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Rachel V Thomas

WHO Updates Contraception Guidance With Mifepristone, Pills And Implants: What To Know

The <span>World Health Organization</span> (WHO) has updated its <span>contraception</span> guidance, recommending mifepristone as an additional emergency contraception option and providing new guidance on <span>contraceptive pills</span> and <span>implants</span>.

The recommendations aim to expand access and give people more flexibility in choosing and using contraception.

“Choice is a gender equality issue,” said Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing.

“Contraception isn't one-size-fits-all. Men and women both need a range of options that reflect what science and innovation can now offer, weighed against convenience, invasiveness, behavior, reliability and accessibility. Real choice means the confidence and control to choose a method, change it, or stop it.”

<h2>What’s New In The WHO Guidance?</h2>

The guideline covers five areas: three contraceptive methods not previously included in WHO guidance and two changes to existing contraceptive practices.

<ul><li>Mifepristone: Recommended as an additional emergency contraception option.</li><li>Ormeloxifene: WHO suggests against adding it because more high-quality safety and efficacy evidence is needed.</li><li>Quinestrol-containing pills: WHO recommends against adding the specified combinations, citing limited evidence and the need for safety monitoring.</li><li>Combined oral contraceptive pills: Can be used for extended periods of up to six months or continuously for up to one year, alongside cyclical use.</li><li>Etonogestrel implants: Can be used for up to five years, in line with the updated manufacturer-approved duration. </li></ul><h3>Mifepristone For Emergency Contraception</h3>

WHO recommends a 10–50 mg single dose of mifepristone for emergency contraception, taken as soon as possible and within five days of unprotected sex. A 10–25 mg dose may be preferred where available.

<ul><li>WHO suggests against ormeloxifene due to insufficient safety and efficacy evidence.</li><li>It also recommends against quinestrol-quingestanol and quinestrol-norgestrel, and suggests against quinestrol-levonorgestrel. Safety monitoring is advised where quinestrol products are used.</li></ul>

<h3>Longer Use Of Pills And Implants</h3>

<ul><li>Combined oral contraceptive pills can be used for up to six months in extended regimens or continuously for up to one year.</li><li>WHO also supports etonogestrel implants for up to five years, potentially reducing replacement procedures and clinic visits.</li></ul><h2></h2><h2>Why Contraceptive Access Matters</h2>

The number of women of reproductive age using modern contraception rose 87% between 1990 and 2022, from 467 million to 874 million. Yet an estimated 164 million women who want to delay or avoid pregnancy are not using contraception and have an unmet need for family planning.

WHO says expanding access must go hand in hand with identifying methods that lack sufficient evidence for wider use.

<h2>WHO Pushes For More Male Contraceptive Choices</h2>

Men currently have relatively few contraceptive methods under their control, mainly condoms, withdrawal and vasectomy. Still, around 30% of couples rely on a male method.

A new global study in <em>Contraception</em> found that more than 75% of couples surveyed would be willing to use a new male contraceptive, while more than 85% of women said they would trust their male partners to take responsibility for contraception.

The WHO also developed its first Target Product Profile for male contraceptive methods, outlining desired characteristics such as safety, effectiveness, acceptability and affordability.

Several hormonal and non-hormonal male contraceptives are in development, with some candidates in advanced clinical trials. New reversible male contraceptives could potentially reach the market within the next five to 10 years, according to WHO.

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The World Health Organization (WHO) has updated its contraception guidance, recommending mifepristone as an additional emergency contraception option and providing new guidance on contraceptive pills and implants.The recommendations aim to expand access and give people more flexibility in choosing and using contraception.“Choice is a gender equality issue,” said Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing.“Contraception isn't one-size-fits-all. Men and women both need a range of options that reflect what science and innovation can now offer, weighed against convenience, invasiveness, behavior, reliability and accessibility. Real choice means the confidence and control to choose a method, change it, or stop it.”What’s New In The WHO Guidance?The guideline covers five areas: three contraceptive methods not previously included in WHO guidance and two changes to existing contraceptive practices.These include:Mifepristone: Recommended as an additional emergency contraception option.Ormeloxifene: WHO suggests against adding it because more high-quality safety and efficacy evidence is needed.Quinestrol-containing pills: WHO recommends against adding the specified combinations, citing limited evidence and the need for safety monitoring.Combined oral contraceptive pills: Can be used for extended periods of up to six months or continuously for up to one year, alongside cyclical use.Etonogestrel implants: Can be used for up to five years, in line with the updated manufacturer-approved duration. Mifepristone For Emergency ContraceptionWHO recommends a 10–50 mg single dose of mifepristone for emergency contraception, taken as soon as possible and within five days of unprotected sex. A 10–25 mg dose may be preferred where available.Ormeloxifene And QuinestrolWHO suggests against ormeloxifene due to insufficient safety and efficacy evidence.It also recommends against quinestrol-quingestanol and quinestrol-norgestrel, and suggests against quinestrol-levonorgestrel. Safety monitoring is advised where quinestrol products are used.Longer Use Of Pills And ImplantsCombined oral contraceptive pills can be used for up to six months in extended regimens or continuously for up to one year.WHO also supports etonogestrel implants for up to five years, potentially reducing replacement procedures and clinic visits.Why Contraceptive Access MattersThe number of women of reproductive age using modern contraception rose 87% between 1990 and 2022, from 467 million to 874 million. Yet an estimated 164 million women who want to delay or avoid pregnancy are not using contraception and have an unmet need for family planning.WHO says expanding access must go hand in hand with identifying methods that lack sufficient evidence for wider use.WHO Pushes For More Male Contraceptive ChoicesMen currently have relatively few contraceptive methods under their control, mainly condoms, withdrawal and vasectomy. Still, around 30% of couples rely on a male method.A new global study in Contraception found that more than 75% of couples surveyed would be willing to use a new male contraceptive, while more than 85% of women said they would trust their male partners to take responsibility for contraception.The WHO also developed its first Target Product Profile for male contraceptive methods, outlining desired characteristics such as safety, effectiveness, acceptability and affordability.Several hormonal and non-hormonal male contraceptives are in development, with some candidates in advanced clinical trials. New reversible male contraceptives could potentially reach the market within the next five to 10 years, according to WHO.

who updates contraception guidance with mifepristone, pills and implants: what to know

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