Contraception in the 1990s
Shoupe, D.
Current Opinion in Obstetrics and Gynecology 8(3): 211-215
1996
ISSN/ISBN: 1040-872X PMID: 8818532 DOI: 10.1097/00001703-199606000-00011Document Number: 302249
In the face of legal challenges and adverse scientific publications that threaten the acceptance of various methods of contraception, this article reviews the forms of contraception currently available in the US and assesses their safety, efficacy, and medical benefits. Information is provided on 1) male and female condoms, which offer protection from pregnancy and from sexually transmitted diseases; 2) the spermicide Nonoxynol-9, which kills harmful microorganisms but is toxic to vaginal epithelium; 3) the contraceptive sponge; 4) the diaphragm (used with spermicides) and cervical cap; 5) Norplant, which is associated with troublesome side effects but still scores 78% satisfaction ratings; 6) Depo-Provera, which has been associated with bone loss; and 7) IUDs, which were used by 10% of women in the 1970s but are used by less than 2% today. The bulk of the report is devoted to oral contraceptives (OCs), which are described as "one of the most thoroughly studied pharmacological agents of the 20th century." The risks associated with OC use are reviewed, as are such topics as failure rates, mechanism of action, side effects, beneficial effects, effects of use on cancer rates, safety for breast-feeding women, contraindications, and the risk of venous thromboembolism associated in recent studies with formulations containing third-generation progestins. It is concluded that the development of contraceptive technology is being guided by a new emphasis on protecting health while preventing pregnancy.