Contraception

The October 2002 edition of ReCAPP focuses on contraception. It includes:

This month's Topic in Brief includes information about some of the newly developed forms of contraception and resources for more comprehensive information on contraception.

Hormonal Contraceptives

• Both Ortho Evra and the NuvaRing were approved by the FDA at the end of 2001. Both new methods contain hormones similar to those in birth control pills, so their advantages — and disadvantages — are similar.
  
  Ortho Evra is an adhesive patch that delivers pregnancy-preventing hormones through the skin. A woman wears it for one week at a time for three consecutive weeks. The fourth week is patch-free, which allows her to have her menstrual period. For more information on Ortho Evra, visit: www.orthoevra.com.
  
  The NuvaRing acts like a time-release capsule in the form of a ring. It is a flexible ring, two inches in diameter, that a woman inserts in her vagina once a month. Once inserted, the ring releases hormones for three weeks. For more information about the NuvaRing, visit the manufacturer's web site at: www.nuvaring.com.
  
  
• Lunelle is a hormonal contraceptive that is administered monthly. Lunelle is given as a shot to the woman's arm, thigh, or buttocks. Although it has been on the market since early 2001, Lunelle is the most recent contraceptive injection to become available in the United States. For more information on Lunelle, go to ReCAPP's May 2001 Topic in Brief or www.pharmacia.com/
  
  
• A pill called Seasonale, which is currently undergoing clinical trials in the United States, is similar to the traditional oral contraceptive pill. It provides the same combination of hormones and is taken orally. However, it has the added benefit of providing women with less frequent periods by increasing their menstrual cycles to three or even four months. For more information on Seasonale, go to: www.ivillagehealth.com/conditions/reproductive/articles/0,11299,166936_210502,00.html

A new intrauterine system known as the Mirena IUS is now available. Made of light plastic, the t-shaped Mirena works like many other types of intrauterine contraceptive systems. It is fitted by a health care professional and remains in the womb for a fixed amount of time. It is different, however, in that it is much more effective than traditional intrauterine contraceptive devices (IUDs), avoids many of the side effects associated with IUDs, and does not have to be replaced for five years. For more information, visit: www.womens-health.co.uk/mirena.htm

Research is underway on a variety of microbicides that will not only prevent pregnancy but also protect against HIV/AIDS and other sexually transmitted infections (STIs). One version currently undergoing testing is known as the "Invisible Condom" which is a heat-activated liquid that a women applies to her vaginal area with an applicator. When the liquid encounters body heat, it turns into an odorless, tasteless gel. The gel acts as a barrier and contains microbicides to further destroy microbes. It has the added benefit of mimicking vaginal lubrication. For more information on the invisible condom, see: www.ashastd.org/news/invisiblecondom.html

The pharmaceutical company Wyeth announced in August 2002 that it would not resume U.S. marketing of Norplant, a contraceptive implant in the form of six "matchstick-sized" rods implanted under the skin, despite new evidence of its effectiveness. Wyeth temporarily removed Norplant from the market two years ago in the wake of controversy over its efficacy and lawsuits from women claiming they were not adequately informed of its risks. Some family planning specialists are concerned that Norplant's demise could cause trouble for other implantable contraceptives that may be on the market soon. These new products include:

• Jadelle, a "two-rod version of Norplant" that is also manufactured by Wyeth and was approved by the FDA in 1996. Although it has not yet been sold in the United States, Jadelle is currently used in dozens of other countries, according to Wyeth spokespersons.
  
  
• Implanon, a single implantable contraceptive rod, for which Organon International is currently seeking approval. Implanon contains the hormone desogestrel, which may cause fewer side effects than levonorgestrel, the hormone used in Norplant. Also, Implanon is designed to last for three years as opposed to five years for Norplant.

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Organizations and web sites with information on contraception:

• Association of Reproductive Health Professionals (ARHP)
  2401 Pennsylvania Ave., NW, Suite 350
  Washington, DC 20037-1718
  2002-466-3826
  www.arhp.org/success/
  
  
• Feminist Women's Health Center
  www.fwhc.org/birthcontrol.htm
  
  
• National Library of Medicine
  www.nlm.nih.gov/medlineplus/birthcontrolcontraception.html
  
  
• Planned Parenthood Federation of America
  810 Seventh Ave.
  New York, NY 10019
  1-800-669-0156
  www.plannedparenthood.org/bc/cchoices.html

• ETR Associates
  4 Carbonero Way
  Scotts Valley, CA 95066
  1-800-321-4407
  www.etr.org/pub/
  
  
• Journeyworks Publishing
  PO Box 8466
  Santa Cruz, CA 95061-8466
  1-800-775-1998
  www.journeyworks.com

• Contraceptive Technology, 17th ed. (book and monthly newsletter)
  by Robert A. Hatcher, MD, et.al.
  Ardent Media, Inc.
  1998
  
  
• Kaiser Family Foundation Daily Reproductive Health Report
  www. kaisernetwork.org/daily_reports/rep_repro.cfm
  To be notified of the latest health policy issues, news, and webcasts via email, sign up at: www.kaisernetwork.org/email_alert/email.cfm
  
  
• The New Positive Images: Teaching Abstinence, Contraception and Sexual Health
  by Peggy Brick
  The Center for Family Life Education, Planned Parenthood of Greater Northern New Jersey
  Hackensack, NJ, 1995
  
  
• Our Bodies, Ourselves for the New Century: A Book by and for Women (rev.)
  by The Boston Women's Health Book Collective
  Touchstone Books, Simon & Schuster
  New York, NY, 1998
  available through Women's Health America, 1-800-558-7046
  www.womenshealth.com/orderitems/Descriptions/ourbod.html
  
  
• Reducing the Risk, 3rd ed. (curriculum)
  by Richard Barth, MSW, PhD
  ETR Associates
  Santa Cruz, CA, 1996
  
  
• Safer Choices, Level 2 (curriculum)
  by Karin Coyle, PhD, and Joyce Fetro, PhD, CHES
  ETR Associates
  Santa Cruz, CA, 1998

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