over the past several decades -- expresses the view that women make their choice when they choose sex, and it's up to them to figure it out after that. That there is no social or moral or governmental obligation to make it easier for them to make choices that follow from a perfectly human impulse to want sex but not babies. For women, sex is an option, an inessential luxury like LASIK eye surgery."

In Colorado, after money ran out on a family planning project that resulted in a massive drop in teen pregnancies and abortions across the board, conservatives in the legislature turned down a bill to fund the program. One local anti-choice group said giving teens access to contraception "does not help them understand the risks that come with sexual activities."

These anti-choicers want no part of a program that teaches young women how to be sexually responsible, or that doesn't scare them into believing the only way sex can end is badly. These same conservatives refuse to fund anything that benefits children once they leave the uterus, who vilify single mothers, who bemoan "entitlement programs" for the most vulnerable families and children. In voting against those measures, conservatives are voting for teen pregnancy, unplanned births and abortion.

As more clinics introduce Liletta to their clients, and more health care plans offer it as a choice (mine does!), the 10% of women who rely on IUDs for birth control will only continue to grow. Republicans will keep pushing for policies that attempt to stop women from having sex, instead of plans that actually benefit women's reproductive health and offer real choice. doclink

Female Condoms Are Power, Protection, Pleasure

Pathfinder International

To these young women, the female condom is a game changer

In some parts of the world, a woman asking a man to wear a condom is counter to cultural practices. A condom for women puts the power and protection in her hands. Pathfinder International is on the ground around the world working to tear down these barriers and we need your help.

September 16 was Global Female Condom Day. Join us in spreading the word about condoms for women! doclink

First Self-injectable Contraceptive Unveiled in UK

Pfizer launches Sayana Press long-acting reversible contraceptive which can be administered at home instead of a GP surgery or clinic
September 24, 2015, Mail and Guardian

The Sayana Press long-acting reversible contraceptive has received a license, which means women can inject themselves at home instead of having to go to their GP surgery or clinic.

Each jab of the UK's first self-injectable contraceptive for women provides contraception for at least 13 weeks. Around 5 million women in the UK use hormonal contraceptives. doclink

Karen Gaia says: Chances of getting pregnant with the Sayana Press: less than one percent. If women wait too long between shots, the failure rate increases to 6%.

Fertility does return once the injections are stopped, but the time varies from one woman to the next. Some women may not be able to conceive for up to a year, sometimes longer, after having their last injection. Read here for more if you are interested in using Sayana Press:

These Amazing New Contraceptives Could Be the Future of Birth Control

February 6, 2015, VOX Media   By: Megan Thielking

Due in part to high failure rates (18%), only 20% of couples choose condoms. Scientists continue working to develop better options. The pill is still the most commonly used contraceptive in the US, but since women must remember to take the pill every day, it has a 9% failure rate. Potential side effects include nausea, mood swings, and possible stroke. For these reasons, there's a push to develop new, long-acting reversible contraceptives, says Dr. Michael Thomas, OB/GYN at the University of Cincinnati's Center for Reproductive Health.

Longer acting options include a hormonal patch called Ortho Evra that must be changed every week, and the NuvaRing hormone-releasing uterine ring that must be changed every three weeks. Contraceptive implants are thin plastic devices inserted under the skin on the upper arm. Current versions release hormones for up to three years. Still, removing them requires a trip to the doctor. A T-shaped intrauterine device (IUD) under study may work for up to 12 years, but removing an IUD still requires a trip to the doctor.

Working with the Gates Foundation, MicroCHIPS Biotech is developing an implant that will last up to 16 years, which women can to turn it off by remote control. Human trails should start next year. The same microchip technology has been tested successfully in women with osteoporosis, so MicroCHIPS Biotech believes the implant could be on the market by 2018.

Over the longer term (at least 10 years), the NIH is partnering with researchers to develop a lower-dose version of emergency contraception Ella, which would work like "the pill" if taken daily. The estrogen-free pill would reduce side effects and be more effective for certain women, particularly obese women who have higher failure rates using estrogen-based contraception.

Northwestern University says that, like condoms, new vaginal rings could prevent sexually-transmitted infections. Two-in-one options under study include a contraceptive similar to the current Nuvaring, which is placed in the vagina. It uses hormones to prevent pregnancy and also releases an antiretroviral drug to inhibit HIV and herpes.

Men use about one-third of all contraception. Aside from condoms, some men rely on vasectomies that can only be reversed via surgery. In coming years men will have more reversible birth control options. In the 1950s, scientists tested on prisoners a form of male birth control that weakened the sperm. It worked until it was tested outside of the prisons, where interactions with alcohol caused vomiting, profuse sweating, and headaches. Over 60 years later, scientists are still trying. Dr. John Amory of the University of Washington is now testing molecules to gum up an enzyme that facilitates sperm maturation. If this works, they will approach the FDA within the next few years to start clinical trials.

RISUG stands for reversible inhibition of sperm under guidance. Trials in India showed the procedure to be 100% effective. A doctor injects the vas deferens with a gel that makes the sperm unable to travel. The procedure lasts for years and can be reversed at any point with another injection. A U.S. company used the same concept to create Vasalgel. It is now in animal testing, still years from approval.

The NIH, in partnerships with the University of Washington and UCLA, is researching gels currently used for hormone-replacement therapy in men with low testosterone. The gels stop sperm production with hormones - much like "the pill" works for women. The challenge is to manage sperm production without reducing testosterone levels for the rest of the body. Each day men apply a progestin hormone gel on the abdomen and a testosterone gel on the arm. The progestin gel halts sperm production by blocking the supply of testosterone in the testes. Then, a testosterone gel applied to the arm reintroduces the hormone to the blood, which allows it to stimulate libido and enable ejaculation. Diana Blithe, Program Director at the NIH's Contraceptive Discovery and Development Branch said that in human trials, "It works if they use it every day, and even pretty well if they miss a day," The gels will be combined into a single, easier-to-use formula. Blithe anticipates at least a 10 year wait before the product is available. doclink

How Likely is it That Birth Control Could Let You Down?

September 13, 2014, New York Times   By: Gregor Aisch and Bill Marsh

Note: click on the link in the headline to see these wonderful interactive charts that show the effectiveness (or ineffectiveness) of most major kinds of birth control

Misuse and failure of birth control are major contributors to the millions of unplanned pregnancies in the United States each year. Failure rates of contraceptives usually refer to a given year of use. Over time the risk of failure is compounded over time. The longer any method of contraception is used, the greater the probability of unplanned pregnancy.

These charts show probabilities of pregnancy for each method by two standards: typical use, which is usually incorrect or inconsistent use, and perfect use - when used exactly as specified and consistently followed. Over long time periods, few couples, if any, achieve flawless contraceptive use.

Only the 10 year probability is shown here. Jump to the link to see the charts.

* Spermicides 96% chance of pregnancy

* Fertility awareness-based (ovulation method) 94%

* Sponge (after giving birth) 94%

* Withdrawal 92%

* Condom (female) 91%

* Condom (male) 86%

* Diaphragm 72%

* Sponge (prior to any births) 72%

* Pill, Evra patch, NuvaRing 61%

* Depo-Provera 46%

* Copper IUD 8%

* Female sterilization 5%

* Levonorgestrel IUD 2%

* Male sterilization 2%

* Hormonal implant 1%

Sources: James Trussell, Office of Population Research, Princeton University; Brookings Institution doclink

Karen Gaia says:

a) The average American woman spends 30 years trying to avoid pregnancy. 11% of women at risk of unintended pregnancy are not currently using any contraceptive method. 18% of these are teens.

b) 16% of women using birth control use the pill, while 15.5% use female sterilization, 9.4% use male condoms, and only 7.2% use IUDs or implants, although this number is growing.

Male Birth Control, Without Condoms, Will Be Here by 2017

September 9, 2015, Daily Beast   By: Samantha Allen

Vasalgel, a reversible, non-hormonal polymer that blocks the vas deferens, is about to enter human trials. How will rhetoric change when male bodies become responsible for birth control?

Vasalgel is proving effective in a baboon study. Three lucky male baboons were injected with Vasalgel and given unrestricted sexual access to 10 to 15 female baboons each. Despite the fact that they have been monkeying around for six months now, no female baboons have been impregnated.

It is essentially a reimagining of a medical technology called RISUG (reversible inhibition of sperm under guidance) that was developed by a doctor named Sujoy Guha over 15 years ago in India, where it has been in clinical trials ever since. Unlike most forms of female birth control, Vasalgel is non-hormonal and only requires a single treatment in order to be effective for an extended period of time.

Elaine Lissner of the Parsemus Foundation is worried about the effectiveness of the pill, given how many women forget to take pills during any given cycle. The Parsemus Foundation has to rely on donations and crowdfunding in order to bring male birth control to the market. Potential funders in the pharmaceutical industry would much rather "sell pills to men's partners every month." doclink

U.S.: The Rise of the IUD

December 11, 2014, Think Progress   By: Tara Culp-Ressler

Long acting reversible methods of birth control (LARCs) is a category of highly effective contraceptives that includes intrauterine devices (IUDs) and hormonal implants. These methods are chosen by U.S. women more and more, according to the CDC, despite political controversy stoked by religious conservatives, who assert they're comparable to abortion.

The birth control pill has been the most common contraception for many years. Long-acting birth control, meanwhile, has historically been one of the least popular methods even though it's actually the most effective reversible option.

From 2006 to 2013, the rate of women choosing IUDs and implants nearly doubled -- jumping from 3.8% to 7.2%.

In the past, doctors avoided prescribing IUDs to young women who hadn't yet given birth, assuming that they would be too hard to insert or that younger patients wouldn't want to stick with the method. And some medical professionals have been reluctant to give long-term contraceptives to unmarried women, reflecting somewhat of a discomfort with female sexuality outside of serious relationships.

Recent research in the field has confirmed that IUDs are safe for younger women, and that, when presented with all the options, teenage girls are 16 times more likely to choose an IUD than any other method. The American College of Obstetrics and Gynecology and the American Academy of Pediatrics now encourage doctors to give IUDs to their teenage patients.

Obamacare's birth control benefit eliminates out-of-pocket costs for FDA-approved contraception, so women no longer have to pay hundreds of dollars upfront to insert an IUD.

Right-wing religious groups claim that IUDs are a form of abortion, even though there's no scientific evidence to back that up. doclink

Long-Acting Birth Control for Guys Coming in 2017

November 4, 2014, Sex, Etc   By: Krystal Rodriguez

Long-acting, reversible birth control methods, like intrauterine devices and implants, are available for girls and women, but are there long-acting, reversible birth control options for men? The Parsemus Foundation is developing Vasalgel, a gel which is injected into the vas deferens (the tube that the sperm travel through from the testicles to the urethra). When the gel hardens, it blocks sperm from mixing with the fluids that are released during ejaculation. This means the fluids ejaculated don't contain sperm.

Vasalgel has been compared to a vasectomy, where the man's vas deferens are cut, so there is no sperm in his semen. Vasalgel uses an injection of gel into the vas deferens to prevent sperm from mixing with semen. If a man no longer wants to use Vasalgel or would like to be able to contribute to a pregnancy, the gel is dissolved with another injection.

Vasalgel will be on the market in 2017. It has been tested on male baboons, and human trials are expected to start next year. Vasalgel will not prevent the transmission of sexually transmitted diseases. doclink

Birth Control Methods


Visit this interactive website to learn about the various forms of birth control. Which ones are the most effective? Which are hormone free? And other questions are answered. doclink

How Has Birth Control Developed? a Brief History of the Pill, by the Decade

May 9, 2014, Bustle   By: Camille Bautista

It has been 54 years since the Food and Drug Administration first approved the birth control pill, forever changing the lives of women across America. 80% of American women take the Pill. Though the Pill has maintained its controversial status over the decades, it has also established itself as a symbol of women's freedom and rights.

In 1960, the FDA approved the new oral contraceptive Enovid, the first drug given to a healthy person for long-term use, launching a cultural shift in family structure and attitudes toward sexual health. A year after the Pill was approved, 400,000 women in the United States were taking it - a number which increased to 1.2 million by 1962.

By 1965, the Supreme Court, in the Griswold decision, struck down the legislation mandating that "any person who uses any drug, medicinal article or instrument for the purposes of preventing conception shall be fined not less than forty dollars or imprisoned not less than sixty days." The Court found that the law violated the "right to marital privacy" and couples were allowed access to birth control, including the Pill.

In the 1971 Eisenstadt v. Baird case the Supreme Court struck down a state ruling, allowing unmarried citizens to have all the protected sex they wanted.

While 6.5 million American women were on hormonal birth control by 1965, studies started to reveal medical concerns with the Pill. Word of serious side effects started to spread, including blood clots, heart attack risk, and weight gain. As a result, birth control pill sales dropped 24% in the late 70s. Some Black women were urged not to take the Pill after powerful African-American leaders criticized the contraceptive as contributing to "black genocide."

Then in 1968, Mircette became one of the first oral contraceptives to offer a low estrogen dose coupled with progestrin.

In 2000 a ruling from the Equal Employment Opportunity Commission required employers to provide contraceptive coverage as part of their health plans. The sentiment would reemerge in 2012 with President Obama's similar mandate at no cost.

While it's been a long and controversial road for the Pill, one thing is clear: birth control is here to stay. doclink

Forget the Pill, IUD is the New Queen of Birth Control

With an estimated 4 million unintentional pregnancies each year, gynecologists are urging their patients switch from oral contraceptives to an intrauterine device (IUD). Just three years after doctors cast it off as unsuitable, the IUD is reigning supreme.
May 30, 2014, Daily Beast   By: Sarah Kunst

In the United States there 4 million live births each year, and half are estimated to be unplanned or unintended. Of the majority of unplanned births the largest majority come from women in their 20s.

With the questionable efficacy of condoms and the widespread misuse of birth control, an alternative has now been recommended by the American College of Obstetricians and Gynecologists: Intrauterine devices (IUD). With less than one pregnancy per 100 women in a year, its the most effective birth control method available on the market, yet only 10% of women using birth control are using this form of birth control.

It has been estimated that of the 2 million births in America in 2011 came unexpectedly. According to Dr. Tina Raine-Bennett of the Women's Health Research Institute at Kaiser Permanente Northern California, "20-24-year-olds have highest number of unintended pregnancies across all demographic groups while over one-third of unintended pregnancies end in abortion."

Despite current birth control methods, in 2012 the American College of Obstetricians and Gynecologists got behind the IUD recommending it as the preferred birth control option for all women, even those who haven't yet given birth. Although there are risks, that can be said for any drug or implant. Smaller issues that result from IUDs mirror those of other contraceptives, such as menstrual cramps, spotting, or infection. But more dangerous issues can, in rare cases, arise. One in about 1000 users may experience perforation (the IUD puncturing the uterus wall), while others may experience expulsion (the IUD falling out completely).

Overall there is hope for the device, and studies show women are generally more satisfied with IUDs compared to the pill. doclink

Karen Gaia says: this is really where we ought to be focusing. IUDs are more expensive and many women don't know enough about them. Let's start helping projects that focus on IUDs, making them affordable, and making sure contraceptive counselling includes them.

Preventing Misconception: the Debate Between "Family Planning" vs. "Contraception" (idealogue)

April 8, 2014, Rabin Martin

(Excerpts from the conversation)

Earlier this year, the Lancet published a commentary about the debate between the terms "family planning" and "contraception," noting the connotations associated with each term and the fact that "a girl aged 16 years is not necessarily concerned about planning a family, but she does not want to get pregnant," so the term "family planning" might not apply.

Women's rights are often defined solely in terms of women's familial relationships to other people. Societies are encouraged to enact policies to protect their mothers, sisters, and daughters. While being part of a family can certainly be an incredibly important part of women's lives, this type of framing undermines the reality that they don't need another person to legitimize their empowerment. Women deserve access to birth control not because they're mothers with families, but because they're human beings who need the autonomy to determine the course of their own lives.

Pregnancy is a potential outcome for many women having sex with men. Contraception is a potential method to prevent that outcome. The fact that we may engage in sex for pleasure rather than reproduction does not negate the real possibility of pregnancy, so we should talk about it.

Women Deliver found that many young people didn't identify the term "family planning" with issues like contraception, sex education, sexual rights, or even preventing unintended pregnancies.

Contraception and family planning are not interchangeable terms: planning a family is different from preventing an unwanted pregnancy.

Choosing not to become pregnant is exercising your right as a woman to plan when you are ready, or not, to begin or extend your family. If we begin to remove the connection of potential pregnancy, one of the most life-changing outcomes of sex for most women, from the conversations around contraception, at what point do we have to begin taking responsibility for the increased number of unwanted pregnancies? As the parent of a young woman, I always want my daughter to be informed of the potential outcomes of her actions, and for her to feel that she has the right to choose what actions and outcomes are acceptable for her as an individual. If a woman does not want to become pregnant, then she needs to use contraception every single time she engages in sexual activity. Planning not to have or extend a family is still planning, and I would not want to see the reality of such a life changing outcome lost due to semantics.

Missing from the mainstream discussion of family planning - whether for these people or a teenage girl interested in sex for pleasure - is an understanding of reproductive justice, "the right to have children, not have children, and to parent the children we have in safe and healthy environments." While there is indeed a global need for contraception, there is a much greater need for reproductive justice. doclink

11 New Condom Ideas -- Will Casual Sex Ever Be the Same?

The Bill & Melinda Gates Foundation put out a call to build a better condom and 800 inventors, scientists and innovators responded to the Gates challenge
November 28, 2013, AlterNet

There is an old saying that wearing a condom during sex is like taking a shower in a raincoat. As a result of various different factors such as the loss of sensation, lack of availability, poverty and just not caring enough, condom usage worldwide is estimated at about 5%. This poor number consequentially has tremendous implications for both public health and poverty.

In March 2013, the Bill & Melinda Gates Foundation put out a call to build a better condom - to create the next generation of condoms, one that enhances pleasure and is easier compared to current products publically available.

A little over 800 inventors, scientists and innovators responded to the Gates challenge. The result is that eleven individuals have received $100,000 each to continue developing their products. Among the suggestions are thinner-yet-stronger materials than latex and easier applications for users. The lucky winner will get $1,000,000, and bragging rights as the inventor of the "condom of the future."

The 11 potential condoms of tomorrow are:

1. Ultra-Sensitive Reconstituted Collagen Condom

2. Dynamic, Universal Fit, Low-Cost Condom

3. Ultra-Sheer "Wrapping" Condom with Superior Strength

4. Project Rapidom

5. Biologically Inspired Condom

6. Graphene-Based Polymer Composites For High Heat Transfer, Improved Sensitivity and Drug Delivery

7. Super-Hydrophilic Nanoparticle Condom Coating

8. Ultra-Thin Adaptable Condoms for Enhanced Sensitivity

9. Condom Applicator Pack (CAP)

10. Enhanced Condom Using Nanomaterials

11. Ultra-Sensory Condoms Based on New Superelastomer Technology

Follow the link in the headline to read about each new condom. doclink

It Takes 2

It takes 2

Starting to feel comfortable in your relationship? Keep a good thing going worry-free. Two people, two ways to protect yourselves against pregnancy. Find out the best way to stay safe.

Follow the link in the headline to see the It Takes 2 website doclink

Health Insurance Marketplace - What Are My Birth Control Benefits?

September 26, 2012,

Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.

These plans must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider. Covered contraceptive methods

All Food and Drug Administration-approved contraceptive methods prescribed by a woman's doctor are covered, including:
* Barrier methods (used during intercourse), like diaphragms and sponges
* Hormonal methods, like birth control pills and vaginal rings
* Implanted devices, like intrauterine devices (IUDs)
* Emergency contraception, like Plan B© and ella©
* Sterilization procedures
* Patient education and counseling

Plans aren't required to cover:
* Drugs to induce abortions
* Services related to a man's reproductive capacity, like vasectomies.

For more information about specific contraceptive services your plan covers, check your plan's materials or ask your employer or benefits administrator. doclink

Celebrate and Support World Vasectomy Day on Oct. 18

September 21, 2013, Durango Herald

First published in the Durango Herald September 21, 2013

It was time: I walked across the hall, lowered my pants and lay down on the exam table. Dr. Sam Callaway took good care of me. We had two great sons, and our family was complete. Although my wife volunteered to get her tubes tied, I decided to practice what I preached and went for the vasectomy.

That was 30 years ago, and I've never regretted that decision. My largest fear was that Sam's office nurse would be around still, but Judy had already left. Sam talked to me as he worked, and I barely felt any discomfort. He explained that he used a very thin needle for the local anesthesia, made tiny incisions and he was gentle. In a few minutes it was all over, and I was on my way.

I'll admit to some soreness that evening when I spoke at the prepared childbirth class my wife was teaching. And I moved carefully the next day when I needed to perform a cesarean. All in all, I took just a few aspirins (that was before ibuprofen!) and never had any ill effects. Men have an anatomical advantage when it comes to sterilization. Whereas a woman's tubes are deep inside her body, a man's tubes, the vasa deferentia (singular: vas deferens) are much more accessible. When they are interrupted, sperm cannot get released, and the man is unable to cause pregnancy. Fortunately, sperm are only a tiny fraction of the male ejaculate, so sex is unchanged - or better, for lack of fear of pregnancy.

A vasectomy takes only a few minutes, is done with local anesthesia and is amazingly safe and effective. The main hitch is that it takes several months to wash out all the sperm, and the man should be tested to be sure that he really is shooting blanks before trusting the surgery. The failure rate is less than 1 in 100. Tubal ligation is more common in the U.S. than is vasectomy. Among married couples, 1 in 7 men is sterilized while 1 in 5 women has had the surgery.

Because many sexually active people are not married, the overall statistics show a larger preponderance of women taking control of their fertility - more than a half million women are operated on every year while only half that number of men get snipped. The popularity of vasectomy varies by country. It is rare in many parts of the world such as in Africa, but a quarter of the men in New Zealand have had the surgery.

In Durango, perhaps only one physician is left performing this important procedure after Centura took over the family practice group at Mercy. Dr. Mark Forrest has performed hundreds of vasectomies, including on some of my friends - and they have all done well. He says that it usually takes two visits: a consultation, then the actual surgery. He will check semen samples two and three months later, and if both are negative for sperm, the surgery can be considered a success. If this protocol is followed, the failure rate is lower than the rate of pregnancy after tubal ligation.

Furthermore, vasectomy is much less expensive. Nationwide, the price of male sterilization is $350 to $1,000. Female sterilizations can now be done without an incision. Essure™ is an office procedure performed through the woman's cervix, with mild sedation and local anesthesia. Unfortunately, its overall cost is about the same as tubal ligation - $1,500 to $6,000.

The first World Vasectomy Day will be observed Oct. 18. This event was decreed by Jonathan Stack, an award-winning documentary filmmaker. The event will be celebrated by Dr. Doug Stein performing his favorite operation - you guessed it! - live from Australia. Stein has performed more than 30,000 vasectomies, perhaps a world record. Stack went to Stein for his own procedure, and thus got the idea for the film. His reasons for favoring vasectomy include: "It's time for men to share the burden of family planning" and "we have to do a fairer job of sharing the planet's finite resources."

You can find out more at:, including links to the film's trailer. They need money to finish this important film. I donated already, and hope that you will also consider supporting this film - because it is time for men to share the burden of family planning. doclink

Derided as 'Slut Pill,' New Contraceptive Coming Soon?

August 13, 2013, MSN News   By: James Eng

A study published last month in the journal Contraception looked at whether women at abortion and family-planning clinics might be interested in repeated use of a pericoital pill. A majority said they were.

Five decades after the birth-control pill debuted in the United States, a so-called "pericoital pill" is among the alternative contraceptive choices scientists have been busy studying.

Currently, no oral birth control method is approved for use only when needed - that is, at the time of sex.

"There is widespread agreement that the best candidate for a pericoital pill is a woman who has sex infrequently," said Diana Greene Foster, an associate professor at the University of California San Francisco's Department of Obstetrics, Gynecology and Reproductive Sciences and an author of the Contraception study.

"Women who have frequent sex would do better to take the daily pill (lower dose of hormones and higher effectiveness) or use a long term method of birth control like the IUD or implant," she said.
. . . more doclink

Cost of Birth Control Higher in Some Low-income Neighborhoods Than in Wealthy Ones

May 6, 2013, Huffington Post

A small study by the University of Tennessee physicians that analyzed prescription price data from Florida reported: "We saw several contraceptive options that are more expensive in lower income areas, and that expense may limit access." The findings were released at meeting of the American Congress of Obstetricians and Gynecologists.

Researchers focused on the price of seven commonly-used contraceptives -- including various forms of the pill as well as transvaginal options like the ring. Nearly every prescription contraceptive was more expensive in low-income zip codes, the cost varying in most cases by just a few dollars, but for two of the contraceptives, it was significantly less in the wealthiest zip codes.

The reason for the difference may be that certain neighborhoods do not have a chain pharmacy that offers lower prices and runs specials.

Dr. Jeffrey Peipert, vice chair of clinical research at the Washington University in St. Louis Department of Obstetrics and Gynecology, pointed out that uninsured consumers have access to, and regularly utilize, other options, including federally funded clinics that offer free birth control, or one that offers services on a sliding scale based on income. However, Peipert agreed that cost is one of the biggest barriers to prescription birth control access. "We have so many barriers in the U.S., and we have rates of unintended pregnancy that are far higher than other developed countries," he said.

Peipert led the project which counseled young women on contraceptive methods and offered the method of their choosing at no cost. After a year, 86% of the women who chose a long-acting contraceptive method were still using it, as were 55% of women who chose a non long-acting method, like the pill.

"The big question is why don't we, in the U.S., level the playing field so all women can have equal access to no-cost contraception?" Peipert said. doclink

Karen Gaia says: see

When more than 9,000 women ages 14 to 45 in the St. Louis area were given no-cost contraception for three years, abortion rates dropped from two-thirds to three-quarters lower than the national rate, because women chose the more expensive, more effective types of birth control.

Plan B OK'd Over Counter for 15 and Older

May 1, 2013, Boston Globe   By: Deborah Kotz

The Food and Drug Administration said that it would allow Plan B One-Step emergency contraception to be offered on drugstore shelves next to other family planning products such as condoms and pregnancy tests. -- but only to those age 15 and over.

Consumers will be required to show proof of age at the register. Many of those under age 17 may not have a photo ID if they do not yet have a driver's license.

Emergency contraception contains high doses of the female hormone progestin and needs to be taken within three days of unprotected sex to prevent pregnancy; it's currently available without a prescription to those age 17 and over but is kept behind a pharmacy counter and dispensed only when the pharmacy is open.

The FDA said that women age 15 and older "understood that the product was not for routine use and would not protect them against sexually transmitted diseases" and could be used safely without a doctor's supervision. doclink

Karen Gaia says: the latest news is that President Obama is planning to appeal this decision.

Infographic on Contraception

April 11, 2013, Greatest

Get health and fitness tips at


Fertility and Economic Growth in Bangladesh

Population Reference Bureau blog

While the average family in Bangladesh today has about four children fewer than their parents' generation, that family has about six times the purchasing power. This PRB ENGAGE Mini-Presentation examines how fertility and income have changed in Bangladesh, and highlights the role that family planning can play in helping families achieve higher levels of education and in accumulating more wealth.


U.S.: The Truth of Emergency Contraception

February 20, 2013, Oklahoma Gazette   By: Annie-Rose Strasser

Under the Affordable Care Act, contraception coverage without cost to women is required as part of basic health care coverage. However, despite overwhelming evidence that the ability to plan and space pregnancies critically impacts a woman's health and the health of her children, many employers are suing the federal government, claiming that the requirement to cover contraception violates their personal religious beliefs, one of which is that emergency contraception, the "morning-after pill," is the same as abortion.

Abortion foes believe what isn't true when they equate contraception and emergency contraception with abortion. They don't believe what is true when they fail to see that the best way to prevent abortion is to provide reliable birth control.

After unprotected intercourse, sperm can live in the woman's reproductive system for up to five days, waiting for the egg to be released. But the morning-after pill works by preventing the release of the egg, thereby preventing fertilization and pregnancy. It decreases the likelihood of pregnancy by about 80%.

The product descriptions for the two available medications state that blocking implantation of an embryo is a possible mechanism for these medications, but newer studies dispute this. Neither medication interrupts an established pregnancy, so the idea that emergency contraception equates to abortion is false.

Rape victims and women who have a contraceptive failure have a vital need for access to emergency contraception.

The medical practice has always helped people recover from the consequences of their lifestyle choices. We provide emergency care to people injured from risky behavior and cardiac care to patients who develop heart disease from their diet and exercise habits, and we treat lung cancer patients who smoke.

50% of U.S. pregnancies are unplanned, and 25% end in abortion. Data from the U.S. and other countries shows us that making abortion illegal does not prevent its occurrence.

A study of no-cost contraception provided to women in the St. Louis area showed that, without cost as a determining factor, more women chose the very effective long-acting methods of contraception, and had 75% fewer abortions than other women in the same region. The teen pregnancy rate in study participants was 6 per 1,000 teens compared to 34 per 1,000 for the region.

We must expand access to the only proven method of abortion prevention: effective contraception. doclink

U.S.: Morning-after Pill Not Making Women Slutty

February 17, 2013, Mother Jones

CDC reports that 5.8 million American women have used emergency contraception (EC) between 2006 and 2010. Nearly a quarter of sexually active women ages 20 through 24 have used it.

In 2002, only 4% of fertile, sexually active women said they had used EC, compared with 11% today.

Only 5% of women over 30 have used it. Most respondents say they have only used it once -- disproving the theory that the morning-after pill is enabling women to be irresponsible hussies.

Last year, HHS ruled that Plan B One Step could be sold to women under 17 only by prescription. This differed from the FDA's determination that it is safe for all women who are old enough to bear children.

The HHS decision made it harder for all women, not just teenagers, to access EC. Now people get carded at the pharmacy, which makes it more difficult for women without ID -- or their male partners -- to purchase the drug. Delays in accessing EC can reduce its effectiveness since it must be used within 72 hours of unprotected sex.

Black and Hispanic women - and women with no more than a high school diploma - were more likely to have used EC after unprotected sex. White women and women with a bachelor's degree or higher use it as a backup method when they feared their primary method had failed.

The prevalence of EC will likely increase, especially when places like Shippensburg University of Pennsylvania install EC vending machines. doclink

U.S.: IUD Evangelism: the Birth Control That Converts

December 10, 2012, Cut   By: KAT STOEFFEL

An IUD is a T-shaped device - smaller than a penny - that is inserted by a doctor or nurse in a less-than 15 minute procedure, and remains in the uterus, preventing pregnancy for up to ten years with minimal side effects.

In 2002, IUDs made up 2% of Americans' contraceptive use. Now combined use of the ParaGard copper IUD and Mirena hormonal IUD accounts for more than 10%, and the rate is expected to continue rising, thanks to inclusion in the Affordable Care Act's contraception coverage mandate.

There are about 4,700 IUD-related threads on

Costs for the device and insertion can be as much as $1,000. An aggressively marketed and fatally defective seventies model, the Dalkon Shield, waylaid the IUD's popularity when it was recalled amid a highly publicized, class-action lawsuit. One of Dalkon Shield's disastrous side effects was pelvic inflammatory disease, a complication of gonorrhea and chlamydia that can cause infertility. Consequently, some doctors can be reluctant to prescribe IUDs to women who haven't finished having children or sleeping around. Nonetheless, its reputation held in Europe, where about 20% of contraceptive-using women currently have one.

Are you tired of refilling birth control prescriptions? Can't remember where you left your pills? With the IUD, you're baby-proof for up to ten years. Do the hormones in birth control pills make you cry? The IUD is as effective as sterilization until you take it out.

USAID workers say that the IUD is among the most popular methods of birth control worldwide, favored in countries where men resist condom use.

The device is inserted into the uterus is through the cervix, which can hurt.

The American College of Obstetricians and Gynecologists has recommended IUDs "as a first-line contraceptive option" for sexually active teenagers this year, but NARAL Pro-Choice New York recently found that about a third of 16- to 17-year-old women don't know anything about the IUD, and one in five 18- to 25-year-olds had never heard of it either.

Finding a doctor who will insert and IUD may be a problem. "Many providers are not up to date on the research," said Dr. Sophia Yen, an adolescent medicine specialist who thinks the IUD is an underrated strategy for preventing teen pregnancies. doclink

Electrically Spun Fabric Offers Dual Defense Against Pregnancy, HIV

November 30, 2012, Science Daily

Electrically spun cloth with nanometer-sized fibers which can dissolve to release contraception and drugs to prevent HIV has been developed by a University of Washington team.

"Our dream is to create a product women can use to protect themselves from HIV infection and unintended pregnancy," said Kim Woodrow, a UW assistant professor of bioengineering. "We have the drugs to do that. It's really about delivering them in a way that makes them more potent, and allows a woman to want to use it."

The electrospun stretchy cloth could be inserted directly in the body or be used as a coating on vaginal rings or other products to physically block sperm or release chemical contraceptives and antivirals.

One of the fabrics they made dissolves within minutes, another dissolves gradually over a few days, providing an option for sustained delivery, more like the birth-control pill, to provide contraception and guard against HIV.

The fabric could incorporate many fibers to guard against many different sexually transmitted infections. Mixed fibers could be designed to release drugs at different times to increase their potency, like the prime-boost method used in vaccines.

While this technology is more discrete than a condom, and potentially more versatile than pills or plastic or rubber devices, researchers say there is no single right answer. It depends on cultural background and personal preferences of the people who might use it.

The research to date was funded by the National Institutes of Health and the UW's Center for AIDS Research. The Bill & Melinda Gates Foundation last month awarded the UW researchers almost $1 million to pursue the technology. The team will use the Gates Foundation grant to evaluate the versatility and feasibility of their system. The group will hire more research staff and buy an electrospinning machine to make butcher-paper sized sheets. The expanded team will spend a year testing combinations that deliver two antiretroviral drugs used to treat HIV and a hormonal contraceptive, and then six months scaling up production of the most promising materials. doclink

U.S.: IUDs, Implants Urged for Teen Girls' Birth Control

September 20, 2012, Sacramento Bee   By: LINDSEY TANNER

Teenage girls may prefer the pill, the patch or even wishful thinking, but the American College of Obstetricians and Gynecologists recommends IUDs or hormonal implants - long-lasting and more effective birth control that you don't have to remember to use every time.

The IUD and implants are safe and nearly 100 percent effective at preventing pregnancy, and should be "first-line recommendations," the American College of Obstetricians and Gynecologists said in updating its guidance for teens.

Both types of contraception are more invasive than the pill, requiring a doctor to put them in place. And they cost hundreds of dollars. But birth control pills often must be taken at the very same time every day to be most potent. And forgetting to take even one can lead to pregnancy, which is why the pill is sometimes only 91% effective.

An IUD, or intrauterine device, is a small, T-shaped piece of plastic inserted in the uterus that can prevent pregnancy for up to 10 years. An implant is a matchstick-size plastic rod that releases hormones. It is placed under the skin of the upper arm and usually lasts three years.

The organization's previous guidelines, issued in 2007, also encouraged the use of IUDs and implants among teenagers. The new guidelines go further in saying physicians should discuss the two types of birth control with sexually active teens at every doctor visit.

The gynecologists group said condoms should still be used at all times because no other birth control method protects against AIDS and other sexually transmitted diseases.

43% of girls ages 15 to 19 have had sex, a government survey found. Most are using some kind of effective birth control, but only about 5% use the long-lasting devices.

In 21 states, all teenagers can get contraceptives without parental permission, according to the Guttmacher Institute, which tracks laws affecting women's health. A few other states allow it under certain circumstances.

Some pediatricians have been reluctant to recommend IUDs for teens, partly because of concerns over infection risks; an IUD called the Dalkon Shield that was sold in the 1970s was linked to dangerous and sometimes deadly infections. Newer IUDs have been found to be safe, and the gynecologists group said the risk of pelvic infections increases only slightly during the first three weeks after insertion.

The hormonal implant has been updated, too. The newest kind uses just one thin rod; an older type no longer sold in the U.S. used six rods that sometimes didn't stay in place. IUDs and implants can be removed at any time with no lasting effect on fertility, the gynecologists group said. doclink

U.K.: Contraception is No Stroll in the Park and Men Should Share the Stress

September 12, 2012, Mail and Guardian   By: Ray Filar

Whether you want childless sex with a partner, or free-for-all romps in rooms covered in baby oil, sexual liberation comes at a price. (1)

It was recently revealed that the contraceptive implant Implanon can sometimes just disappear inside women's bodies. It is undetectable by x-ray. (2)

Older women were originally prescribed the implant because, post-removal, fertility returns more quickly than with the contraceptive pill. But if the implant is lost, by the time the implant's hormones run out (they last for three years) these women may no longer be fertile. (3)

The NHS has now upgraded to an x-rayable version of the implant, but if it travels, it would still require surgery for removal. With Implanon, almost 20% of women experienced prolonged bleeding and more than 10% experienced headaches, vaginitis, weight increase, acne, breast pain or abdominal pain. (4)

NHS guidelines repeatedly note cost effectiveness as a reason for recommending hormonal implants, injections, and intrauterine systems to women. (5)

Meanwhile, the contraceptive pill comes with a whole host of similar assorted miseries. Though for many women these can be liberating choices that unshackle pleasurable sex from reproduction, for others, dramatic side-effects make life a trial. Women have many "choices", each as woeful as the last. Implants get lost, barriers might break, or give you cystitis; injections make you fat. Faced with this, women are playing hormone roulette, holding out for the one perfect method that often doesn't exist. At the same time, nobody is asking what it means for up to 44% of British fertile women to be constantly on a cocktail of synthetic hormones. (6)

An apparently 100% effective, side-effect free, non-hormonal male contraceptive named RISUG is currently stalled in advanced clinical trials in India. While stops and starts in developing RISUG might also represent a worthwhile care over its safety, no such qualms are extended to contraceptives for women.

The lack of male contraceptives places the onus of contraception squarely on women's shoulders. With condoms sometimes an unsatisfactory solution in long-term relationships, and -- despite 16% of British men under 70 opting for vasectomy -- the likely permanence of the procedure makes it an impractical option for most men.

Women are made into gatekeepers of sex, responsible for all precautions, reprehensible where precautions fail. doclink

Karen Gaia says: While the author does have a point about RISUG, I do take exception to the following points: 1. Sexual liberation? How about freedom from having so many children within a marriage or relationship? 2. Implanon rods can be located through high-frequency ultrasound or MRI. 3. The chances of migration are very slim. Woman will weigh that risk when they consider what method of birth control to use. 4. As in #3, women need to choose the method that works for them. In the case of all modern contraception, the risks of pregnancy far outweigh the risks of contraception. 5. Implants and IUDs are the most effective method of birth control. Again, the risks of pregnancy far outweigh the risks of contraception. 6. Sounds like the author has been listening to much to anti-contraception, anti-sex propaganda. I know plenty of people who have suffered no or only minimal side effects from contraception, but were very appreciative that they didn't have 12 children instead of a

U.S.: Women Report Available Contraceptive Methods Do Not Fully Meet Their Needs

September 17, 2012, Guttmacher Institute   By: Lauren N. Lessard, Deborah Karasek, Sandi Ma, Philip Darney, Julianna Deardorff, Maureen Lahiff, Dan Grossman and Diana Greene Foster

A study surveyed 574 women who were seeking abortions and considered to be at high risk of engaging in unprotected sex and experiencing an unintended pregnancy, and it was found that the contraceptive methods currently available largely lack the features that are important to them, such as: effectiveness (84%), lack of side effects (78%) and affordability (76%). In addition, more than two-thirds of women surveyed wanted a method that was easy to access (74%) and to use (74%), and that they had control over (70%) or were responsible for using (69%).

For most (91%) of the women, not a single available contraceptive method had all of the features they deemed most important. The average match ranged from 67% for the contraceptive ring and sponge to 37% for withdrawal and natural family planning. Oral contraceptives, the reversible method most commonly used by American women, were a 60% match, while male condoms were a 42% match. If the pill were available without a prescription, it would have 71% of the features women prioritized.

New contraceptive options based on women's preferences need to be designed and promoted, thereby increasing their satisfaction with their method choice, and potentially encouraging more consistent use. More consistent use could, in turn result, in lower rates of unintended pregnancy. doclink

U.S.: How to Find Out If and When Your Health Plan Will Begin Covering Women's Preventive Services with No Co-Pay

August 30, 2012, Center for Reproductive Rights

If your plan is not grandfathered*, your health plan should be providing coverage for women's preventive services with no cost-sharing in the next plan year. Call your insurance plan to find out when you'll begin receiving coverage for women's preventive services without cost sharing and how these services will be covered.

We have provided a phone script for you to use when talking to your insurance plan. (Be aware that if your next plan year is more than 30 days away, your plan may not know the details of the new coverage. You may need to call them back closer to the first day of the new plan year.)


Long-Term Contraception More Effective

May 24, 2012, Yahoo! News

Women who choose birth control pills, the patch or vaginal ring are 20 times more likely to have an unplanned pregnancy than those using long-term methods such as IUDs and implants, researchers at the Washington University School of Medicine in St. Louis found.

Among young women under 21 who chose the pill, the patch or vaginal ring, the risk of unintended pregnancy is almost twice as high as that for older women.

Intrauterine devices "and implants are more effective because women can forget about them after clinicians put the devices in place."

Unplanned pregnancies remain a major health problem in the United States. About three million pregnancies per year -- half of all pregnancies -- are unplanned, very high for a developed nation.

IUDs and implants have failure rates of less than 1%. "But although IUDs are very effective and have been proven safe in women and adolescents, they only are chosen by 5.5 percent of women in the United States who use contraception," reported senior author and OBGYN Jeffrey Peipert. Few women can easily afford them as the cost can reach around $500. However "when IUDs and implants are provided at no cost, about 75 percent of women chose these methods for birth control." doclink

U.S.: A Political History of Contraception: When the Catholic Church Nearly Approved the Pill

February 26, 2012, Washington Post

The battle over birth control was fought and won half a century ago. At that time, the vast majority of Americans, nearly all mainstream religious organizations and leaders in both political parties accepted contraception as beneficial to families, society and the world.

The move toward acceptance of contraception began in the early 20th century and accelerated in the 1940s. When the Birth Control Federation of America changed its name to the Planned Parenthood Federation of America, Abraham Stone, medical director of the Margaret Sanger Research Bureau, explained at the time that "planned parenthood" signaled "the need for individual couples to plan their families and for nations to plan their populations."

In 1959 President Dwight D. Eisenhower declare: "The government will not, so long as I am here, have a positive political doctrine in its program that has to do with the problem of birth control. That's not our business." But in the 1960s, President John F. Kennedy - the first Catholic US president - supported family-planning programs as part of foreign aid. Then Eisenhower came around, saying "Governments must act. . . . Failure would limit the expectations of future generations to abject poverty and suffering and bring down upon us history's condemnation."

Thereafter, for two decades, every American president promoted contraception as an essential part of domestic and foreign policy. Even the Catholic Church considered lifting its prohibition on contraception - and almost did.

Prior to the 1930s, the church had no official position on contraception. But on Dec. 31, 1930, Pope Pius XI issued a papal encyclical which for the first time explicitly prohibited Catholics from using contraception.

Margaret Sanger, a daughter of Irish Catholic immigrants, protested the pope's decree; her passionate commitment to promoting birth control stemmed from watching her mother weaken and die at age 50, having given birth to 11 children. She blamed her mother's premature death on constant childbearing and lack of access to contraceptives.

John Rock, a devout Catholic doctor - who taught at Harvard Medical School and who would become one of the leading clinical researchers responsible for developing the pill - also opposed the ban. Besides being medically necessary at times, he said it was personally desirable for maintaining happy marriages and well-planned families and essential for those who could not afford many children. In the 1940s, Rock promoted diaphragms - even though birth control was illegal in Massachusetts.

Rock believed church would accept the pill was a means of birth control because it simply repressed ovulation and replicated the body's hormonal condition in early pregnancy. He even wrote a book on it: "The Time Has Come: A Catholic Doctor's Proposals to End the Battle Over Birth Control."

In 1962 Pope John XXIII convened the Second Vatican Council, which resulted in a number of reforms that modernized church practices. But he died as he was putting together a committee to consider the matter of the pill. In 1964, Pope Paul appointed a commission to advise him on birth control. Many journalists, clergy and lay Catholics expected the church to lift the ban. A significant majority of its members including 60 of 64 theologians and nine of the 15 cardinals favored lifting the ban. But Pope Paul issued a formal encyclical, Humanae Vitae ("Of Human Life") in 1968, siding with the minority and reaffirming the church's prohibition of any form of artificial birth control.

Many Catholic leaders criticized the decision. Two years after the decree, two-thirds of Catholic women were using contraception. Now, according to data from the Department of Health and Human Services, Catholic women use birth control at the same rate as non-Catholic women.

In 1984, during the presidency of Ronald Reagan, the United States sent two opponents of abortion rights to a United Nations conference on population in Mexico City. These delegates established the Mexico City Policy, a global gag rule that refused U.S. government support to any agency, American or foreign, that used its own funds to support abortion services. Such facilities were prohibited from receiving any U.S. funds for family planning, even if the money would not be used for abortion-related services.

It was after this that bipartisan support for contraception began to crumble.

The Mexico City Policy was rescinded by Democratic President Bill Clinton, reinstated by Republican George W. Bush, and rescinded by Democratic President Barack Obama.

Now, even though more than 99% of sexually experienced women report having used contraception, we are once again debating whether women should have access to birth control. doclink

Who Guidance Confirms Safety of Hormonal Contraception for Women at Risk of HIV Or Living with HIV

February 17, 2012, EngenderHealth News Blog

EngenderHealth, with 70 years of experience in ensuring clients' rights and improving access to quality family planning and reproductive health services, supports the WHO guidance and reccommends to its staff that no restrictions be placed on the use of hormonal contraceptives for women at risk of HIV or living with HIV. There is insufficient evidence of an association between hormonal contraceptive use and HIV risk to warrant any change in this guidance, but they strongly advise women at high risk of HIV who are using progestogen-only injectables to use condoms and other HIV preventive measures. Furthermore, WHO stresses the need for women and couples to have access to a wide range of contraceptive methods and for further research on the relationship between hormonal contraception and HIV to be undertaken.

Women living in places hit hardest by HIV and AIDS-they are at higher risk of contracting HIV and of dying from a pregnancy-related condition.

Because the possibility of a link between hormonal contraceptives and HIV was widely covered in the media worldwide, women must be assured that their method of choice does not put them at undue risk of HIV-and that not using contraception poses the risk of an unplanned pregnancy, which carries another set of potential dangers. Access to hormonal contraceptives must continue to preserve women's health and well-being.

The ability for individuals to make informed choices and voluntary decisions, not only about family planning, but about all aspects of sexual and reproductive health, is a fundamental principle rooted in human rights and underpinning quality care. It means that a wide range of contraceptive methods is available and accessible-including long-acting and permanent options-and that women and couples are counseled about the known risks and benefits of each method.

Engaging men on the importance of sharing responsibilities for family planning and reproductive health-including encouraging them to use condoms for dual protection and to access health care services, including getting tested for HIV-is essential for preventing HIV infection and maintaining strong reproductive health.

Because some 50-85% of women living with HIV do not want to become pregnant, access to voluntary, affordable, and appropriate contraceptive information and services can help women avoid unintended pregnancies and associated health risks, including the risk of vertical transmission.

Women must have a wide choice of family planning methods - when a woman's method of choice is unavailable, she is more likely to forgo contraception altogether. Many modern methods of contraception, including long-acting and permanent methods (LA/PMs), such as the intrauterine device (IUD), are vastly underutilized in Africa, even though women and couples who have decided to space and/or limit their families could benefit greatly from using them. doclink

A Contraceptive's Risks (According to Betsy Hartmann)

October 12, 2011, New York Times*

We need to combat this misrepresentation by writing LTEs to the New York times.

Dr. Betsy Hartman, director of the population and development program at Hampshire College, wrote the following Letter to the Editor (excerpted) regarding the article Contraceptive Said to Double Risks of H.I.V. (see the link in the headline above).

She said:

"There is a larger context behind the recent finding that the injectable contraceptive Depo-Provera may increase the risk of women and their male partners becoming infected with H.I.V. For over a decade other studies have warned about this connection."

"As a matter of precaution, family planning agencies should have started phasing out injectables, especially in communities at high risk of H.I.V., and encouraged other contraceptive methods. Instead, injectables are vigorously promoted in Africa because they are viewed as a cheap, effective way to reduce population growth."

"Depo-Provera has other serious risks and adverse effects, including loss of bone density in young women, significant weight gain and increased depression. In the United States it is mainly targeted at low-income women and women of color."

~~~ Now, Lets look at a more complete picture:

The most popular contraceptive for women in eastern and southern Africa, a hormone shot given every three months, appears to double the risk the women will become infected with H.I.V., according to a large study published Monday. And when it is used by H.I.V.-positive women, their male partners are twice as likely to become infected than if the women had used no contraception.

The findings potentially present an alarming quandary for women in Africa. Hundreds of thousands of them suffer injuries, bleeding, infections and even death in childbirth from unintended pregnancies. Finding affordable and convenient contraceptives is a pressing goal for international health authorities.

But many countries where pregnancy rates are highest are also ravaged by H.I.V., the virus that causes AIDS. So the evidence suggesting that the injectable contraceptive has biological properties that may make women and men more vulnerable to H.I.V. infection is particularly troubling.

Injectable hormones are very popular. About 12 million women between the ages of 15 and 49 in sub-Saharan Africa, roughly 6 percent of all women in that age group, use them. In the United States, it is 1.2 million, or 3 percent of women using contraception. While the study involved only African women, scientists said biological effects would probably be the same for all women. But they emphasized that concern was greatest in Africa because the risk of H.I.V. transmission from heterosexual sex was so much higher there than elsewhere.

"The best contraception today is injectable hormonal contraception because you don't need a doctor, it's long-lasting, it enables women to control timing and spacing of birth without a lot of fuss and travel," said Isobel Coleman, director of the women and foreign policy program at the Council on Foreign Relations. "If it is now proven that these contraceptions are helping spread the AIDS epidemic, we have a major health crisis on our hands."

Mary Lyn Gaffield, an epidemiologist in the World Health Organization's department of reproductive health and research said "We want to make sure that we warn when there is a real need to warn, but at the same time we don't want to come up with a hasty judgment that would have far-reaching severe consequences for the sexual and reproductive health of women," she said. "This is a very difficult dilemma."

The researchers recorded condom use, essentially excluding the possibility that increased infection occurred because couples using contraceptives were less likely to use condoms.

The researchers also found that oral contraceptives appeared to increase risk of H.I.V. infection and transmission, but the number of pill users in the study was too small to be considered statistically significant, the authors said.

Previous research on the pill has been more mixed than with injectables, which could have a greater impact because they involve a strong dose meant to last for three months.

In another troubling finding, results from the same study, published separately, showed that pregnancy also doubled the risk of women's contracting H.l.V. and of infected women's transmitting it to men. That may partly be due to increased unprotected sex, but could also relate to hormones, researchers said.

But there are no simple solutions, the authors acknowledge. Any warning against such a popular contraceptive method may not only increase complications from pregnancy but increase H.I.V. transmission, too, since pregnancy itself may raise a woman's risk of H.I.V. infection.

First, the researchers and others say, greater emphasis should be placed on condom use along with hormonal methods.

Dr. Ludo Lavreys, an epidemiologist who led one of the first studies to link injectable contraceptives to increased H.I.V. risk, said intrauterine devices, implants and other methods should be explored and expanded. "Before you stop" recommending injectables, he said, "you have to offer them something else." doclink

Karen Gaia says: I know people who have used Depro-Provera, and they had no side effects.
Statement from Pathfinder:
The international health community, led by WHO and USAID, has been swift to caution that the weight of evidence does not indicate that use of hormonal contraception increases the risk of HIV acquisition, transmission, or progression.
Our family planning and HIV experts support WHO and USAID's recommendation for more research. Premature speculation can have an enormous and harmful impact on the health of women, men, and young people Pathfinder serves. Learn more about Pathfinder's position on the study:

Long-term Effectiveness of New Family Planning Method Shown in Study

September 20, 2011, Georgetown University Medical Center

The Standard Days Method© a simple-to-use, fertility-awareness based method of family planning was found in 2002 to be more than 95% effective at avoiding pregnancy. Recently a multi-country study of 1659 women found that this effectiveness continued throughout the second and third years of use. This effectiveness rate is higher than other use-directed methods such as diaphragm or condom

The Standard Days Method identifies the 12-day "fertile window" of a woman's menstrual cycle. These 12 days take into account the life span of the woman's egg (about 24 hours) and the viable life of sperm (about five days) as well as the variation in the actual timing of ovulation from one cycle to the next. It does not involve medications or devices that might affect womens health. It was developed at Georgetown University Medical Center. Women use these methods for health or religious or cultural reasons.

James N. Gribble, Sc.D. of the Population Reference Bureau and senior author of the 2011 paper, says: "Family planning enables women to have the desired number of children and to space and time births. Almost all the 2011 study participants had children, often with at least one child younger than two years old, before they began to use the Standard Days Method," he says. "Yet few of the study participants had unplanned pregnancy over the three-year period of the study due to the method's very high effectiveness."

Women who follow the Standard Days Method often use CycleBeads©, a string of 32 color-coded beads with each bead representing a day of the menstrual cycle, to know on which days pregnancy is likely or unlikely. Beginning with the red bead, which represents the first day of her menstrual period, the woman moves a small rubber ring one bead each day. The brown beads are the days when pregnancy is very unlikely, and the glow-in-the dark white beads (beads 8-19) represent her fertile days.

Funding for the new study was provided by the Institute for Reproductive Health and a grant from the United States Agency for International Development (USAID).

With support from USAID, more than three million women in Asia, Africa, South and Central America have been exposed to the fertility awareness-based family planning methods developed by Georgetown researchers. doclink

Karen Gaia says: the cycle beads may also be useful in communicating to the husband when the wife needs to avoid intercourse. Of course this method requires the full cooperation of the husband. In some areas birth control has to be kept a secret, if not from the husband, then from the in-laws or the mullah.

Female Condoms Slowly Gaining Popularity

August 11, 2011, Alternet

The UN Population Fund (UNFPA) reports "For the fourth consecutive year, access to female condoms has increased dramatically, reaching a record number of 50 million... in 2009."

The female condom is a 17cm-long polyurethane sheath with a flexible ring at each end. It provides about the same protection from sexually transmitted infections - including HIV - and unwanted pregnancy as the male condom, but unlike the male condom, can be used with oil- and water-based lubricants without the risk of breakage.

Governments and technical agencies have worked in partnership on the Female Condom Initiative launched in 2005 in 24 countries to ensure that female condom programming was integral to national AIDS policies and reproductive health programs.

The female condom has turned out to be a tool for women's empowerment, enabling women and adolescent girls to take the initiative to protect their own and their partners' health.

In Zimbabwe, billboards, radio spots and TV adverts helped boost female condom distribution by the public sector from about 400,000 in 2005 to more than two million in 2008, while the sales of female condoms went up from 900,000 in 2005 to more than three million in 2008. Hairdressers also helped market the female condom.

"Often the hairdresser will work from a chair in her back yard. Such improvised salons stay open at all hours, so women can have their hair done - and discuss personal matters - in privacy," the authors reported.

This approach was also used successfully in Guyana and Malawi.

Married women in Ethiopia, learned about the female condom at coffee ceremonies, an age-old social custom. Because condoms - perceived to be used by promiscuous people and sex workers - are highly stigmatised in Ethiopian society, programmers highlighted the family planning benefits of the female condom.

In Myanmar, efforts targeted high-risk female sex workers and men who have sex with men.

Male condoms still have a higher popularity rating than the female condom. In Kenya women have shown little interest. Sex workers show a high demand, but overall demand is low due to general unavailability and lack of information.

"Except for female sex workers and highly empowered women, most other women do not have the capacity to demand safe sex... the majority of women depend on their sexual partners to protect them." doclink

U.K.: Contraception: Busting the Myths; We Have More Birth Control Options Than Ever but We've Never Been So Confused

August 16, 2011, The Independent

Three out of four women are using some form of contraception when they get pregnant. The Pill has a failure rate of 8% due to incorrect use.

Even though the Pill is widely held to be one of the leading inventions of the 20th century, giving women power over their bodies, birth control in the UK remains hit and miss - with 600 abortions every day and more than 40% of pregnancies unplanned.

A YouGov survey shows that 50% of women spend less than half an hour choosing birth control, with decisions based on half-truths and gossip.

For example, many women believe the Pill is the most effective contraceptive. It has a failure rate of only 0.3% if taken correctly, but one in 12 women forget to take up to four pills every month. Women who work shifts regularly or cross time-zones, such as air stewards for instance, will have problems taking the Pill on time," says the Family Planning Association's information manager, Lynn Hearton.

Another myth is that condoms are useful only to prevent STDs in casual sex, but they are very useful for couples in and out of long-term relationships, says Hearton: "Used properly, they are very effective with no side effects." The failure rate for perfect use is 2%, but can be as much as 15% in typical use in one-night stands. "Anything can go wrong in the heat of the moment," says Hearton. What to do: Practise condom negotiation with the help of the International Planned Parenthood Federation's website:

Many think that long-acting reversible contraception (LARCs) is difficult to remove and can cause infertility, but they are, in fact, very effective, easy to remove and do not affect fertility. It is this myth that accounts for the low usage of LARCs, with only 8% of U.K. women using them, including implants, injections, the copper coil (IUD) and hormonal coil (IUS), In Scandinavia and much of Europe has a much higher rate of LARCs usage, because of greater efforts to keep women informed.

Many women do not know that different contraceptive methods can bring major health benefits. Women with heavy periods or endometriosis can benefit from the hormonal coil, which makes periods lighter, shorter or stop. The combined Pill can help alleviate heavy, painful periods as well as alleviate PMS. Acne, hirsutism or polycystic ovary syndrome (PCOS) can be helped with the Combined Pill containing anti-androgenic progestogen. Yasmin is the best product for mild symptoms, while Dianette is suitable for the more severe disorders. There are claims that the contraceptive ring (Nuva ring self-inserted in the vagina monthly), improves blood flow to genital areas, thereby boosting libido. A handful of studies also suggest that contraceptive Pills with lower levels of progestogen boost mood and prevent vaginal dryness.

Many women feel that, once you've finished your family, sterilization is best,. However, sterilization is rarely reversible. It may make more sense to use a long-acting contraceptive that can be removed.

Women should also know that, as well as the emergency Pill, the copper intrauterine device (IUD) can also be used as emergency contraception as long it is fitted up to five days (120 hours) after unprotected sex.

50% of women make an appointment to see the GP and simply ask for the Pill, usually ending up with the cheapest possible Pill,. Dr Tina Peers, consultant in contraception and sexual health at Surrey PCT said, "Unfortunately, up to 60% of women discontinue the Pill within a year, often because of unwanted symptoms." It is better to spend time getting informed before you see an expert.

FPA has an interactive page on contraception at doclink

Birth Control: Yesterday, Today and Tomorrow

July 29, 2011, The Nation (US)

On the heels of the Institute of Medicine (IOM) recommendation that birth control be covered by all insurance plans, and without co-payment, the author reviewed Janet Farrell Brodie's fascinating Contraception and Abortion in Nineteenth-Century America.

In antebellum America,there were tracts like Charles Knowlton's "Fruits of Philosophy or the Private Companion of Young Married People" (contained a summary of what was then known about the physiology of conception, listed a number of methods to treat infertility and impotence, and explained a method of birth control: to wash out the vagina after intercourse with certain chemical solutions); newspapers carried ads for medications; and douches and 'womb veils,' early forms of the diaphragm, which some women wore for years at a time.

In most states abortion before 'quickening' was legal until after the Civil War and widely practiced; abortifacient drugs were easy to find under brand names like The Samaritan's Gift for Females.

Nineteenth-century methods included withdrawal (not for everyone), reusable condoms, and douching with cold water and baking soda after intercourse. Some so-called experts got the rhythm method exactly backward. With these methods backed up by abortion, the average native-born American woman had only four in 1900 compared to eight in 1800, despite the clampdown on birth control and information by the Comstock laws of the 1870s.

Contraception is not some newfangled fad foisted by the cultural elite on decent God-fearing folk. Americans have striven to separate sex from reproduction for more than two centuries. Today 99%of women have used birth control at some point. It is lifesaving and health-preserving medicine. And yet the myth that birth control is 'controversial' persists.

How many women does it take to equal one bishop? doclink

U.S.: Implants for Birth Control Work Best

St. Louis Post-Dispatch

The Contraceptive Choice Project by Washington University researchers found the best way to prevent unintended pregnancies and abortions is to provide women with affordable, implantable birth control, which means long-acting, reversible birth control options like intrauterine devices (IUDs) and implants.

"Offering women and men the means with which to plan the timing of their children's births is fundamental to the health of families and society," reads an editorial co-written by Dr. Jeffrey Peipert of Washington University in a recent New England Journal of Medicine.

In the study, a total of 9,250 sexually active women ages 14 to 45 were provided free birth control for three years. More than two-thirds of the women in the study chose an IUD or implant, while the others picked alternate methods including pills, patches or vaginal rings. In the general population, fewer than 3% of women have a birth control implant.

In addition to reducing unplanned pregnancies and abortions, researchers hope to inspire lawmakers to include implantable birth control in preventive care services that insurance companies will be required to cover under health care reform.

The researchers looked at teen pregnancy and repeat abortions - because they are good indicators of an unplanned pregnancy to see if the project was working.

The percentage of repeat abortions in the study area declined from 48% in 2006 to 46% in 2009, while in another area, which did not have the same access to free semi-permanent birth control, the percentage of repeat abortions increased to 49% from 46%.

There was also a "remarkable decline" in births to teenagers, but "there's a trend in the country of teen births going down, so we have to be cautious in our interpretation," Peipert said.

Project leaders say doctors should offer devices and implants as the first and best option for contraception to women. In reality, most women choose birth control pills, which have lowered effectiveness because of missed doses.

About half of all pregnancies in the U.S. are unintended, and half of those women report using contraception during the month of conception, according to surveys conducted by the National Center for Health Statistics.

"People don't realize the failure rate for birth control pills is about ten times higher than IUD or implant," Peipert said. "People always say if you take them every day they work perfectly. It's true, but it just doesn't work that way."

The main barriers to increased use of IUDs are cost and awareness, Dr. Jeffrey Peipert of Washington University said.

The IUD is placed in the uterus to prevent sperm from fertilizing an egg, and the implant is inserted under the skin to release hormones that prevent pregnancy. Both devices can last up to 10 years and are removable at any time. Although the implants are cost-effective over time compared to birth control pills, the initial price of $500 to $1,000 is usually not fully covered by insurance.

"If we had a health care system that allowed all women to have access to birth control free of charge, we would save health care dollars and keep young people healthier," Peipert said. doclink

U.S.: An Argument for Making Birth-Control Pills Available Over The Counter

March 1, 2011, Time online

The Guttmacher Institute, a reproductive health think tank, reports that American women spend about five years either pregnant, trying to get pregnant or postpartum; they spend three decades trying to avoid having a baby, making a case for good birth-control options - and lots of them.

A new study from the University of California, San Francisco, found that women who had with a year's supply of birth-control pills had a much lower rate of abortions and unintended pregnancies. Another study from the University of Texas (UT) at Austin found that U.S. women who crossed into Mexico to buy OTC birth control pills are more likely to stay on the Pill longer than women who get pills by prescription at U.S. clinics.

Women who got their pills at clinics in El Paso Texas were 60% more likely to stop taking them during the study period in comparison to women who bought pills without a prescription across the border. And those who got less than six packs of pills at a clinic visit were 80% more likely to stop taking them compared to over-the-counter users.

However, with OTC, women may be choosing a pill that puts them at risk for complications. Women who left Mexico with pills containing synthetic estrogen and progesterone - as opposed to progesterone-only pills - were more likely than women who got prescription pills to have contraindications, or health conditions incompatible with the combination pill (hypertension or smoking over age 34, for example), according to Ibis Reproductive Health, a nonprofit research organization.

But any pill is better than getting pregnant, health-wise.

The progestin pill is used by smokers over the age of 34 or women with high-blood pressure, or for breast-feeding mothers because it doesn't interfere with lactation. However, only 5% of women who use oral contraceptives take it, perhaps because there's some concern it's less effective than the combo pill, although research has not borne that out.

If oral contraception were to be dispensed without a prescription, Ibis recommends the progestin-only pill be the only one offered initially. The combination pill would probably need to be offered along with a conversation with the pharmacist, a checklist of contraindications or perhaps refills only.

So far no birth-control pill manufacturer has applied to the FDA for OTC delivery of the Pill. doclink

Morning-After Pill May Be OK for Non-Emergency Use

March 7, 2011, Reuters

A new report published in Obstetrics and Gynecology say the morning-after pill may be safe and effective as a regular birth control method, comparing favorably with condoms and spermicides in terms of reported rates of unwanted pregnancies. However, it is only approved as an emergency backup after unprotected sex, and the government discourages using it as regular contraception.

Women who have sex infrequently, or for some other reason, may not want to use a regular birth control method and would prefer to use the morning-after pill just before or after the infrequent sex.

The morning-after pill is not as effective as methods women use on a longer basis, such as patches or regular birth control pills, but women using pill around the time they had sex have an estimated 5% chance of getting pregnant over one year, compared to 16% of women whose partner used a condom.

In the U.S., the morning-after pill costs between $10 and $70 and is available over the counter for people over 17. Most morning-after pills (brands include Plan B One-Step and Next Choice) are made of levonorgestrel, a synthetic hormone. doclink

Year's Supply of Birth Control: Limits on Birth Control Pills May Be Costly

March 9, 2011, Reuters

A study found that only 1% of lower-income California women who got a year's supply of the Pill had unplanned pregnancies compared to 3% of those women who got only enough packages for one or three months at a time.

Currently private and public health insurance plans in the U.S. generally limit how many months' worth of birth control pills can be prescribed at once. doclink

The Birth Control Pill and Breast Cancer Risk

Web MD

Note from Karen Gaia: I just did a web interview for Peer Review Radio. On the same podcast, following my interview, was a woman who talked about breast cancer as a risk from birth control pills. The interviewer then suggested that maybe birth control pills were not the best answer for "population control" (as she said it). I am featuring this article from Web MD to set the record straight."

Since the early 1960s, birth control pills have become the most popular and one of the most effective forms of birth control used in the U.S.

A study of more than 100,000 women suggests that the risk of breast cancer was greatest among women aged 45 and over who were still using the pill. This group of women was nearly one-and-a-half times as likely to get breast cancer as women who had never used the pill.

But experts caution that many of the women were using older birth control pills that contained higher doses of hormones. Today's lower-dose birth control pills are thought to reduce this risk.

Ovarian cancer risk, on the other hand, is REDUCED by as much as 30%-50% among women taking birth control pills for at least three years. New studies show that as little as six months of use can dramatically reduce the risk of ovarian cancer, and that protective effect increases the longer a woman is on the pill.

A new study suggests oral contraceptives may also reduce the risk of colorectal cancers. The European study found that women who had ever used birth control pills were about 20% less likely to develop colorectal cancers than women who had never used the pills. The reduced risk was great even if the woman had used the pills recently.

Research found that 10 years or more after women stopped using birth control pills, their breast cancer risk returned to the same level as if they had never used birth control pills.

A study published in the Journal of the American Medical Association found that women with a strong family history of breast cancer may have up to an 11 times higher risk of breast cancer if they have ever taken the pill. But experts caution that the study involved mainly women who took birth control pills prior to 1975, when it contained much higher levels of the hormones estrogen and progestin than today's lower-dose pill.

Those with a family history of breast cancer related to mutations in the BRCA genes should use caution before taking birth control pills. doclink

Karen Gaia says: I am one of those women who took birth control pills to prevent pregnancies after the birth of my daughter in 1963 (I was age 19 and still going to college). I am very thankful that I had the pill because they prevented pregnancy until I had my son 9 years later. Without the pill I would never have completed college nor got the wonderful job that I started when my daughter was 3. The risks of being pregnant and child-bearing are greater than the risks of the pill, and I now have problems caused by childbirth, which would be worse if I had more children, so I am twice as thankful. My daughter was conceived due to careless use of contraceptive foam and impetuousness, which makes me wonder if I could have ever properly used the so-called 'natural' method without getting pregnant.

Failure Rates of Contraception

April 7, 2006

No Contraception 85%
Spermicide use 29%
Withdrawal 27%
Rhythm Method 25%
Diaphragm 16%
Condom 15%
The Pill 8%
Breast Feeding 2%
IUD 0.8%
Tubal 0.5%
Vasectomy 0.15%
Abstinence 0%

Emergency Contraception - Behind the Confusion and How it is Available in the Bathroom of 27% of All Women Using Contraception

April 25, 2003, Patrick Burns

The Yutzpe Method

General instructions: Take one dose every 12 hours for 24 hours, discard the last 7 pills in a 28-pill pack as they do not contain any hormones. If you are using Triphasil, Tri-Levlen, or Trivora, use only the correct color of pills that are noted below. Source: Trussell J, Koenig J, Ellertson C, Stewart F. Preventing unintended pregnancy: the cost-effectiveness of three methods of emergency contraception. American Journal of Public Health 1997;87(6):932-937. Please note that the FDA has explicitly declared that the brands of birth control pills listed above are safe and effective for use as emergency contraceptives. These protocols work!
Confusion among pharmacists and the lay public is widespread, and those in the family planning movement are at least partly to blame. Some incredibility is due to the fact that: in the early 1980s and 1990s, RU-486 (now called the abortion pill) was refered to as 'emergency contraception' and not abortion, leading to confusion as to what we now call 'Emergency Contraception' really is, which is OTC abortion. At the very same time that this was going on, there was little effort to educate women about the use of regular birth control pills as emergency contraception. RU-486 is new to the U.S., but taking massive doses of birth control pills is NOT new. The Yutzpe method (developed 20-25 years ago by Dr. Al Yutzpe), when using the most commonly available birth control pills in the U.S., are that two doses should be taken, 12 hours apart, and within 72 hours of having sex. Like the Dorothy in the Wizard of Oz, most women already have access to emergency contraception. Just as the shoes on her feet got Dorothy home, so too can the birth control pills already in her cabinet (or in her friend's cabinet) get her out of the trouble she is in if a condom breaks or she has a serious lapse of judgment. For more information, see: doclink

Karen Gaia says: this is an old article, and the details may be outdated, but the principle remains the same.

Burning Bras? It's the Pill That Gave Women Freedom

July 18, 2005, Daily Mail

The availability of birth control pills and liberal abortion laws have had the greatest impact by far on women's lives in recent years. A new study by researchers at the London School of Economics, which collected data from 45,000 women in Britain and 11 other European countries, indicates that the birth control pill, which became available to married women in 1961, has enabled women to stay in school longer, get better paying jobs and derive better satisfaction from life.

The study found that other items on the feminist agenda, such as parity in divorce laws and better maternity leave policies, had minimal, or in the case of divorce, a negative impact on women's lives. But the benefits of birth control and legal abortions for women have been on a par with substantial pay rises.

Anti-abortion advocates have maintained that while these benefits have indeed accrued to women, their extension to teenagers and younger women have resulted in loose morals and lower birth rates, without the same economic advantage that is deemed vital for the woman who has entered the workforce. doclink

Costs and Net Health Effects of Contraceptive Methods

Contraception Jounal

The net impact of contraception on women's health has not been reported previously. An analysis compared 13 methods of contraception to nonuse of contraception with respect to healthcare costs and quality-adjusted life years (QALYs). The analysis applies to women of average health and fertility, from 15 to 50 years old, sexually active in a monogamous relationship. Compared with no contraception, contraceptive methods of all types result in cost savings over 2 years, ranging from US$5907 for tubal sterilization to US$9936 for vasectomy and health gains ranging from 0.088 QALYs for diaphragm to 0.147 QALYs for depot medroxyprogesterone acetate. Even in 1 year, any method other than sterilization results in financial savings and health gains. Every method of contraception dominates non use. Increasing the use of more effective methods will improve health and reduce costs. Methods that require action by the user less frequently than daily are both less costly and more effective than methods requiring action on a daily basis. doclink

Clinical Trial of the World's First Contraceptive Spray for Women - Acrux and Population Council Announce Positive Data

June 19, 2005, PharmaLive

An international research organization, Population Council Inc, and Acrux Limited, the Australian pharmaceutical company, announced positive results from the first clinical study of a contraceptive spray for women. Research has shown that spray delivery is preferred to oral or patch. Results showed that once-a-day dosing of the contraceptive spray Nestorone provided delivery of the contraceptive agent, Nestorone(R). The spray was well tolerated, with no serious adverse events. Potential advantages of Nestorone MDTS(R) over existing methods of contraception are suitability for breast feeding mothers and women who cannot tolerate combined oral contraceptives containing oestrogens, increased flexibility in dosing time, reduced skin irritation compared to patches, convenient dosing which leaves no visible residue. Acrux's system applies a pre-set dose of formulation on the skin that forms an invisible depot within the skin from which Nestorone(R) is slowly absorbed into the bloodstream. doclink

U.K.: Age Alone is Not a Contraceptive, Experts Warn

May 11, 2010, BBC News

Experts fear older women are ditching contraception in the mistaken belief that they cannot get pregnant past a certain age. But women can still get pregnant well into their thirties, forties and even fifties.

Abortion rates for women aged 40 to 44 match those for the under 16s, figures for England and Wales show: both at the rate of four per 1,000 women. Women often opt for abortions when there are birth abnormalities in the baby, which are more common when the mothers are older, but some of the abortions are because women wrongly assumed they could not get pregnant because they were too old.

The FPA's campaign 'Conceivable?' reminds women to stay vigilant about unplanned pregnancy and to keep using contraception until after the menopause. While fertility does decline with age, the message is often overplayed, alongside disproportionate messaging about unplanned teenage pregnancies.

All methods of contraception were suitable for the over-35s.

Women aged 30 to 34 continue to have the highest fertility rate - 113.1 live births per 1,000 women. But the rate among women aged 40 and over has more than doubled since 1988, from 5.1 to 12.6 per 1,000 women, and there were more than 26,000 live births to women in this age group in 2008, figures from the Office for National Statistics show.

Many older women facing an unplanned pregnancy are shocked to find themselves in this position - many assume that their irregular periods are due to menopause, and are surprised to learn that they are in fact pregnant. doclink

Chile: Morning-After-Pill Faces Resistence

May 20, 2004, Santiago Times

Three mayors refuse to distribute the morning after pill in their clinics, in defiance of a policy to provide the pill to victims of rape. The mayors of two Santiago boroughs, Puente Alto and Lo Barnachea, together with the mayor of Concepcion said they will block distribution in their communities. The Puento Alto mayor maintains the pill is abortive and intercepted 80 doses which were for clinics in his jurisdiction. In Lo Barnachea an official within the Health Ministry held up the pill's distribution. Concepcion mayor Jacqueline van Rysselberghe has taken a different approach, saying she will allow the pill, but only one at a time, dose by dose, and only to the hospital closest to the woman requesting it. Despite these dissents, the delivery of the pill continues smoothly in other regions and 17,000 doses have been delivered. The Ministry of Health warned that those mayors who interfere with the pill's delivery may face sanctions and possible budget cuts as punishment. doclink

Ella, Morning After Pill Approved by FDA in Tablet Form

August 14, 2010, USA Newsweek

Ella is a new morning after - or emergency contraception - pill that has been approved by the US Food and Drug Administration (FDA). It prevents prevents pregnancy if taken within five days after unprotected sexual intercourse.

The pill, comprised of ulipristal acetate, can be obtained by prescription only

The FDA stressed that people should not use Ella as a contraceptive.

Ella inhibits or delays ovulation. It has been sold in Europe since May 2009 under the name EllaOne.

Women don't use emergency contraception enough to make an impact on pregnancy or abortion rates, Dr. James Trussell of the Office of Population Research said.

Ella package side effects: headache, abdominal pain, nausea, dysmenorrhea, fatigue, dizziness doclink

U.S.: Working Group Advocates for Over-the-Counter Access to Birth Control Pill


The Oral Contraceptive Over-the-Counter Working Group, a coalition of women's health experts, aims to gain FDA approval to market an oral contraceptive for nonprescription use, citing evidence that nonprescription access does not compromise safety.

The group, funded by the Hewlett Foundation, believes prescription-only access to birth control patronizes women, restricts contraceptive freedom and does little to curb teen pregnancy rates. There are barriers that have to do with the logistics of insurance, or the policy at the doctor's office.

The group, focusing on the so-called "mini-pill," hopes to have the pill on the market within five years. The mini-pill has a lower risk of adverse effects than other hormonal methods, and typically is prescribed to women who are lactating or have a higher risk of complications, such as stroke and heart attack, because they smoke or are older than age 35. It contains the same synthetic hormone -- progestin -- that is used in the OTC emergency contraceptives Plan B and Next Choice.

Teens find it is difficult to visit a doctor's office without a parent's help. Nearly 20% of sexually active teens who do not want to become pregnant are not using contraceptives, according to the Guttmacher Institute. A 2006 study published in Contraception found that 68% of surveyed women said they wanted a birth control pill that was available without a prescription, with uninsured women showing a high level of interest.

Until recently providers followed guidelines to perform a pelvic exam and Pap test at every family planning visit, but new guidelines suggest that most women need less frequent screening.

"Holding birth control hostage until women have had a pelvic exam is a paternalistic attitude to women's health." The two aren't linked.

One concern is that moving to OTC status could cause the pill's cost to jump, which is what happened when EC became available without a prescription, however, supporters are investigating strategies to keep costs down. doclink

Expanding Contraceptive Choice: Five Promising Innovations

Population Reference Bureau

Family planning prevents unintended pregnancies, averts maternal and child deaths, prevents abortions and also saves public sector resources.

Half of married women worldwide use contraception, but 200 million women still have an would like either to stop having children or delay their next birth, but are not using an effective contraceptive method. Their need can be reduced by expanding access to methods that are currently underutilized.

Ongoing contraceptive research aims to improve affordability and ease of use, and to provide users with options that are more within their control. This policy brief highlights five "next generation" contraceptives, each of which offers one or more advantages over similar earlier methods.

Contraceptive implants are flexible rods placed under the skin of a woman's upper arm, inserted and later removed in a quick, minor surgical procedure by a trained provider. Protection against pregnancy lasts three to five years.

Depo-SubQ Provera 104 is an injection under the skin rather than into the muscle.

NES-EE Vaginal Ring Hormonal lasts 12 months. Does not require refrigeration before insertion. Potential for use as emergency contraception.

SILCS Diaphragm Barrier - One size eliminates need for fitting by a provider; user-friendly design eases insertion and removal.

Standard Days Method With Cell Phone Alerts Fertility - Users reminded of fertile period and need to abstain or use barrier method via cell phone short message service (SMS). doclink

Condoms Catch Up with Pill as Safe Sex Message Gets Through in UK

October 21, 2009, Times

Condoms are now the most popular contraceptive for one in four women, the same proportion that favours the Pill, according to a study of over 2,500 people.

The study also found that 34% of sexually active men who were not in a steady relationship said they had increased their use of condoms in the past year.

Warnings over rising incidences of chlamydia, gonorrhoea and even syphilis may have made condoms more popular. Eight years ago they were the choice of only 1/5 of women.

Durex, a condom manufacturer, had a 10% rise in sales last year.

The female condom has had few sales and a new 'spray-on' condom of liquid latex is unlikely to prove popular because of its 'drying time' of two to three minutes.

Women seem slow to use the long-acting contraceptives, such as implants and injections, perhaps because they are more expensive and require doctors to have training on their use.

Groups judged to be at risk of contracting sexually transmitted infections (STIs) were less likely to use condoms, with less than half who had more than 2 sexual partners using them regularly. There has been a sudden increase in STIs from 1998 to 2007: chlamydia 150%, herpes 51% and gonorrhoea 42%. Syphilis cases also increased.

90% of those who used condoms used them as protection against pregnancy while 45% used them to avoid STIs.

Television advertising was the primary source of information about STIs and condoms. doclink

Emergency Contraception: Have We Come Full Circle?

August 21, 2009, RH Reality Check

Two decades ago, Dr. Felicia Stewart began her campaign to let out of the closet "America's best-kept secret" - emergency contraception twenty years ago.

Many providers thought the method was "not effective enough," or would lead women to use it "too much" - in place of using other more effective methods.

Dr. Stewart and other women's health advocates pushed to make emergency contraception more public and more available because they saw the need for a method that could be used after sex and one that was safe enough to provide without the barrier of a medical interface. They believed that women could learn to use the method appropriately, and that women had the right to this important option.

After twenty years there are many dedicated emergency contraception products now available worldwide, women's awareness and use of EC has been increased, and, in the U.S., the direct to consumer marketing of EC by a pharmaceutical company. Also the method is popular.

Recently it has been shown that emergency contraception is not as effective in reducing unwanted pregnancy rates at a level for which we once hoped, which has slowed funding, and women are using it repeatedly instead of switching to other more effective methods. Also, by providing it directly to women we are missing opportunities to provide women with a full range of reproductive health services.

However, it should be remembered that emergency contraception fills a unique and important role in the mix of available contraceptive methods; it is effective enough to be promoted as a contraceptive option; and women's use of the method contributes in a positive way to every woman's significant challenge of how to avoid unplanned pregnancies over her lengthy fertile years.

Emergency contraception is the only method a woman can easily use post-coitally, important not only for women who have had no control over their exposure to sex, as in the case of sexual violence, but also for couples who find themselves in need of contraception after sex. Also the method is convenient compared to other methods because it can be used without having to see a doctor or health care provider.

Women are willing to pay more for emergency contraceptive pills than for a month of oral contraceptive pills. This should tell us something about what women want.

While EC did not produce the hoped-for level of pregnancy prevention, the fact is that women with enhanced access to emergency contraception do not always use it when they need it - individual women have a right to use the contraceptive method that best suits them, not the one that best contributes to overall demographic indicators.

Estimates of the effectiveness of emergency contraceptive pills range from 59% to 94%, but it is more effective than doing nothing. While it was found that the typical effectiveness of condoms and pills was much lower than their theoretical effectiveness, we did not push women to stop using them in favor of more effective IUDs or towards sterilization because it has the highest level of real effectiveness.

Providing access to a wide variety of contraceptive methods is an effective approach to helping a diverse range of women meet their reproductive needs and desires.

Women (and men), when considering contraception methods, prioritize effectiveness, but also may consider other factors, like convenience, privacy, insurance coverage, avoiding hormones, and the reputation - accurate or not - of the method. These factors change over the course of a woman's life, explaining why the average woman uses between three and four different contraceptive methods during her lifetime. doclink

QS: a Safe, Inexpensive, Readily Administered Method of Family Planning

Bruce Sundquist website

It continues to be demonstrated that a larger variety of modern family planning methods is needed. One method, quinacrine sterilization or QS, which has huge promise, remains underutilized.

The International Services Assistance Fund (ISAF) has focused on expanding QS usage.

This simple, safe, easy to administer method of female sterilization has been used by over 200,000 women, some for 30 years, in over 50 countries including the US, with no reported deaths or life threatening complications.

An FDA Phase III Trial was permitted in June 2006, but put on "clinical hold" in January 2007 until additional safety data can be supplied. This major data gathering is now under way, and a renewal of the trial is anticipated once this data is presented. To date, some 1700 providers have used QS around the world with excellent results. One MD has provided the method to nearly 600 HIV positive women, since surgical sterilization in such situations can be difficult to arrange.

For more information check our web site at doclink

Benefits of the Essure Procedure


Essure is a proven minimally invasive form of permanent birth control approved for use in the United States. The procedure involves no incisions, no hormones, no general anesthesia and can be performed in a physician's office in about 10 minutes. 270,000 women worldwide rely on Essure for their family planning needs.

The Essure micro-inserts are passed through the body's natural pathways and inserted into the fallopian tubes. There is no cutting into the body, burning, or destruction of the fallopian tubes.

The Essure procedure is covered by most insurance providers. It is 99.80% effective.

Risks of the procedure include: perforation, expulsion; theoretical increased risk of ectopic pregnancy; pain, cramping, vaginal bleeding, menstrual pattern changes, nausea, vomiting, or fainting. doclink

U.K.: Morning-After Pill the Choice for 50% of Young Women

Daily Mail

The morning-after pill is the contraceptive of choice. A survey of 500 students found nearly half used the pill. 7 in 10 of those who took it did so because they hadn't used any other form of precaution.

The drug was advertised last month and is on sale online as well as pharmacies.

Critics claim easy availability of emergency contraception will encourage women to have unprotected sex.

The latest study was carried out among students in their late teens and early 20s in SW London.

A fifth said they had had more than one sexual partner in a week and one in ten claimed to have slept with at least two women in one day.

A third said they did not regularly use condoms, leaving them at risk of sexually transmitted infections.

When the morning-after pill was first approved for use in the UK, assurances were given that it would be used only in exceptional circumstances and under the control of doctors.

The morning-after pill is lulling young women into a false sense of security, exposing them to increased risk of sexually transmitted infections. Sex education isn't getting through to people.

The morning-after pill was designed for occasional use only. It is important it doesn't replace regular contraception methods. doclink

Do Condoms Really Work?; Popular Protection May Be Riskier Than You Think

March 29, 2009, The Ottawa Sun

Canadians want the federal government to require warnings on packages about how often condoms break and leak. There is a variation across brands and types of condoms. They report from 0% failure rate up as high as 30%. Failure rates should be written on their packages.

Studies on latex gloves found they tended to break, but not all materials were effective, manufacturers were the same, but the durability of gloves before use was not the same as after use.

Research shows that where one partner is HIV positive and the other isn't, uninfected partners are 80% less likely to catch the disease if they use condoms. But there is still a 20% failure rate.

Human error accounts for a large part of the research on condom effectiveness, health agencies remind the public that condoms must be used correctly.

Breakage and slippage happens about 6-8% of the time with new users. For people with 5 years of experience, the rate is 1.5% to 3%.

If you are having sex with an infected person "over time, it will get you." Condoms only cover so much; human papillomavirus (HPV) and herpes can be transmitted through skin contact. Condom effectiveness also depends on transmission rates of different diseases.

Condoms offer the best protection, apart from abstinence.

In a year, if couples use condoms perfectly, 2% would become pregnant, and if they used it typically, about 15% would become pregnant. Trojan insists its products, when used consistently and correctly, are 98% effective. doclink

U.S.: Birth Control Vaginal Ring (Nuvaring)

Planned Parenthood Federation of America

The vaginal ring is a small, flexible ring a woman inserts into her vagina once a month to prevent pregnancy. It is left in place for three weeks and taken out for the remaining week each month. The vaginal ring is commonly called NuvaRing and it releases hormones that control how our bodies work.

The hormones keep a woman's ovaries from releasing eggs and also prevent pregnancy by thickening a woman's cervical mucus that blocks sperm and keeps it from joining with an egg.

The vaginal ring works best when a woman inserts it, keeps it in place for three weeks, takes it out for one week, and then inserts a new ring. That keeps the correct level of hormone.

Less than 1% of women will get pregnant each year if they always use NuvaRing as directed.

Possible side effects are: bleeding between periods, breast tenderness, nausea and vomiting, increased vaginal discharge, vaginal irritation, or infection and change a woman's sexual desire. In very rare cases: heart attack, stroke, or having a blood clot in the legs, lungs, heart, or brain; high blood pressure, liver tumors, gallstones, or yellowing of the skin or eyes (jaundice). The risk for these problems increases if you are age 35 or older, are very overweight, have certain inherited blood-clotting disorders, diabetes, high blood pressure, high cholesterol, or need prolonged bed rest, or smoke.

If interested read the entire original article at the link above. doclink

U.S.: FDA Advisory Panel Backs New Female Condom

December 14, 2008, Reuters

Female Health Co's new, less costly version of its female condom, won backing from a U.S. FDA panel. In a 15-0 vote,the company's data supported FDA approval as long as some changes were made to the product's label.

The company is seeking to market the new version as a method to prevent sexually transmitted diseases and pregnancy.

It will allow women to take more control to protect themselves. doclink

U.S.: Permanent Birth Control

December 12, 2008, Time Magazine

The maker of Essure--a newer, cheaper, faster, scalpel-free alternative to tubal ligation--is marketing it as "permanent birth control."

It takes just two minutes to get sterilized. A 35-year-old mother of three was awake and relaxed as Bennett inserted first a thin camera into her uterus and then, using a video monitor as a guide, a small coil into each of her Fallopian tubes. Each year about 700,000 women in the U.S. get their tubes tied, with the surgeries requiring a hospital stay and a week of recovery. The health-care data firm projects the female-sterilization market will more than triple, from $80 million in 2007 to $245 million, by 2012, as these women opt for quick fixes like Essure. The local-anesthesia shots she got before the implantation were "painful." And afterward, she had cramps for a few hours akin to the ones during her period. The 1 1/2-in.-long coils contain fibers that irritate the tubes and prompt scar tissue to grow around the tiny loops. After three months, the Fallopian tubes are blocked, preventing eggs from reaching the uterus to be fertilized.

Approved by the FDA in 2002, Essure coils were implanted mostly in hospitals until last year, when the manufacturer had doctors to perform the procedure in their offices. The firm recently launched its first big advertising campaign. Essure cannot be reversed. The most important job is to make sure people are absolutely certain. I would've gotten a vasectomy, if that's what she wanted," says husband Mike. Twice as many married women as married men in the U.S. get sterilized doclink

Botswana: Female 'Bliss' Slow on Take Off

November 20, 2008, Mmegi Online

Selebi-Phikwe District AIDS Coordinator said the use of the female condom known as 'Bliss' is low, as is its distribution.

The district has a target of two million condoms to be distributed, between April and June. But it may not reach its target. Between April and June, 274,608 male condoms were distributed, but only 4,203 female condoms.

The government had come up with the name 'Bliss' to try and bring it to the fore. The district AIDS office came up with promotional materials to promote the condom.

Some claim it is noisy while others say it is not sexy. We are trying all we can to promote it but it is difficult. doclink

Singapore: Birth Control: More Education Needed; 1 in 4 Women Who're Not Ready for Babies Fails to Take Preventive Steps: Poll

November 23, 2008, The Straits Times

Over one-quarter of young women are not prepared for motherhood but avoid using birth control.

More has to be done to educate young women on how to ward off unwanted pregnancies.

Many women do not use contraceptives, thinking pregnancy 'won't happen to me'. Researchers found, of the women who practice birth control, some use more than one method. About 81% use condoms, while 14% the withdrawal method.

Just 11% use the Pill, despite studies that show it is far more reliable, and fails less than 0.1% of the time.

Condoms are up to 98% effective in preventing pregnancy, but that number falls if they are not used properly. The withdrawal method works 80% of the time.

The condom remains the most popular contraceptive, and is seen as the most effective method.

About 52% of women identified the condom as the most reliable birth-control method; only 23% said it was the Pill.

Women shy away from the Pill because they fear it will lead to weight gain and affect future fertility.

But new formulations have done away with the weight-gain problem, and there is no evidence to show that it affects fertility.

Interviews with 814 women aged between 20 and 35, found 45% were sexually active but not prepared to get pregnant.

The high percentage of women who do not use birth control could contribute to the number of abortions.

Last year, 11,933 women had abortions, down from 12,032 in 2006. doclink

The Abortion Pill

The First 12 Seconds of This Video Should End the Anti-Birth-Control Argument

September 5, 2012, Upworthy   By: Rollie Williams

It couldn't be a more clear-cut issue. Women need to be able to control their own futures, and the way to make that possible is through readily available contraception (which would consequently save 700,000 lives per year). Seriously, how could we possibly have gender equality without it?

Giving women and girls access to family planning tools and information is the easiest way to empower them to determine their own futures.

Raise your voice and pledge to support family planning for the millions who need and want it: doclink

Karen Gaia says: Contraceptives prevent the sperm from fertilizing the egg. Saying that contraceptive is killing unborn children is like saying every time a woman menstruates or a man ejaculates outside of vaginal intercourse -- they are killing babies.

Study: Home-Administered Misoprostol Safe Abortion Option for Women Up to 63 Days Pregnant

March 15, 2010, IPPF

Swedish researchers conclude that taking misoprostol at home as part of a medical abortion regimen is a safe option for women who are 50 to 63 days pregnant. In the U.S., women have been permitted to take physician- prescribed misoprostol at home since 2000.

Mifepristone -- the first drug in the medical abortion regimen, which is taken three to four days prior to misoprostol -- is administered at a clinic, physician's office or hospital. Most European countries require that women take both drugs in a clinic, doctor's office or hospital.

Among women who were fewer than 50 days pregnant, 199 experienced complete abortions, while 186 of the women who were between 50 and 63 days pregnant experienced complete abortions. Ten women required surgery. About six in 10 women needed extra pain medication. doclink

U.S.: HHS Moves to Define Contraception as Abortion

July 15, 2008, RH Reality Check website

The Department of Health and Human Services released a proposal that allows any federal grant recipient to obstruct a woman's access to contraception. It is attempting to redefine the birth control, which 40% of Americans use, as abortion. This would protect extremists. The proposed laws prohibit federal grant recipients from requiring employees to help provide or refer for abortion services.

Abortion is the termination of a pregnancy and there are two views on when a pregnancy begins. Some consider it begins at the fertilization of the egg by the sperm, while others consider it to begin when the embryo implants in the lining of the uterus. About 49% of Americans believe that human life begins at conception and think that any action that destroys human life after conception is abortion. Those who believe pregnancy begins at implantation believe abortion only includes the destruction of a human being after it has implanted.

Some medical authorities have defined the term "established pregnancy" as occurring after implantation. Others present different definitions. For example, pregnancy is "the state of a female after conception and until the termination of the gestation." or "the condition of having a developing embryo or fetus in the body, after union of an oocyte and spermatozoon".

Up until now, the federal government followed the definition of pregnancy as: pregnancy begins at implantation. It now claims that pregnancy begins at some biologically unknowable moment and there would be no way for a woman to prove she's not pregnant. Thus, any woman could be denied contraception.

There is no scientific evidence that hormonal methods of birth control can prevent a fertilized egg from implanting in the womb. This argument is the basis upon which the religious right hopes to include the 40% of the birth control methods Americans use, under "abortion." In 1999, the physicians released an open letter stating: "Some special interest groups have claimed that some methods of contraception may have an abortifacient effect. It is speculation, and if a family, decides to use this modality, we are confident that they are not using an abortifacient."

The absence of evidence does not slow anti-abortion attempts to classify hormonal contraception as abortion. Because the statutes seek, in part, to protect the conscience of the individual or institution within the bounds of reason. Both definitions of pregnancy are reasonable. The Department proposes to allow individuals and institutions to adhere to their own views. So HHS proposes that anyone can enforce his or her own definition of abortion "within the bounds of reason." This new rule establishes a legal precedent that may be used as a basis for banning the most popular forms of birth control with abortion. doclink

U.S.: After 2 More Deaths, Planned Parenthood Alters Method for Abortion Pill

March 18, 2006, New York Times*

Planned Parenthood announced that it would change the way it gives RU-486, or Mifeprex. The F.D.A. has received reports that six women in the US died after taking the pills, and a seventh died in Canada. The previous four resulted from infections with Clostridium sordellii. One of the two recent deaths occurred within days of the victim's undergoing a pill-based abortion, while the other woman died within five weeks. Mifeprex has been used in more than 560,000 medical abortions in the US and more than 1.5 million in Europe. The risks of death after using the pill are similar to the risks after surgical abortions or childbirth. When Mifeprex was approved in 2000, the standard regimen was to give the drug in a doctor's office followed two days later by an oral dose of a different drug, misoprostol, also in a doctor's office. Women expelled the fetus over the following days or weeks in a process that mimicked a miscarriage. The procedure must begin within 49 days of conception. Soon after Mifeprex's approval, most doctors instructed women to insert misoprostol vaginally at home two to three days after taking Mifeprex. But this regimen was not approved by the drug agency. As reports of deaths trickled into the F.D.A., officials issued warnings that doctors should stick to the approved regimen but until Friday, Planned Parenthood had rejected those warnings. Patients would still be asked to take the second drug orally at home. The drug agency said it was "investigating all the circumstances associated with these cases." The agency repeated that women who undergo pill-based abortions should be vigilant for signs of nausea, vomiting or diarrhea and weakness with or without abdominal pain and they should be given antibiotics. Doctors may not associate a death with a pill-based abortion, especially if the death occurs weeks later. The risk of infections could be eliminated if abortion patients were given antibiotics as a preventative. But officials say that the risk of infection from Clostridium sordellii is so slight that it does not merit such a precaution. doclink

Australia: Evidence Shows RU486 May Be Safer Than Surgical Abortion

November 21, 2005, AAP (Australia)

The Royal Australian College of Obstetricians and Gynaecologists is backing an effective ban on the pill RU486 to be lifted. The drug should be made available to Australian women. The evidence suggests it may be safer than surgical termination of pregnancy. John Howard signalled he would offer Liberal MPs a conscience vote on the issue. In Australia, women wanting to use RU486 have to apply through their doctor for government approval. The Australian Democrats plan to move an amendment which would remove Mr Abbott's powers to grant approval for the drug's use. Mr Abbott has cited health department advice which warned it could be dangerous for women in rural and remote areas because its use requires medical supervision and access to emergency care. But that advice has been discredited by experts. The first decision a woman makes is whether or not she wishes to have a termination of pregnancy and why she would prefer a surgical or a medical termination. Practitioners would have good evidence so they could discuss that with the woman so she can make an informed decision. doclink

U.S.: More Health Professionals Balk at Giving Birth Control

August 8, 2004, Copley News Service

The overwhelming number of Americans support birth control and use it. However, A small percentage of physicians, nurses and pharmacists have steered clear of supplying contraceptives because of religious convictions. A pharmacist in Cincinnati refuses to fill birth-control prescriptions because she considers abortion a sin and a termination of human life. Some doctors contend that millions of American women are wrongly prescribed birth-control drugs when alternatives such as natural family planning are cheaper and carry fewer health risks. More than 400 health care providers attended the American Academy of Fertility Care Professionals conference, triple the number the previous year. Organizers say the increase is fueled by religious doctrines and advances in drug-free contraception and fertility practices. The issue centers on when human life begins and for many this is when a sperm penetrates an egg, for others once the fertilized egg is implanted in the woman's uterus. Others believe it is when a baby draws its first breath. With such wide-ranging interpretations, the forms of contraception can present difficult moral choices for health care practitioners and some experts wrestle over whether measures of contraception are ethical. The Catholic Church and other religious institutions have long preached against most forms of birth control beyond abstinence or the rhythm method. Twelve million women rely on hormonal contraceptives, which require a prescription, to keep from getting pregnant, but the number of physicians and medical professionals who believe that using birth control and morning-after pills is abortion appears to be increasing. The war on choice is not just about abortion anymore, it's about the right to birth control. In rural communities, patients may have to drive miles to obtain or fill a prescription. Wal-Mart, dispenses birth-control pills but refuses to sell emergency contraception. The San Diego office of Planned Parenthood allows patients to sign up over the Internet for the morning-after pill, which has to be taken within hours of intercourse to be fully effective. Trying to force your beliefs on others is not only arrogant, it breaks the American covenant, which is tolerance of other people's beliefs. Most of the regulatory boards allow health care professionals to opt out of treatments for moral reasons as long as they arrange alternatives for their patients. At least 20 states have bills pending that would recognize the rights of physicians and pharmacists to deny prescribing birth control, but such legislation has only become law South Dakota. Some companies allow workers to refuse service to customers, and others do not. doclink

Male Responsibility

A Male Contraceptive Pill Could Become Reality Using the Poison Ouabain

How a rare poison could help bring the first male birth control pill to market
February 5, 2018, Quartz   By: Gunda Georg, Jon Hawkinson, Shameem Syeda

Ouabain - a plant extract that African warriors and hunters traditionally used as a heart-stopping poison on their arrows, shows promise as a non-hormonal contracetive for men that hinders the sperms' ability to move or swim effectively.

While the birth control pill has been available to women in the United States for nearly six decades-and approved by the US Food and Drugs Administration (FDA) for contraceptive use since 1960 -- an oral contraceptive for men has not yet come to market. The pill has provided women with safe, effective and reversible options for birth control, while options for men have been stuck in a rut.

Men curently have only two forms birth control: condoms or a vasectomy, which account for only 30% of contraception used, while women have 70%.

Vasectomy is an invasive procedure to do that's also difficult and invasive to reverse. A male hormonal birth control pill option is in clinical human trials and likely closer to market, but it has potential side effects, such as weight gain, changes in libido, and lower levels of good cholesterol, which could negatively affect the heart health of users.

For nonhormonal contraception methods work, researchers from the University of Minnesota and the University of Kansas have homed in on ouabain: a toxic substance produced by two types of African plants, which affects a type of transporter subunit called α4, which is found only in sperm cells. This protein is known to be critical in fertility -- at least in male mice.

Ouabain by itself isn't an option as a contraceptive because of the risk of heart damage. So researches have designed ouabain derivatives - versions of the molecule that are more likely to bind to the α4 protein in sperm than other subunits in heart tissue. Once bound to those cells, it interferes with the sperms' ability to swim-essential to its role in fertilizing an egg.

Because the α4 transporter is found only on mature sperm cells, the contraceptive effect should be reversible -- sperm cells produced after stopping the treatment presumably won't be affected. Ouabain may also offer men a birth control pill option with fewer systemic side effects than hormonal options.

This new compound showed no toxicity in rats. The next steps are to test the effectiveness as an actual contraceptive in animals, then human clinical trials within five years.

Reversible, effective male birth control is within sight. World Health Organization numbers suggest that reducing sperm motility by 50% or less is sufficient to temporarily make a man infertile. Our ongoing research brings us one step closer to expanding the options for male birth control, providing the world's 7.6 billion people with a much-needed option for safe and reversible contraception. doclink

German Carpenter Invents On-off Contraception Switch for Sperm

Joiner from Berlin has invented a switch which can turn off the flow of sperm from a man’s testicles, making him temporarily infertile
January 5, 2016, Daily Telegraph   By: Justin Huggler

A German carpenter has invented a valve which he claims will allow a man to turn the flow of sperm from his testicles on and off at the flick of a switch, thus "revolutionizing contraception."

Clemens Bimek told Spiegel magazine about the idea that came to him some 20 years ago.

Mr Bimek said that many of the doctors he has told his story to did not take him seriously, but a few encouraged him to keep tinkering with his project.

Now the valve is to be implanted in more than two dozen men in trials starting this year.

The valves are less than a inch long and weigh less than a tenth of an ounce, and implanted on the vas deferens, the ducts which carry sperm from the testicles, in a simple half-hour operation.

Release of semen can be controlled with a simple on-off switch which the man can reach under the skin of his scrotum.

So far Mr Bimek himself is the only man who has had this valve implanted.

Hartwig Bauer, the urologist who carried out the surgery, told Spiegel the valve was preferable to a vasectomy. "A third of patients want to have the operation reversed later, but it doesn't always work," he said.

But other doctors have expressed concerns over this new technology.

"My assessment is that implanting the valve could cause scarring," said Wolfgang Bühmann, spokesman for the Professional Association of German Urologists.

However, Anneke Loos, head of testing for medical products centre in Hannover, said that "Other implants made of this material have been well tolerated elsewhere in the body. The question is whether it will cause problems when it is implanted in this area." doclink

Rick says: How many men will volunteer to go under the knife?

The Economics of Male Birth Control

October 19, 2015, Priceonomics   By: Rosie Cima

Women have a lot of options for reversible birth control: pills, rings, intra uterine devices, patches, implants, while men are still limited to condoms and withdrawal.

In the 1950s. Carl Djerassi, a chemist, synthesized noresthisterone, an essential component of the first oral contraceptive. His involvement earned him the title, shared with Dr. Gregory Goodwin Pincus, "Father of The Pill." Djerassi said "scientifically, we know how to create a 'male Pill,'" but because of a combination of legal, social, and biological factors, male contraceptive technology hasn't been able to attract the necessary research dollars.

Elaine Lissner, one of his former students, has been working on advancing male contraception research since 1986, when she became interested in the work of a Swiss doctor, Dr. Marthe Voegeli, who discovered a method of male contraception in the 1930s that involved soaking the testes in a hot bath once a day for three weeks. 45-minute-soaks in water 116˚ F resulted in 6 months of infertility. Participants who discontinued use of the method went on to successfully have children, with no apparent complications.

Lissner found it maddening that, though it was eventually used by hundreds of volunteers in India, it was never developed and implemented into an accepted clinical procedure. In a seminar taught by Djerassi, Lissner wrote a report on male contraception. Her research turned up eight, non-hormonal methods that were known to work, but not in use.

Within the health care and pharmaceutical industry, it was believed that there was "no public demand" for new male contraceptives.

Lissner wrote articles on male contraception in Ms. and Changing Men in 1992. For her article in Ms., Lissner received over 200 hand-written letters in response, from both women and men, most of them interested in knowing more about male contraception.

But a product that would better-facilitate sex without the threat of pregnancy existed was considered immoral and obscene. Thus, it was a taboo to attempt to satisfy it.

It took a while for people to come around to the Pill, and once they had, it was assumed, for a long time, that men would not be interested in having their own version.

However, between condoms and vasectomy, men are already covering about a quarter of the country's birth control. If you add withdrawal, that's even more," Lissner adds. Men use the techniques available to them in great numbers, despite the limitations of those methods. Why should anybody think they wouldn't be interested in another option?

Gary Gamerman, a former consultant to Lissner's foundation and vice president of Afaxys, Inc., said to "take the time and effort to develop and test a completely new product, or just an improvement, you could easily spend $20-$50 million. To launch it you're going to spend another $30-40 million in marketing. And the whole thing will take 5 years at the very minimum."

Also any new product pharma companies could introduce would be likely to cannibalize their existing products. After all, one reason for a man to want to use a reversible contraceptive is so his partner can stop taking the pill.

Both old and new companies are deterred from investing in developing new contraception techniques because the liability is much higher than in other areas of research.

With female contraception, the less desirable side effects are offset by the health complications that can arise from unwanted pregnancy. Not so with male contraception products.

Lissner founded the Parsemus Foundation at the end of 2005 after coming into some cash and finding great strides had been made in the non-profit and academic sectors.

First Parsemus tested ultrasound contraception, a variation on Voegeli's method to heat testicles using a hot bath. The method worked great for dogs and rats, but not for humans.

In the last few decades, most of the truly new contraceptive technology was incubated outside the commercial sector and then purchased and brought to market. This includes the popular Mirena IUD, the new Liletta IUD, and the ParaGard copper IUD. Products like Essure -- a tubal ligation alternative -- were developed when a small medical devices company was trying to make something else, and then bought by a larger company.

The California Institute for Biomedical Research recently founded a startup called DARÉ Bioscience. DARÉ's mission is to connect the groups developing the technology -- mostly non-profits and academic organizations -- to more traditional investment dollars. The Gates Foundation and US Agency for International Development fund contraceptive research.

The presiding wisdom is that in these more traditional societies, birth control is still very much a "women's issue," and men are less receptive to anything that might limit their virility.

Parsemus is doing its best to catch male contraception as it falls through the cracks. In 2010, the foundation bought the rights outside India to RISUG: Reversible Inhibition of Sperm Under Guidance. RISUG is a male contraception product that was developed at the Indian Institute of Technology, and would be the model for Vasalgel.

Compared to hormonal birth control, the technology behind RISUG and Vasalgel is simple: the vas deferens is extracted with forceps, as in a vasectomy, and then injected with a gel. When the patient wants his fertility back, they inject the vas deferens with a solvent, and the gel goes away.

RISUG's gel is thought not to rely on blocking the vas deferens entirely, but also destroy or disable the sperm as they pass through.

"Part of what's held male contraception up for so long is a narrowness of thinking," Lissner complains. She says that for a long time people assumed that reversible male contraception would be hormonal, like the female pill. "You've got this narrow tube that all the sperm have to go through. Why not attack there instead of pumping hormones through the whole body?"

RISUG made it all the way to advanced clinical human trials in India, but Vasalgel is still in development for human use. Human trials are expected to start next year, in 2016. If everything goes well, the product could hit the market in 2018.

If that happens, Vasalgel will probably be the salvation of many would-be fathers, who will be glad to have another option. As a man once wrote to Lissner, "Condoms are a nice method. However, I have a 3-year-old that proves they are not 100 percent effective." doclink

We're Closer Than Ever to a Birth Control Pill for Men

February 13, 2015, WIRED   By: Becky Ferreira

The fact that men produce 1,500 sperm every second seems impressive. But that comes at a cost: babies.

A couple of seminal approaches to getting the little swimmers to simmer down may soon start to trickle out of the laboratory. Here are two of the headiest prospects for choking off male fertility.

1. Normally, premature sperm cells grow a tail and head in the testis, but H2-gamendazole keeps them from reaching this stage of development. The unfinished sperm fragments are then reabsorbed into the testis, never ending up in the semen.

2. Jay Bradner and his team at Harvard's Dana-Farber Cancer Institute were working on JQ1 which blocked bromodomain proteins (which are like Post-it notes that remind them cells of their identity) in cancer cells, causing them to forget how to be cancer. But JQ1 was also found to obstruct a testicle-specific bromodomain called BRDT, making the sex cells that would otherwise produce sperm draw a blank about their own behavior. Now mice treated with JQ1 can hump with abandon yet generate zero mouselings. doclink

Male Birth Control Without Condoms by 2017

September 9, 2014, International Business Times (UK)   By: Maria Khan

Vasalgel is a new non-hormonal male contraceptive which is similar to a no-scalpel vasectomy, will be released between 2016-2017, according to its maker, the Parsemus Foundation.

"We'll have to charge enough to make the company sustainable, but for sure it won't be $800 like long-acting contraceptives (IUDs) for women in the US. A contraceptive shouldn't cost more than a flat-screen TV!"

While Vasalgel is similar to vasectomy, it has the significant advantage of being reversible.

A gel is injected into the vas deferens (the tube the sperm swim through), rather than cutting the vas (as is done in vasectomy). If a man wishes to restore flow of sperm, whether after months or years, the polymer is flushed out of the vas with another injection," stated the Parsemus Foundation.

With a recent grant from the David and Lucile Packard Foundation, it is hoped that clinical trials with humans will begin by early 2015. doclink

The Vasectomist

June 17, 2013, Vasectomist website

The Vasectomist tells the story of Dr. Doug Stein, one of the world's leading providers of vasectomies as he travels throughout Florida and the world promoting men's role in family planning. While our film is just finished, our campaign to build awareness about the underlying issues that motivated the project is only just beginning.

On October 18, 2013, we are launching WORLD VASECTOMY DAY to inspire a global conversation. We will bring together 100 vasectomists and 1,000 men in 25 countries to dedicate their vasectomies to the wellbeing of Mother Earth. Dr Doug Stein will lead our 'vasectomy-athon' from Adelaide at the Royal Institution of Australia. Surrounding Doug as he performs vasectomies will be leading experts on population, including author Professor Paul Ehrlich, as well as leaders from varying fields, both those in favor of vasectomies as a contraceptive solution and those opposed. The entire event will be live-streamed as our film has its world premiere. In addition, the film will be screened around the world on World Vasectomy Day by our international broadcasting partners SBS (Australia), CBC (Canada), VPRO (The Netherlands) and DR (Denmark).

In summary, we are proposing a global round table conversation on the most important topic of our time and we'd like your support.

Jonathan Stack

Watch episode 1 of The Vasectomy Series doclink

Karen Gaia says: Vasectomies are an important part of family planning and of voluntary male participation in particular, but - so far - not as popular or as effective in reducing overall fertility as the current non-permanent methods, most of which are used by females. India's most common method of birth control - for many years - has been sterilization. However, Indian women (and likely men) are reluctant to get sterilized until after a son is born, and birth spacing is not accomplished with sterilization. If a woman can space her children, she is more likely to have fewer children because spaced children are healthier and more satisfying to raise.

The Best Contraception is for Men

March 30, 2012, Bangstyle

There is a form of contraception for men known as Vasalgel in the United States and RISUG in India. It has been out for a few years now. There are no unwanted hormone imbalances or depletion of sex drive, and there is no need to remember to take a pill every day. The problem with it is that it is so cheap that pharmaceutical companies lose out on this and have no incentive to promote it. Reports say it is cheaper than the syringe used to inject it.

Vasalgel is reversible. The man would have a polymer (SMA/ DMSO) inserted into his vas deferens through a small hole that would then coat the inside walls and kill sperm. It is a 15 minute procedure. When the man would like to restore his fertility, the polymer would be flushed out with another injection. The gel would not actually stop sperm production; it would only block it.

Vasalgel has an "antimicrobial action" in males to help clear out all traces of HIV in sperm.

Vasalgel should be brought up by Planned Parenthood and in sex education. It seems like a better plan than hoping kids just will not have sex.

It is important to mention that condoms are still the only birth control that protect against STDs. And, anyone not wanting to become pregnant should take measures of their own to prevent that outcome. doclink

Karen Gaia says: Rumor has it that Vasalgel is currently in Phase II in the U.S., not available for general use yet. Also, to express your support for this effort via a petition, and sign up to be kept informed of further developments, click here:

Radical New Birth Control for Men 100% Effective


Men have had only two options when it comes to birth control, condoms or vasectomy, compared to women's many choices: pills, shots, patches, lubes, and tying their tubes.

However, now scientists in India have developed an injection for men called RISUG, or "reversible inhibition of sperm under guidance" that has so far proven to be 100% effective. It lasts 10 years and can be reversed with another injection with no side effects.

Having their partner assume the responsibility for birth control will help some women who suffer side effects of birth control: weight gain and loss, hormone imbalances, and frail bones, and others who have low fertility levels to start with, which is emotionally and physiologically draining if combined with a contraceptive that also lowers fertility.

Getting the injection is the difficult part, involving two needle sticks into the scrotum, the procedure taking about 15 minutes or so. A non toxic, positively charged polymer is injected into the tube that the sperm pass through on their way from the testicles. The polymer shocks (kills) the sperm, which have a negative charge.

Because the injection last 10 years, drug companies won't be making money from RISUG.

India is about to go into Stage III trials with RISUG, practically the last step before it can be used by anyone in India. Thanks to Bill Gates and a 100k donation from the Gates Foundation, we might get RISUG approved here in the US. The company in charge of trying to bring it here is Parsemus, and they are trying to see if RISUG can work on women, too. vp

The author suggests giving RISUG to adolescents: there would be less abortions, and less accidental pregnancies. doclink

India: RISUG - the Revolutionary New Birth Control Method for Men

April 26, 2011, Wired

A new contraceptive procedure for men, known as RISUG (for reversible inhibition of sperm under guidance) is undergoing clinical trials. The new method does not have some of the drawbacks associated with a regular vasectomy. First, sperm would still be able to escape the body normally, which means there will not be the pressure and granulomas that sometimes accompany a vasectomy. More important, it could be reversed easily, with a simple follow-up injection.

In a vasectomy a white tube called the vas deferens, which sperm travel through from the testes to the penis, would be severed, cauterized and tied up the ends, and tucked it all back inside. With RISUG a nontoxic polymer is injected into the vas that forms a coating on the inside of the vas. As sperm flow past, they are chemically incapacitated, rendering them unable to fertilize an egg.

Ronald Weiss,a leading Canadian vasectomy surgeon and a member of a World Health Organization team that visited India to look into RISUG said "If we can prove that RISUG is safe and effective and reversible, there is no reason why anybody would have a vasectomy."

RISUG is not the product of some global pharmaceutical company or state-of-the-art government-funded research lab. It was developed by an Indian scientist named Sujoy Guha spent over 30 years refining RISUG while battling bureaucrats in his own country and skeptics worldwide. In study after study, RISUG has been proven to work 100% of the time. The procedure is now in late Phase III clinical trials in India, which means approval in that country could come in as little as two years.

RISUG is not available to Western men, although there is much interest. Thanks to a novel collaboration between Guha and a San Francisco reproductive health activist, RISUG could soon be on the road to FDA approval in the US.

India will soon surpass China as the world's most populous nation; in the poorest Indian state, women bear an average of nearly four children. Cheap to produce and relatively easy to administer, RISUG could help poor couples limit their families-increasing their chances of escaping poverty. In the developed countries, it would help relieve women of the risks of long-term birth-control-pill use and give men a more reliable, less annoying option than condoms. About half of all pregnancies in the US are unplanned.

The article goes on to describe Guha who turns out to be very interesting, and to describe more about the development of RISUG. You can read it by clicking on the link in the headline. doclink

Finally, a Pill for Men 'with No Side-effects' Which Could Be on the Shelves in a Few Years

Daily Mail / Mail Online

Scientists have developed a drug which temporarily stops sperm production without causing any side effects or long-term harm to male fertility. It will be a male version of the contraceptive Pill.

Until now there has been limited success comimg up with a male Pill, although attempts have been made for many years. Most of the drugs recently developed involve an injection, and many contain steroids which have damaging side-effects including heart disease and impotence.

It has only been tested on mice, long-term studies on humans will be done within a few years.

The pill impairs the male body's ability to use vitamin A, which is vital for the production of sperm. The drug's developers say it will not affect sight. They also claim a man would start producing sperm again almost as soon as he stopped taking the pill.

The pill probably would be taken once a day, but scientists are working on a version that would only need to be taken once a week.

This pill does not affect levels of the sex hormone testosterone, which was a problem with earlier male contraception, especially since altering testosterone levels has been linked to changes in cholesterol levels, which can raise the risk of heart attacks and strokes. It can also affect a man's sex drive and lead to weight gain.

Experts believe that a male version of the Pill would give couples more choice and place more responsibility on the man rather than the woman. doclink

Contraceptive Jab for Men 'is Just as Effective as Pill'

Daily Mail

A male contraceptive injection, which temporarily halts sperm production, has proved to be as good as the Pill in preventing pregnancies.

In the latest study of more than 1,000 men in China, about 1% conceived a child, similar figures to the 1 or 2% of women who become pregnant while taking oral contraception.

However, one stumbling block will be whether women would sufficiently trust men to make reliable use of hormonal contraception. Almost one third of the men enrolled in the trial did not complete it and no reason was proposed.

Until, male options have been limited to vasectomy, condom and withdrawal.

A side effect is the lowering of natural testosterone output. To counteract this a small amount of testosterone is given regularly.

The men's fertility returned to normal in all but two participants after the treatment was stopped. Sperm counts return to normal four to six months after the injections are halted. doclink

India: Let Men Do Their Bit

October 23, 2007, The Pioneer

For 30 years, vasectomy has been taboo, and the burden of family planning has been on women. But modern vasectomy techniques are a success in the West. India needs to try them.

India's most populous State, Uttar Pradesh, will account for 22% of India's population by 2026. Fertility rates here destined to take decades to reach replacement levels. Andhra Pradesh, Karnataka, Kerala and Tamil Nadu are forecast to jointly account for only 13% of the population increase during the same period.

Currently, 42% of India's population produces three or more children. Of 188 million couples requiring contraceptive coverage, only 53% cent are using contraceptives. The percentage of women having more than three children is 57% in Uttar Pradesh, 54% in Bihar and 49% in Madhya Pradesh. Almost half the girls there are under 18 at marriage.

There is urgent need to push up the age of marriage, delay the birth of the first child and widen the scope for spacing and limiting families. Vasectomy is a feasible way.

Unfortunately, any efforts to limit population are attacked by critics as an invasion of "human rights". Given the culture of the northern States, such goals are dumped as "unacceptable" and "impossible" and invariably shunned by many politicians.

The Millennium Development Goals do not envision family planning as the route to improving maternal and child health. This acts as a deterrent to organisations getting involved overtly.

Concentration on maternal and child health services has excluded men. Counselling on vasectomy is just not their business. In India, men have ceased to be the object of family planning ever since eight million male sterilisations were conducted coercively and haphazardly during the draconian Emergency period.

Even now horror stories of three decades gone by give shudders to politicians, especially in the Hindi belt. With no other terminal option available, millions of women have perforce to undergo tubal ligations having already borne the brunt of unwanted pregnancies and induced abortions.

The recent resurrection of the vasectomy programme comes as a welcome surprise. Madhya Pradesh has doubled vasectomies in the span of just one year from 7,000 to over 15,000. Haryana has shown higher and higher performance each passing year. Punjab has quadrupled the number of vasectomies in a matter of one year. Rajasthan has upped the vasectomy performance from just 1,700 during 2003-04 by almost five-times.

On October 6, in Vadodara, nearly 900 vasectomies were performed and hundreds of men had come willingly for this outpatient procedure.

At every health facility, ANMs and village women togged up in their best attire escorted the "acceptors" for vasectomy. Surgeries progressed speedily and while the patients waiting their turn, paranthas, enthusiastic counselling and a bag full of condoms were kept in readiness to complete the day's work.

Whether the carrot was the Rs 200 motivation money or the Rs 1,000 compensation for acceptors, an enormous response was evident. But India's annual vasectomy total remains less than a 10th of the pre-Emergency levels, despite hundreds of surgeons having acquired the Chinese non-scalpel skill.

In India, vasectomies are treated as the poor man's option. In some Latin American countries vasectomy has been presented as an alternative to female sterilisation. What is needed is for decision-makers to stop worrying about resurrecting the ghost of 1975 and understand that our population growth is having a detrimental effect on maternal and infant mortality. doclink

Hassle-Free Pill for Men Gets Nearer

December 28, 2007, Daily Mail (London)

A male pill to prevent pregnancy without affecting sex drive is being developed. Taken every day, the hormone-free contraceptive would have no long-term effect on a man's fertility.

The drug would not protect against sexually-transmitted infections and was most likely to appeal to those in a committed relationship.

Most women are trusting of their partners when they are in a stable relationship. Some women will be reluctant to trust their partners to take their tablets regularly. The development of a male pill would be really useful for a lot of relationships.

The drug, known as CDB-4022, has been tested only on animals. Research, funded by the U.S. government, showed that the drug quickly blocks sperm production. Inside three weeks test animals were considered infertile.

Sperm levels quickly returned to normal after the drug was stopped. Hormone levels, and libido, were not affected and the monkeys did not suffer any visible side-effects.

It didn't have any effects on hormones such as testosterone. Plans are to carry out longer term studies, in which the animals will be mated with females to confirm the drug actually prevents pregnancy. The pill is one of several male contraceptives being developed by companies eager to claim a share of the 21 billion spent each year around the world on the female pill.

Many of the drugs being developed, however, are based on hormones and carry the risk of unwanted side-effects.

It is thought the drug blocks a crucial stage in sperm development. The testing needed to ensure the drug is safe and effective means it is several years from the market. doclink

United States: Breakthrough in Male Birth Control Remains Elusive

October 2, 2007, Seattle Post-Intelligencer

Men have basically two choices of birth control: condom or vasectomy. Many researchers say men should have more options and a shared responsibility.

Dr Bremner and Dr. John Amory, conduct clinical trials testing whether hormone injections or creams adequately reduce sperm enough to prevent pregnancies. One study showed a 98% success rate in couples using a hormone male contraceptive. Side effects include weight gain and acne. One option being developed is a set of tiny implants that block the flow of sperm.

It is more difficult to turn off sperm production than egg production. Women produce one egg per month, men produce 1,000 sperm. And male contraception is a difficult sell to pharmaceutical companies.

Men aren't the ones at risk of getting pregnant, which carries its own hazards. The litigious nature against those in reproductive health and religious opposition are hurdles as well.

Thirty percent of contraception is male-driven, half condom, half vasectomy, and up to 80% of men claimed they would use a new male contraceptive. About 98% of women in monogamous relationships said they would trust their partners.

A male contraceptive will be available in five to seven years, it's going to happen. It's just a matter of time. doclink

Canada: New Male Birth Control May Be 100% Reversible

August 28, 2007, Vancouver Sun

A clinical trial has found a new male contraceptive procedure works as well as a vasectomy. The new procedure implants two silicone plugs, called the Intra Vas Device (IVD), into the scrotum. They block sperm from travelling through the vas deferens tubes, but still allow men to ejaculate.

The plan is to insert the devices, leave them in for a few months and then remove them and see if sperm flow returns to fertile levels.

Currently, pregnancy rates after vasectomy reversals are 50% to 60%. An earlier study on monkeys showed 100% reversibility.

"Once we prove reversibility, this device becomes even more valuable because it will be the world's first implantable reversible contraceptive device for men." doclink

Philippines: No-Scalpel Vasectomy Operation Offered Free in Cebu

July 3, 2007, Age

To help check the Philippine's swelling population and promote responsible parenthood, an international pro-quality life group will sponsor a two-day no-scalpel vasectomy operation. The intention is to help men who desire quality life to their families by conducting a no-scalpel vasectomy operation, free of charge.

An orientation has to be conducted first to ensure that the clients will have a full understanding of the issues before undergoing operation.

No-scalpel vasectomy provides a good option for those whose family planning method have failed them. This technique does not reduce men's sexual urge but rather enhance the sexual relationship of couples. They will also sponsor a free sperm check for those men who have undergone the no-scalpel vasectomy conducted last February. doclink

Male Contraception: One Door Opens, Another Closes

November 21, 2006,

Researchers announced a breakthrough on a non-hormonal compound known as (miglustat) Adjudin. By injecting the compound with a modified hormone that seeks out the testes, researchers have found that a low dose is both safe and effective in rats. Without this targeting mechanism, only higher doses are effective--but they are harmful.

The next step is to find a more appealing delivery system, both a gel and implants have been discussed.

But nothing is guaranteed. People need to distinguish between research and studies in men. There is still a lot of hurdles to overcome.

The latest promising contraceptive that didn't make the leap is FDA-approved and on the market in Europe and the US, is for treatment of a rare genetic disorder. Scientists were excited when they realized that it was acting as a contraceptive in their male mice. A researcher was able to obtain funding to test the drug's effect in seven healthy men. The result? Nothing even at a dose high enough to cause unpleasant side effects.

Schering was simultaneously testing miglustat and found the same results -- contraception in the first strain of mice, but no effect in the other strain or other species. doclink

U.K.: Sperm-Blocking Contraceptive Hope

November 27, 2006, BBC News

Scientists are working on a contraceptive which would stop men ejaculating and hope to have a treatment in five years.

The treatment being developed acts by preventing the muscle in the vas deferens contracting to propel sperm out of the penis.

The team are set to test the treatment on animals and then humans.

It is proposed men would take a pill each day, or could take one a few hours before they plan to have sex.

A man's fertility should return the following day.

If a man was taking the pill over a period of several months and decided to come off it, we would expect his fertility to return just as quickly. doclink

Would You Trust Your Man to Take the Male Pill?

November 6, 2006, Daily Mail

Hormone-based methods of stopping sperm production have produced side effects - enlarged prostates, nausea, headaches, acne and jaundice - that have hindered the development of a Pill for men.

Men have shied away from trials because of side effects and weekly or monthly injection.

Researchers have developed a contraceptive involving the substance Adjudin, which doesn't interfere with male hormones, is largely side effect-free and can be taken as a patch or implant. This would give men control over their own fertility.

A side effect-free contraceptive would give men control in the same way as women have now.

It gives the man control in the event of a woman trying to make him an unwilling father.

The chemical dislodges a link between sperm and the cells that help them grow and mature. The sperm die away, causing temporary infertility. The next stage is human trials.

The ideal would be a pill but the next best alternative would be a patch with few side effects.

Men don't like jabs or anything that makes them feel unwell. They need encouraging to take a contraceptive.

The contraceptive would have to be administered as an implant or patch. An inactive hormone is used to help it reach its target.

For a male contraceptive a very low level of toxicity is unacceptable. Tests on vital organs showed the drug had no side-effects.

Restoring fertility in humans would be a key factor if the contraceptive was to get approval from drug regulatory authorities.

The other problem is that any contraceptive for men has to stop all sperm production for a sufficient period of time. In the past, one or two sperm have still been produced or the contraceptive hasn't worked long enough.

The U.S. scientists are expected to treat male volunteers next year. doclink

India: More Men Go for Hassle-Free Sterilisation

January 23, 2006, Indo-Asian News Service

More Indian men are going for a sterilisation method that does away with surgery. The 'no-scalpel vasectomy' (NSV) involves a tiny puncture in the abdomen of the male and the cost is just Rs.100. Though male sterilisation came first, men were unwilling to undergo the procedure, but it has now progressed to three percent male sterilisation at the national level. The NSV procedure, which is faster and safer than conventional vasectomy, was started in China in 1974 and India adopted the technique in 1992. In the last two years, around 80,000 male sterilisations were done. It was initially a difficult task to convince men to undergo the procedure. Around 5,000 doctors in India have been trained in NSV. A few states are yet to participate. Though the NSV surgeons target 20 percent male sterilisation in the country in the next five years, it will be a matter of pride for Punjab to achieve the feat this year. Now men above the age of 35 years were showing keen interest in NSV. In Punjab, NSV campaigns create "faith in men about the process". By 2050 the Indian population will total 1.63 billion and China's 1.44 billion. doclink

Hong Kong: Men Choose Marriage, Women Opt for Abortion

October 26, 2005, South China Morning Post

When faced with unexpected pregnancy, young Hong Kong men are more keen to get married than women. 56% of men would suggest marriage if their partners fell pregnant, while 51% of women would choose abortion and only 39% would opt for marriage. Even though the males are not economically ready, they tend to shoulder the responsibility and marry their girlfriends. The female, who is often more pragmatic, tends to choose abortion as a solution. The survey's findings also suggest that young women often opt for the morning after pill as a means of contraception, with 51% admitting they would continue to have sex if no contraception was used and 28% saying they would take emergency contraceptive pills afterwards. 66% of men said they would continue to have sex. Women often dealt with unplanned pregnancy by going to the mainland for terminations. When it came to the responsibility for contraception most couples felt this should be shared. doclink

U.S.: Team Working on Birth Control for Men

June 20, 2005, Associated Press

Researchers are developing a contraceptive for men and plan to test about a half-million chemical compounds to find a pill that does not involve hormones, is close to 100% effective and has no risky side effects. It will be at least five years before trials could be conducted on men. Only 27% of women who practice contraception rely on their partners to use condoms or have vasectomies. Researchers identified a chemical compound that causes temporary infertility in male rats and filed a patent application for that compound. Male contraceptives being tested in China and Europe are hormone-based. Studies have shown hormonal contraception to be effective and men regain their fertility after several months. But testosterone injections raise concerns about side effects. The researchers are looking for chemicals that can disable enzymes that scientists have identified as critical to male fertility. The researchers will test about 400,000 compounds. The best compounds then will go to the Kansas School of Medicine, to test them on mice or rats to see if they are effective and safe, and whether the rodents regain fertility after they stop receiving them. doclink

Indian Male Contraceptive Injections Ready for Market

April 2, 2005, Xinhua General News Service

An Indian male injectable contraceptive that can be reversed is ready to be marketed. Called RISUG (Reversible Inhibition of Sperm Under Guidance), the drug would be manufactured by a Danish company and hit the market by the year-end. The male contraception injection could remain effective for up to 10 years. The contraceptive could be retrieved from the body. The cost of a single injection would be around Rs. 200 (around 5 US dollars) but would sell for more in foreign countries. RISUG is injected through special syringes into the vas deferens. The drug kills by disrupting the electrical charge of the sperm's head, which ruptures, forcing out enzymes - leaving sexual pleasure and performance unaffected. It uses a polymer called styrene maleic anhydride, which renders sperm ineffective. A single injection of 60 mg is enough to keep the sperms at bay for at least 10 years. The compound can be removed by flushing the vasa deferentia with an injected solvent. doclink

Rod Instead of Pill Will Be Used for Future Male Contraception

February 26, 2005, Push newsfeed

The future "male pill" for contraception will be a tiny rod. The rod-like implants, about the size of a matchstick, would be inserted under the skin of the upper arm of the user. They would contain progestogens which block sperm production. Users would have to receive an injection of testosterone once every three months. The new male contraceptive would be available within four to five years. doclink

Canada: Birth Control for Men Promising

February 24, 2005, CanWest News Service

The Intra Vas Device has the potential to transfer the responsibility for birth control to men. The IVD is a reversible alternative to vasectomy but works better. The IVD a 2.5-centimetre hollow silicone plug is implanted into the vas deferens tubes to block the flow of sperm. Implanting the IVD involves accessing the tubes, like a vasectomy, but rather than cutting the tubes, only a small opening is made. The tubes are then capped with silicone plugs. The seven-minute procedure is carried out under local anesthetic in a doctor's office. The IVD can be removed in a similar procedure, re-establishing sperm flow. Shepherd Medical has been given a $1.4-million grant from the U.S. National Institutes of Health for clinical trials on humans, expected to begin this year. These trials will leave the device in 90 men and then follow them for 18 months to to assess the contraceptive efficacy. They will test the device for side-effects and complications. So far, the IVD has completed two primate studies and preliminary human trials. doclink

Closer to a Male 'Pill'; with Promising Studies and Changes in Social Norms, Safe Hormonal Contraception for Men Could Soon Be Available.

December 6, 2004, Los Angeles Times

We are close to having a hormonal regimen for male contraception. The trick is to find the combination of hormones that will shut down sperm production. There is a neeed for this in developing countries where half of pregnancies are unplanned. Men account for a third of contraceptive use in the U.S., and 10% among married couples worldwide. Yet condoms interfere with sensation and can break, about 15% of the time, and vasectomies are usually irreversible, rendering a man sterile. In the last decade scientists have discovered hormonal methods of temporarily halting sperm production and there is more acceptance of a male pill and men are more comfortable talking about their reproductive health. Scientists are testing a combination that stops sperm production. 60 volunteers received progestin that acts on the pituitary gland and reduces the production of two hormones that signal the testes to make sperm. It also decreases testosterone, the male sex hormone necessary for libido and secondary sexual characteristics such as muscle bulk. So volunteers rub a testosterone gel on their shoulders every day to maintain levels of this hormone. Preliminary results are encouraging. After three or four months, sperm counts dropped to zero though the final results won't be available until next year. The researchers hope to achieve an efficiency of 95% and drug companies are searching for ways to deliver the hormones in pill form. One study involves 350 volunteers who have an implant in their arm that contains progestin and they receive testosterone injections every three months. Researchers hope to have results next year. It will be at least five years before a male contraceptive is available in the U.S. Scientists around the world are studying birth control for men. Researchers have discovered an enzyme in sperm that is necessary for sperm movement and could be used to develop future contraceptives. Mice bred without this enzyme produce sperm that can't swim toward egg cells to fertilize them and found that a drug used to treat Gaucher disease makes the sperm in male mice abnormal, rendering them sterile. doclink

Shot Shows Promise as Male Contraceptive

November 11, 2004, Associated Press

Researchers point to a new method male contraception that shows promise, a shot that prompts an immune reaction to a protein produced in the male reproductive system. This has worked on male monkeys, most of which regained their fertility when the treatments stopped. Immunocontraception for males hopefully will be developed but progress depends on funding and even with unlimited money, translating the findings into human use could take a decade. The success in monkeys indicates a new possibility for male contraception. The monkeys were immunized using a protein produced in the testis and epididymis, the ducts that carry sperm. Male monkeys that developed an immune response to the eppin were still able to copulate. It is thought that the immunocontraception works by preventing the sperm from freeing itself from the seminal fluid to make its way to the uterus and oviducts to fertilize the egg. In the experiments, seven of the nine males tested developed high antibody levels. Five of the seven recovered fertility once the immunization stopped. They were injected with eppin every three weeks to maintain the immunization. Normally the body does not produce antibodies against its own proteins, but the testis and epididymis are protected by a barrier so the protein never gets into the bloodstream. When eppin was injected the immune system did not recognize it and produced antibodies. Now it is necesary to repeat the experiment in other animals or in more monkeys. Researchers need to show that what happened in monkeys is likely to occur in humans. Two major European drug companies are collaborating to develop hormone-based male contraceptivessuch products. doclink

City Team Hails 'Male Pill' Trials

September 27, 2004, The Scotsman

Scottish scientists have successfully tested a safe "male pill". The progesterone rod implanted under the skin is set to be available within three years. More than 30 volunteers took part in the tests which prevents sperm production and they were also given testosterone to ensure their sex drive was not affected. Once the implant is removed, the sperm count returns to normal after three months. Volunteers had not suffered side effects such as acne or weight gain. doclink

Docs Perfect Pill for Men; GPS to Prescribe Implants by 2007

September 27, 2004, Push Journal

Scottish scientists have developed a safe 'male pill' that could be available within three years. The trial is on-going and when the implant is inserted, the men's sperm count goes down to nothing. There are not the side-effects we have seen before. Each of the 36 volunteers had one progesterone rod implanted under the skin to prevent them producing sperm. They were also given a dose of testosterone to make sure their sex drive was not adversely affected. Half the group were given the male hormone in an implant form, while the other half had tiny pellets inserted into their stomachs every three months. Within four months their sperm count had been temporarily reduced to zero. Once the implant is removed the sperm count returns to normal after three months. The volunteers had not experienced any side-effects. The progesterone implant stops the testicle producing sperm and testosterone. The testosterone implant gives them back enough testosterone so that they feel normal and their sex drive is normal. doclink

India: Chinese Family Planning Method Getting Popular in Himachal

August 27, 2004, Hindustan Times

A Chinese method of family planning not involving surgery is gaining popularity in Himachal Pradesh with new training centres for doctors. The technique involves a hook to seal the male vein carrying semen and no stitches are needed. It has evoked good response at several state-run hospitals. Two centres for training doctors in the vasectomy technique are being set up in Chamba and Kullu towns. doclink

Uganda: Men Shun Vasectomy

June 21, 2004, New Vision (Uganda)

Kampala providers at Mulago hospital are disappointed at men's poor response to vasectomy that accounted for less than 5% of family planning. Some men had a vasectomy without the consent of their wives, who continued trying to conceive and some men have demanded reversal which is impossible. The major limitation was that men were not aware of its availability and had misconceptions about its effects. The Ministry of Health has to increase publicity through electronic media, train more counsellors and introduce outreach programs. Vasectomy cannot be marketed like the pill or the condom - it can only be through health centres distributing reading materials and training health workers to provide counselling. However the Ministry of Health did not have enough resources. doclink

Scotland: Men Reluctant to Participate in Male Pill Trial

May 21, 2004, BBC News

A male contraceptive pill may have to be shelved before clinical trials are complete from a lack of volunteers. The contraceptive combines an implant and injections to lower sperm production temporarily. The implant was 'virtually free' of side effects, but no one knew what the consequences of long term use would be. There's a strong idea that women should suffer in the service of preventing pregnancy. The Family Planning Association (FPA) said that men would take the pill once it was available. A study of Scottish women suggested they would trust a man if he said he was taking contraception. 90% of women thought a male pill a good idea, 65% felt the responsibility for contraception falls too much on women. doclink

Schering, Organon Trial Male Pill

January 22, 2004, Push newsfeed

German drug maker Schering and Dutch company Organon starting Phase 2 trials on a combined implant and injection that could be a step towards the "male pill". Schering said trials would be completed by December 2005 and the drug could come on to the market in 5-7 years. Schering and Organon admit that the potential size of the market, and sales forecasts, are impossible to assess. doclink

U.S.: Many Men Prefer STDs to Condom Use

January 22, 2004, UPI

Two-thirds of men with a primary sexual partner and one-third of those without a primary partner said they don't use condoms consistently. Even after seeking treatment for a sexually transmitted infection and acknowledging the protective value of condoms, many men refuse to use them. Men in intimate relationships were the least likely to use a condom regularly. Those with the least confidence in using condoms with a main partner wanted their partner to know that they were committed to the relationship. Men with no steady sexual partner or who used drugs and alcohol were the least likely to use condoms. doclink

Kiwi Men a Cut Above Rest

October 12, 2003, Sunday Star

19.3% of Kiwi men use a vasectomy compared to 14.4% of women who are sterilised, while 20.5% of married women use the pill. In the Netherlands 10.5% of men and 4.8% of women are sterilised, in the UK 12% and 11% respectively. Bhutan had the fewest female sterilisations at 3.1% and 13.5% of men had a vasectomy. Sterilisation was the world's most widely used contraceptive method with about one in four couples. New Zealand men are family orientated and have realised this is something they can do. doclink

Australian Researchers Successfully Test Hormone Combination That Suppresses Sperm Production

October 9, 2003, Reuters

Australian researchers have successfully tested hormone injections to suppress sperm production. In 55 male-female couples the men received testosterone every four months and progestin every three months given by injection. None of women became pregnant, there were no serious side effects and normal fertility returned in a few months. The hormones turn off sperm production, but also shut down men's testosterone production, so they need to be given extra doses to maintain health and sex drive. This will lead to a single injection contraceptive taken on a three-to-four monthly basis. Schering and Dutch-based Organon announced they will begin a Phase II trial for an experimental male oral contraceptive that combines testosterone injections and a progestin implant injected under the skin once every three or four months. There will be a product to market in about five years. doclink

Barrier Methods

South Africa: Can a Faster Condom Help Prevent HIV? Unwrap This Timesaver Before You Get Busy

October 22, 2011, Today's Good

Pronto is a condom that claims to go from package to shaft within three seconds. The inventor of South African Willem van Renburg, who sought to develop a barrier method that didn't "kill the mood" with all that awkward fumbling. South Africa has the world's highest population of HIV-positive people.

Men refusing to wear condoms is a major factor in the global spread of HIV. Traditional rubbers present problems of smell, fit, feel, the length of time and difficulty in putting them on. Reducing that process to a second could go a long way in convincing some couples to stay safe.

Pronto's packaging doubles as an applicator. Users just need to crack the package in half, slip it on, and discard the applicator in one quick motion. doclink

U.S.: Female Condoms Are Gaining Ground

March 3, 2011, USA Today

The female condom has been redesigned, and seems to be making a comeback in the U.S.

Free FC2s - second-generation female condom - were handed out on Valentine's Day by San Francisco's health department, and Walgreens stocked them in about 10% of its 7,600 stores.

The number of FC2s distributed in the USA tripled in the past year., says the founder of the Female Health Co., which makes the condoms. It's the only female condom on the U.S. market, but it's sold in more than 100 other countries.

The first female condom in was approved 1993, but it was hard to find in stores other than Walgreens and it cost more than male condoms.

FC1 was made of polyurethane while FC2 is made of easier-to-work-with synthetic latex and has no seams, so it's more comfortable to wear. doclink

Demand for Condoms on the Rise in Kashmir

January 9, 2006

Demand for condoms in Muslim- majority Indian Kashmir has outstripped supply. The government has sent a letter to the federal Health Ministry seeking fresh supplies. Kashmir's Family Welfare Department, which distributes condoms for free, had been forced to turn away condom- seekers, the official said. Despite the fact that Islam forbids the use of contraceptives, the demand for condoms in Kashmir has risen significantly. The wellfare department distributed about 1,1-million condoms in 2002, 1,8-million in 2003 and 2,6-million in 2004. Last year's figure outstripped that of the previous year. Pharmacist Altaf Ahmed said condom sales were increasing every year. Most of those buying condoms, he added, were shy Kashmiris who reluctantly asked: "Can we have a pack of protection?" doclink

Rwanda: Culture Hindering Use of Female Condoms

June 26, 2007, Africa News Service

Culture is one of the major hindrances to the use of female condoms. Sometimes women don't know how they introduce female condoms to their spouses. It is difficult in African societies for women to propose the use of condom to their husbands.

In some cases, women complained that they are not user-friendly and that they make a lot of noise during sexual intercourse. A female condom lines the vagina and prevents pregnancy and sexually transmitted infections.

Anti-AIDS campaigners expressed their concern about the unpopularity of female condom.

One reason why female condoms were not popular is because of lack of women empowerment. Some condoms have been rejected because of their bad smell. doclink

India: Condom as a Safe Tool for Sex

February 19, 2007,

In India the condom is seen as a family planning device but among married couples it is still to be projected as one that can be used to guard against HIV/AIDS.

There are no efforts to collect information on reproductive tract infections (RTIs) women may be suffering from. In Andhra Pradesh and Tamil Nadu, where HIV and AIDS cases are high, their spread among the population, especially largely monogamous women, is likely to increase because once a woman is sterilised she cannot negotiate with her partner about the use of a condom.

Promotion of dual methods of contraception, along with appropriate counselling, has no place in the family planning programme. Media should be used to spread awareness among couples. Four South Indian states Andhra Pradesh, Karnataka, Kerala and Tamil Nadu where 22% of India's total population of 1.02 billion live, have completed their fertility transition. According to a recent survey, fertility rate ranged between 1.8 and 2.1 in these states.

In the wake of sterilisation for promoting family planning, the consequences are dire. The success of southern states in population stabilisation will be helpful in framing similar strategies for rest of the country.

But HIV continues to be a cause of concern in the South, along with anaemia and malnutrition among children. Sex selection and pre-birth elimination of females is rampant. The government will raise public spending on health from 0.9 of GDP to 2% to 3%. doclink

Uganda: Condom Crisis; it is Anticipated That If All the Condoms Come in on Time, and All the Development Partners Honour Their Pledges, the Country's Stocks Will Hit 157 Million Condoms, Enough to Last to Year End

February 1, 2006, East African (Kenya)

Uganda has ordered enough condoms to create a buffer stock to last to the end of the year. If all come in on time, the country's stocks will hit 157 million condoms, enough to last up to the end of the year. Some of the condoms had been distributed while others are awaiting post shipment test clearance. On average, the country has an annual consumption of 80-120 million condoms. 20 million emergency condoms have been procured through funding from the Ireland, Denmark, Sweden. The increase in imports comes after warnings that the US Plan For Aids Relief eschewing condom use, was forcing Uganda to promote abstinence above other workable options. Last year USAID, distributed 5.3 million to high-risk groups such as clinics that treat sexually transmitted, infections, internally displaced persons and commercial sex workers, while 18 million condoms procured through the UNFPA are at the medical stores in Entebbe. USAID ordered 34 million condoms of which 23 million were targeted for the public sector; and 76 million Lifeguard condoms have been ordered for AIDS, Tuberculosis and Malaria, of which 55 million will be for the public sector. Another 1 million condoms, a gift from China, are also expected before the end of the year. The Ministry of Health maintained that the condom shortage resulted from the discovery that a batch of Engabu condoms from China was "bad" and supply had to be halted. Condom distribution is co-ordinated by the Ministry of Health and distributed through public health facilities up to the grassroots. Hotels, bars and lodges are involved in dispensing of condoms. Uganda had been promoting the Engabu brand of condoms but they were withdrawn due to complaints of defects and foul smell in one of the batches. Experts attribute the drop in HIV from 30% to 6% to condom use. Demand for condoms reached 100 million a fourfold increase in 1995 due to Aids awareness and public education on condom use. Uganda has made considerable progress to ensure that sexually doclink

U.S.: F.D.A. Reports Reduced Risks With Condoms

November 11, 2005, New York Times*

The FDA said found that latex condoms are "highly effective" at preventing infection by H.I.V., gonorrhea, chlamydia, trichomoniasis and hepatitis B. Condoms seem to be less effective against genital herpes, human papillomavirus, syphilis and chancroid because lesions from these diseases may appear on skin not covered by condoms. Still, condoms provide protection against each of these diseases and the typical pregnancy rate after six months' reliance on condoms is 5.4% to 7.9%. Senator Tom Coburn, who sponsored the report, criticized its contents as the latest example where the agency has provided inaccurate information about condoms. Mr. Coburn claims that condom labels provide exaggerated reassurance that condoms protect against sexually transmitted disease. Mr. Coburn complained that the agency overstated condoms' protection against the virus that causes cervical cancer. The report discusses the risks and benefits of condoms that use as a lubricant the spermicide Nonoxynol-9. Studies suggest this may increase the risks of infection by sexually transmitted diseases because it irritates vaginal and anal skin. The report dealt only with latex condoms. doclink

Condoms and Toothpaste

May 29, 2005, Palo Alto Medical Foundation

Condoms should be viewed as ordinary as toothpaste, says Adam Glickman, owner of the Condomania stores. "People have gotten past asking, 'Isn't brushing my teeth every morning a hassle?'". Abstaining from sex is the only foolproof protection against sexually transmitted diseases (STD's) and unwanted pregnancies. But for those who choose to have sex with someone who has a chance of being infected, using a latex condom significantly reduces the risk of STD's. The Food & Drug Administration has also approved two alternatives to the latex condoms: the polyurethane condom, for those who may be allergic to latex, and the female condom.

Millions of Americans are infected with STD's every year and thousands become seriously ill or die. In one national survey, it was found that only 17% of adult heterosexuals with multiple sex partners regularly use condoms, greatly increasing their exposure to STD's. The bottom line in protection seems to be: Abstain! Stick with one partner! Use a latex condom and learn to use it corrrectly! doclink

New British Condom Boosts Erection, Prevents Slippage

May 16, 2005, Deutche Presse-Agentur (Germany)

The "condom safety device" was designed by scientists at Futura Medical in England and is expected on the market within 18 months. Around 2% of condoms slip off because men don't maintain a full erection during intercourse, resulting in unwanted pregnancies and risk of sexually transmitted infections. Around 13 billion are sold each year. The new product, named CSD500, is impregnated with a chemical in its teat, called glyceryl trinitrate (GTN), which is absorbed through the skin and causes the blood vessels in the penis to dilate. Viagra works in a similar way, but the condom was meant for men who do not suffer from impotence. Sexually healthy men can be unable to maintain an erection while wearing a condom because of the loss of sensation. The company found that 88% of condom users would buy an erection-boosting condom, and half of men who do not use prophylactics would consider doing so if it helped their erections. Futura Medical had to ensure the effect of the condom was not too strong, which might have made gaining approval more difficult. The company is developing a more powerful version for treating impotence. doclink

Don't Be Fooled: Not All Condoms Created Equally

May 10, 2005, Miami Herald

There is a difference in the quality of condoms. Latex condoms are slightly more reliable than polyurethane. Always choose a well-known name brand and in the US, condoms should be FDA approved. Thinner condoms increase sensitivity, but may be more susceptible to breakage. Be aware that the use of oil-based lubricants break down latex condoms and place you at risk for breaks that can increase your risk for pregnancy and STDs. Use only water-based lubricants. Condoms work better when they are worn, not when they're in your wallet. They won't protect other parts of your body from infection that are exposed to sexual secretions - i.e. oral sex. The stakes are high to protect yourself from an environment that could potentially harbor infectious diseases like chlamydia, HPV, syphilis, herpes, genital warts and HIV. So, keep your head on straight in the heat of the moment and always remember, "no glove, no love." doclink

Condoms: Extra Protection

January 24, 2005, Consumer Reports

Condoms remain the only method that also can help prevent HIV that infects 110 Americans each day, at least half under 25. Concerns have evolved over older sexually transmitted diseases, including gonorrhea, because they have become resistant to the drugs used to treat them. The study evaluated 23 kinds of latex condoms and two types made of polyurethane, marketed to people allergic to latex. All latex condoms passed minimum standards but none exist for polyurethane. We found no correlation between performance and price, thickness, or the country of manufacture. Condoms are tested by inflating them until they burst and the best had no premature breakage among the 120 samples tested for each model and also averaged at least 38 liters of air. The worst broke 18 of 120 times below 25 liters. Most models met standards for length and thickness but Durex Extra Sensitive, Durex Performax, larger-size versions of TheyFit, and Trojan Magnum slightly exceeded the maximum width. There's no reason to choose spermicidal condoms as they have no benefit in preventing pregnancy, have a shorter shelf life, and may cause urinary-tract infections in young women. Nonoxynol-9 came under scrutiny when a report from the WHO warned that if used frequently, it may cause vaginal irritation and increase the risk of HIV. Some condom makers have dropped models with nonoxynol-9. In our tests, condoms labeled "ultra thin" lived up to that claim. TheyFit condoms come in 55 sizes. The Inspiral Lubricated has a raised, wraparound "seashell" tip. Two condoms had a "desensitizing" lubricant containing benzocaine to delay orgasm; another a lubricant to "warm" on contact with body fluids. Any of the top-rated latex condoms offer the best protection. Don't use condoms past their expiration date, never reuse a condom and store in a cool, dry place. Open the packet with care and use only water-based lubricants, such as Astroglide or K-Y Jelly. If you're allergic to latex buy condoms made from a synthetic material such as polyurethane; lambskin is too porous to prevent disease. For plain-language instructions on using a condom, use the Web site doclink

Condoms in India Find New Life as Sari Cleaners, Highway Surfaces: Only One-Quarter of Health Devices Were 'Properly Utilized,' Health Workers Say

August 13, 2004, Daily Telegraph

Only 25% of more than one billion free condoms manufactured annually in India were used to combat AIDS and a soaring population. Health workers said millions were melted down and made into toys, or sold as balloons. Villagers used them as water containers to wash, after relieving themselves in the fields. India's soldiers covered their gun barrels as protection against dust. Of the 891 million condoms to be handed out, many were acquired by road contractors who mixed them with concrete and tar that renders road surfaces smooth and resistant to cracks. A large number of condoms was used to waterproof roofs. Weavers used 200,000 condoms daily to lubricate looms and to polish the gold and silver thread used to embroider saris. Condoms were purchased in bulk from agents, who acquired them from agencies in family planning and AIDS prevention. The government began distributing free condoms in the 1960s. The country's population stood at about one billion on March 1, 2001, and is forecast to reach 1.5 billion by 2035. doclink

Birth Control Condom Campaign to Begin in Conservative Afghanistan

May 3, 2004, Agence France Presse

Population Services International (PSI) has begun to distribute in Afghanistan about 1.6 million 'Number One' condoms at the price of one Afghani (2 US cents). The project has been a success, but they face their biggest challenge when they begin a public awareness campaign. 400,000 condoms have been sold in four months but because of the cultural context they adopt an approach not to offend Afghan sensitivities. Prophylactics are available but little used and always hidden. The PSI condoms will be sold in navy packs of three with bright yellow writing devoid of sexual references. It has been difficult to translate the instructions and to design packaging which doesn't shock - for example, to use a diagram to illustrate how to put on a condom or to translate into local languages instructions issued with condoms in Western countries. PSI abandoned their slogan "Have a smaller family" as unsuitable where a woman is expected to have five or six babies. "Have a more comfortable life, make your family Number One" will be used instead. Financed by the US, the 5 million dollar programme plans to distribute female contraceptives, the pill, water purification and anti-mosquito products. With few cases of HIV/AIDS, the promotion of condoms is to encourage couples to space their children and fight against Afghanistan's maternal mortality rate, one of the highest in the world. doclink

Timed Fertility, Natural


August 26, 2011, FertileView website

FertileView is the most advanced fertility management program on the market today. FertileView is a simple tool that allows you to chart your fertility signs and interprets your information based on your fertility goal of either achieving or avoiding pregnancy. This comprehensive software program is designed to teach you about your own personal fertility. doclink

Pioneer of 'Billings Method' of Contraception Dies

April 2, 2007, Age

John Billings, founder of the natural contraceptive system known as the Billings Method, has died in Australia aged 89. The doctor and his wife Evelyn began work on their natural family planning system in 1953, and spent the next five decades perfecting the method which bears their name. It allows a woman to determine her ovulation cycle, and therefore avoid sex when she is most fertile, by monitoring cervical mucus.

The Billings Method has assisted couples to achieve pregnancy through enhanced understanding of the woman's ovulation cycle.

The Billings Ovulation Method has been introduced into China, where it is the only government-approved method of natural family planning.

Billings is survived by his wife and eight of their nine children. doclink

Ralph says: Nine children??? Makes you wonder how well the system works!

Philippines Shifts Campaign to Natural Family Planning

August 9, 2007, Sun Star

The Population Commission (Popcom) has shifted to natural family planning after the US stopped the supply of contraceptives. Popcom supported by several NGO's had campaigned for scientific approaches to family planning. These contraceptives were given to us by USAID, but now purchased by the users, unless the Government will shoulder the cost. The regional office of the Commission on Population now gives emphasis on the Natural Family Planning (NFP) methods and organizing Responsible Parenting Movement (RPM) up to the barangay level.

With the shift of the campaign to natural family planning, it does not follow that they will also abandon the scientific method.

The shift was due to the fact that most of those who are adopting the family planning and reproductive health approach were coming from the poorest sectors and, with the pull out of the USAID, could not afford to buy one.

Popcom's emphasis on natural family planning methods will have the Roman Catholic Church as an ally. doclink

Modified Rhythm Method Shown to Be as Effective as the Pill' But Who Has That Kind of Self-control?

April 3, 2007, Scientific American

A new German study has found that, when practiced correctly, a method of periodic abstinence known as the sympto-thermal method (STM) leads to an unintended pregnancy rate of only 0.6% annually, comparable with women who use birth control pills.

For SMT to work, women must keep track of their core body temperature, the fertile days as measured by a calendar, and their cervical secretions. Using this information, women are able to abstain from sex during their fertile period. STM is more effective than the other abstinence methods because it uses more than one type of information to predict a woman's fertile period.

The method is free and appeals to women who want a natural birth control method, but requires a commitment on the part of both partners.

"But the researchers went back and took data from an ongoing study from the past 20 years. They chose the users who were the best for this method.

Periodic abstinence has been jokingly referred to as "Vatican roulette,"

Some often stop using periodic abstinence methods after only a few months because it's difficult to abstain from sex for two out of four weeks. STM requires only 7-10 days of abstinence, but related methods practiced in the U.S. do require up to two weeks of abstinence every month.

Studies of periodic abstinence are often motivated in part by religious beliefs. Some 74% of the women who participated in a study, listed their religion as Roman Catholic, a faith for which this is the only church sanctioned method of family planning.

But a Canadian volunteer organization devoted to teaching couples how to practice the method, says that although religion was the early impetus, couples who practice STM are now seeking "natural" birth control.

But another insists it is misleading. STM is very unpopular, hard to use, and has a poor success rate in average couples. A U.S. study in 1980 had a 90% dropout rate after less than two years.

Less than 1% of women who use birth control in the U.S. use STM as it can only work for couples who stick to the plan 100%.

All contraceptive methods have their drawbacks, including the potential of passing along transmitted diseases best prevented by condoms. Ultimately, the best method for a couple to use is whatever they want. doclink

Natural Contraception 'Effective'

February 21, 2007, BBC News

The symptothermal method (STM) assesses fertility levels by measuring body temperature, and observing cervical secretions.

A study found using STM correctly led to a rate of 0.4 pregnancies per 100 women per year.

Natural family planning is effective - provided it is taught and carried out correctly.

The lowest pregnancy rate was among women who abstained from sex during their most fertile period.

Among those who used a condom, the pregnancy rate rose to 0.6 pregnancies per 100.

Among women who had unprotected sex during the fertile period, the pregnancy rate was only 7.5 pregnancies per 100 women per year. This was because women probably only had unprotected sex around the boundaries of their most fertile period.

For a contraceptive to be rated as highly effective it should lead to less than one pregnancy per 100 women per year.

The effectiveness of STM is comparable to modern contraceptive methods, and is an acceptable method of family planning, but STM is governed by rules, which take some time to learn.

Studies suggest that a woman's libido is higher during her fertile period, and this could be one of the reasons why natural family planning methods have had a reputation for being less effective but women also identify other parts of their cycle with increased sexual desire. doclink

Natural Family Planning Offered

November 22, 2006, United Press International

Researchers at Georgetown University's Institute for Reproductive Health say natural methods have been under-represented among the family-planning options because they require lengthy instruction and are difficult for many women to learn. But offering these methods fits well with the philosophy of nurse-midwives. The goal in developing natural methods is to meet the needs of the women who want to manage their own fertility without without hormones or devices and the burden of daily monitoring and charting required by older natural methods. These new methods are effective as well as easy to teach, learn and use. The findings are published in the Journal of Midwifery & Women's Health. doclink

Ugandan First Lady Launches Family Planning Device

October 8, 2006, Xinhua General News Service

Uganda launched a new family planning device called Moon Beads to help women control their pregnancies.

The string of 32 colored beads can help women know when they can get pregnant, through counting the beads.

The first lady called on local health service providers to ensure that such vital services could also reach the people in the countryside.

The device requires an individual to move a ring around different beads with different colors everyday starting from the red bead.

Once the ring touches the white beads, it means it is not safe for unprotected sex. When it moves to the brown beads it would be safe.

Family planning is one of Uganda's key policies, and focuses on saving women and children's lives, and involving men in responsible decision making.

The device is to be distributed throughout Uganda in a five year project funded by the US. doclink

Karen Gaia says: There is no mention of the success rate of this device. I read once that natural family planning does work with a decent success rate - for couples in their thirties and forties.

Philippines: Feeding, Clothing, and Sheltering

November 22, 2005, The News (Philippines)

With the ecosystems getting more fragile, society must confront the problem of feeding, clothing, and sheltering the masses yet to come. One solution is the aggressive promotion of birth control. The Philippine population of 85 million may double in the next 25 to 29 years unless the government supports the use of birth control. The country's population growth is the highest in the region, and the Philippines may fail its poverty reduction targets if it continues to oppose the use of contraceptives. The government has yet to allocate resources for modern contraception in a situation where the natural method of birth control is not effective. One of the most beautiful things for two people in love is to make love but if it will bring forth an innocent child it must be loved and fed, clothed, sheltered, and educated. If these are beyond you, resort to birth control. A woman with a regular menstrual cycle has seven or more fertile days each month. Periodic abstinence means you do not have sex on the days that you may be fertile. Fertility awareness means that you can be abstinent or you use a method to keep sperm from getting to the egg. Oral Contraceptives are taken daily to block the release of eggs and are 95% to 99.9% effective. The Mini-Pill has progestin, and taken daily prevents sperm from reaching the egg. Continuous Abstinence means not having sexual intercourse at any time and is the only sure way to prevent pregnancy. NO method of birth control prevents pregnancy all of the time. Birth control methods can fail, but you can increase a method's success by using it correctly. Inquire about other methods suited to your own reproductive health needs: Intrauterine Device, Female Condom, Depo-Provera, Diaphram, Cervical Cap or Shield, Contraceptive Sponge, The Patch, Hormonal Vaginal Contraceptive Ring, Surgical Sterilization Non-surgical Sterilization, and Emergency Contraception. doclink

Help Reduce Child Mortality Through Breastfeeding, Mothers Urged

May 29, 2005, Ghana Web

The Breastfeeding Promotion Committee has stressed the need for lactating mothers to adopt the exclusive breastfeeding policy to reduce under-five mortality rate. The WHO survey on Ghana showed that exclusive breast feeding for six months reduced under five mortality by 13%. Exclusive breast feeding was the surest way for reducing infant mortality and underscored the need for the policy to be enforced against the violation of the practice. The 2003 report on Ghana's infant and child mortality indicated a slowing of the mortality rate. Studies showed that for babies born to HIV-infected mothers, the use of niverapine combined with baby formulas to prevent mother-to-child transmission, could reduce child mortality to only 2% while the use of insecticide-treated bed nets could reduce it by 6%. Statistics showed that the infant mortality rate for children under-one was soaring because of mixed feeding with baby formulas. Exclusive breastfeeding in fighting mortality in children has become a serious issue and called for stringent measures in enforcing the ban on baby food companies to stop the promotion of their products to ensure that breastfeeding was practiced. doclink

Zambia: Catholics Negatively Influencing Family Planning

June 7, 2005, The Post (Zambia)

The Catholic Church in Zambia has negatively influenced family planning and early marriageshas caused the number of children to be higher than that of elders. The district had recorded a rise in the number of children because people did not use family planning methods. The Catholic Church discourages the use of pills and encourages natural family planning. It also discouraged the use of condoms. Natural family planning requires full participation from both partners and is not ideal, as evidenced by the many children in the district. Family planning depends on people making decisions, you can't force them to take pills. The health ministry had opened discussion at the Catholic diocese to teach people about natural family planning and a pilot programme would be launched to help address the problem although it would not be easy as roads are bad and communication is difficult. Early marriages had caused children to start having children and child spacing for the young people did not apply. There were serious effects of marrying at a young age, as some girls were not ready for child bearing. Family planning had been integrated into outreach programmes as in the past, frequency of reaching people was not good. doclink

U.S.: Beads Play Role in Family Planning

May 25, 2005, Chicago Tribune (USA)

Those who prefer natural family planning can turn to CycleBeads, that help women count the days to determine when they are likely to become pregnant. CycleBeads were developed by the Institute of Reproductive Health at Georgetown University and the method has been found to be more than 95% effective. doclink

Rise in Use of Natural Planning

April 26, 2005, BusinessWorld (Philippines)

The use of natural family planning methods among Filipinos has increased despite accusations that the government is pushing for artificial family planning methods with its acceptance of millions in contraceptive donations from foreign sources. About 300,000 couples were surveyed in a door-to-door campaign and the number opting to use natural family planning methods had risen to 18% from only 0.9% in 2003. This proved the Government was not pushing for only one type of family planning method. doclink

Philippines: Church Will Take Pill to Supreme Court

April 2, 2005, Standard, The

In an effort to block passage of a bill on reproductive health, Church supporters in the Phillapines will petition the Supreme Court to rule on whether contraceptives such as IUD and the Pill induce abortion. If they are abortion-inducing materials and chemicals, and since abortion is illegal, these contraceptives will be banned. Foreign companies who are distributing pills and other chemicals and materials will be named respondents. Businessmen said they support the move to consult the Supreme Court and propose to conduct a massive information campaign on the merits of the natural family planning method. Bishop Antonio Ledesma said about 600 couples in his 19 parishes practice natural methods. He supports the move to ask the Supreme Court to settle the abortion question and showed journalists rosary-like beads used in the Standard Days method to tell a woman's fertile and nonfertile days. doclink

Pakistan: Clerics Express Reservations on Use of Contraceptives

June 1, 2005, Daily Times

Clerics have expressed reservation on the use of contraceptives as they restrict reproduction and conflict with Islamic injunctions. Some clerics have called for separating married HIV patients from their spouses although NACP officials said it would be a social boycott of infected people. Sources said the clerics were not impressed by the NACP standpoint. Clerics said if a person committed 'adultery' and was infected with the virus, he/she did not have the right to deceive his/her family and there were no guarantees that using contraceptives would avoid transmitting the disease. NACP observed that it was difficult to determine whether an individual was infected through sexual intercourse, a contaminated syringe or unscreened blood. The NACP prepared an information kit for the clerics, which covered HIV among young people, the diseases transfer from mother to child and HIV reduction measures. The text was revised to suit Islamic ideologies and by taking into consideration Pakistan's unique characteristics. doclink

Workshop on Fertility Awareness Concludes

April 18, 2004, The Hindu

Participants at a two-day workshop evolved an action plan to create awareness regarding the natural method of family planning. Population has to be stabilised and the programme is to create awareness regarding the menstrual cycle of women and the fertile and non-fertile days. The target groups are couples who want to delay the first child and for spacing the second child. Coloured beads provided by the programme help women keep track of their menstrual cycle. A woman who has regular cycles between 26-32 days, the fertile period of 12 days starts from the 8th day of starting the menstrual flow to the 19th day. The method can also be used for couples who are planning to have a child. In the slum where the plan was introduced, there was an improvement in interpersonal communication between the man and woman. doclink

Australia: Birth Control Experts Cast Doubts on Updated Rhythm Method

April 11, 2004, The Age

Creators of a new rhythm contraception say it is reliable, but Australian experts are not enthusiastic. Researchers at Georgetown University in the US call their version the Standard Days method. A computer model based on 7500 menstrual cycles compiled by the WHO, identified a 12-day window when a woman can become pregnant. For example, a woman who has sex on the Tuesday before the Saturday she ovulates has only a slight chance of becoming pregnant. On the Wednesday that chance is greater and so on until the Sunday after she ovulates, when she has little chance of becoming pregnant. It will work only with women whose cycles are reliably 26-32 days long which accounts for 80% of the population. The Standard Days method comes with a set of beads that allows women to chart their cycle. On day one a band is placed around the first bead and each day is moved one bead until it reaches the first of 12 white beads, which are the days the woman is fertile. In Australia, the oral contraceptive pill is the primary method of birth control, but 3% practise abstinence. Trials have shown the Standard Days' failure rate is 5% if used perfectly, but it doesn't come near other forms of contraception. The pill has a failure rate of 5% in the first year but 1% in perfect use. Condoms 14% in the first year, but 3% when used properly. But unless women are in a stable long-term, monogamous relationship, they should use condoms to protect them from sexually transmitted diseases. The rhythm method is gaining appeal, with more than 100,000 women using it but condoms are promoted in developing countries because of AIDS, gonorrhoea and syphilis. Western family planning groups are increasingly offering the Standard Method as an alternative for women wanting hormone-free, non-invasive birth control. doclink

Natural Family Planning Aid Cycle Beads

December 11, 2003, Wall Street Journal

The Wall Street Journal profiled CycleBeads, an inexpensive aid for natural family planning. The device consists of a ring of color-coded beads, each representing one day in a woman's menstrual cycle. A woman considers herself able to become pregnant on days 8 through 19, requiring a 12-day period of abstinence or a method of birth control. The device can be used only by women with regular menstrual cycles between 26 and 32 days. This method had a first-year pregnancy rate comparable to condoms, spermicides or diaphragms. doclink

FDA Clears New Saliva-based Test for Determining Ovulation

August 16, 2003, TCI Optics - Diagnostics & Imaging Update

TCI Optics is introducing a saliva-based test, called OvuLook to determine when women are ovulating and improve their chances of getting pregnant. The test is a reusable mini-microscope no bigger than a compact. The woman places a drop of saliva onto the device, lets it dry and pushes a button. A light stays on for 45 seconds to see the results. The OvuLook tells when ovulation is nearing which is important as a women's egg only survives 24 hours. The "ferning" pattern that appears on the device allows a women to accurately pinpoint ovulation. OvuLook is the first device of its kind to receive clearance from the FDA. Other devices which test saliva have been approved by the FDA, but with them women can't save their results to detect patterns in their cycles. TCI Optics has improvements to make based on feedback from women, before introducing the product commercially. In trials, the results showed 98% accuracy. The product will be manufactured in the Czech Republic and will be on sale in 30 to 45 days. doclink


India: Drug Firms Push Unapproved Fertility Drugs

January 2, 2004,

Lax drug regulations in India allow companies to push unapproved drugs and contraceptives that pose risks to women's health. They are distributed through private practitioners and quacks and nothing is being done to prevent it. The government agreed to investigate the use of anti cancer Letrozole as a pro-fertility drug. SUN Pharmaceuticals and Dabur (India) Ltd have been warned from promoting Letrozole pending its approval as a fertility drug. It has been approved in India for breast cancer but doctors have used it to improve fertility in women. Several doctors acknowledged that they were encouraged to test the drugs on infertile women by representatives from the pharmaceutical companies. 400 women are believed to have used the drug on a trial basis. It is said to be toxic to embryo and foetus, by the original discoverer, and drug regulators, including the US (USFDA), the British (BMHRA) and Australian (TGA). The anti malarial drug Quinacrine banned for use as a contraceptive has been widely distributed and used on women who are not informed of its effects. 32 women who where sterilised with Quincarine were unaware it had been banned and had serious health hazards. Practitioners who break the ban are immune from prosecution. doclink


India: Achieving Family Planning Goals with 'Cycle Beads'

September 20, 2005, Press Trust of India

What the 'nasbandi' of the 70's and the family planning drives could not achieve, doctors are trying to accomplish through a simple colour-coded set of beads. Called the Standard Days Method (SDM), it uses colour beads to identify fertile and non-fertile days and plan spacing between pregnancies. The method has been developed by American researchers and is being used in nearly 25 countries. In a country like India, where 78% of pregnancies are unplanned and nearly 25% unwanted, it can serve as an inexpensive, and 95% per cent effective method of preventing pregnancy. The Indian government has included it in the Reproductive Child Health programme for expanding contraceptive choices and this simple, method should be made widely accessible. doclink

Ancient Alternatives

The Awkward History of Americans Talking About Contraception

August 23, 2012, Atlantic Monthly

The ACLU announced that a California school district is being sued by parents and students over its abstinence-only sex education program. Among other affronts to the concept of comprehensive sex education, the program's textbooks do not mention condoms, even in the chapters on protecting oneself from STIs and unintended pregnancy.

Manufacturers, health officials, and the public have found numerous ways to talk about contraception without really having to talk about it. Condoms were marketed as "sheaths, skins, shields, capotes, and 'rubber goods' for the 'gents.' Many companies emphasized testosterone-fueled virility with names like Spartans or Trojans.

In 1873 the Comstock Act criminalized any and all forms of contraception and euphemisms became a legal necessity. But by World War I, because of an emerging knowledge of communicable disease, particularly venereal disease, condoms began to build their reputation as prophylactics -- and that form of contraception became understood as a public health issue. That was the point where "protection," "safety," and other words with health implications became common.

The term "birth control" entered the lexicon in 1914, when it was coined by Margaret Sanger, a controversial hero in the field of reproductive rights. By "birth control," Sanger meant to put words to the idea of "voluntary, conscious control of the birth rate by means that prevent conception."

Although the health of women and children were also a priority, a lot of what Sanger and her followers were talking about when they referred to "birth control" is deeply disturbing by today's standards: they believed that certain populations -- specifically minorities and the poor -- should be kept from proliferating. Considering its strong eugenic undertones, it's surprising that the term is still so widely used.

On the upside, the introduction of the idea of birth control heralded a new era of talking openly about contraception. In a 1923 editorial for the New York Times, Sanger praised a bill that would allow doctors to discuss contraception with their patients:

In the 1940s, Planned Parenthood introduced the term "family planning" as a less radical way of talking about birth control. Turned intimate, the new discourse concerned a woman's right to sexual expression and to control over her body. In 1971 the Boston Women's Health Collective published When Our Bodies, Ourselves, with this in its preface:

"This knowledge has freed many of us from the constant energy-draining anxiety about becoming pregnant. It has made our pregnancies better because they no longer happen to us, but we actively choose them and enthusiastically participate in them. It has made our parenthood better because it is our choice rather than our destiny. This knowledge has freed us from playing the role of mother if it is not a role that fits us. It has given us a sense of a larger life space to work in, an invigorating and challenging sense of time and room to discover the energies and talents that are in us, to do the work we want to do. And one of the things we most want to do is to help make this freedom of choice, this life span, available to every woman."

In 1965, the Supreme Court made contraception legal for married couples; in 1972, it made access possible for single people as well. Women's health had taken on new meaning in 1960, when the pharmaceutical product was approved by the FDA as a form of oral birth control. By 20 years after it was first developed, 30 million women worldwide, including 10 million in the U.S., were on the Pill, allowing it to become a way of life.

As of last year, birth control is considered preventive care, required by Department of Health and Human Services to be covered by private insurers. And the U.S. government characterizes its family planning services, aided by Title X, as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved." doclink

Karen Gaia says: the claim that Sanger "believed that certain populations -- specifically minorities and the poor -- should be kept from proliferating" is disputed by Planned Parenthood. The term 'birth control' is familiar to couples who used it in the 1960s and beyond as a synonym for contraception. There was never any understanding that eugenics was involved, considering the huge benefits contraception gave to women: education, ability to have a career, more leisure time, healthier families - few women would want to do without.

Mule's Earwax Just Part of New Case Collection; History of Contraception Has More Than 650 Items

December 7, 2004, Plain Dealer

The History of Contraception Museum, at Case Western Reserve University presents the only collection of its kind in the world, representing the practices and products to prevent unwanted pregnancies. Exhibits go back to ancient Egypt where crocodile dung was employed as a suppository prior to intercourse, and the first-ever prescriptions for a contraceptive device (a medicated tampon). Folklore preventatives include beaver-testicle tea, weasel testicles tied to a woman's thigh, and elephant dung. There are displays of intrauterine devices and cervical caps. Condoms stretch from artistic to desperate (candy bar wrappers), not far from the corked, tubed and rubber-balled douches. The items were largely donated by medical professionals and family-planning services, or are re-creations of devices such as the amulet of mule's earwax. The Museum embodies social history, ethical issues, medical concerns and women's issues. People have been trying to devise ways to prevent conception for more than 2,000 years and transcends religions and cultures. doclink

Canada: Museum Puts Contraception on Display

December 5, 2004, The Plain Dealer

The History of Contraception Museum is the latest addition to the Dittrick Medical History Center at Case Western Reserve University. In ancient Egypt, crocodile dung was employed as a suppository before intercourse. Beaver-testicle tea was brewed by Canadian women. The collection includes some 350 intrauterine devices. The items were largely donated by medical professionals and family planning services. Dittrick is a museum and library dedicated to medical history. James Edmonson, Dittrick's chief curator, said the History of Contraception Museum "embodies social history, ethical issues, medical concerns and womens' issues. The collection also has 150 reference books. The collection shows that people have been imagining means of conception for more than 2,000 years. doclink

India: Birth Control Goes Herbal

September 28, 2003, London Sunday Telegraph

Indian scientists are developing the first effective and safe herbal contraceptive pill from a 2,500-year-old medical text. The ingredients are false pepper (embelia ribes) and long pepper (piper longum) mixed with borax. It is to undergo trials on humans, and could be on the market in two to three years. In the ancient world, Europeans used herbal contraceptives. One, a plant, silphium, was over-harvested and became extinct. In its modern form, the herbal contraceptive (pippalyadi yoga) would be taken as a daily pill for three weeks each month to inhibit ovulation. Dozens of plants are mentioned in India's ancient medical texts as preventing pregnancy, including Chinese hibiscus (hibiscus rosa sinensis), a small tree native to southern India. Developing an effective and safe herbal female contraceptive would be a coup for India. With a population in excess of one billion, only 2% of females use the modern contraceptive pill. No natural birth-control products have met the standards in clinical trials and herbal products can also have harmful side-effects. Chinese scientists developed a male contraceptive pill based on the seed of the cotton plant, trials showed it lowered men's sperm but also diminished libido. doclink