WHO Expands Contraceptive Choices as New Male Methods Become Reality

An estimated 164 million women who want to delay or avoid pregnancy are not using contraception, highlighting the need for services that offer practical choices backed by reliable evidence.

Choosing contraception can mean balancing comfort, cost, convenience and plans for the future, but millions of people still lack access to options that suit their lives. The World Health Organization (WHO) is recommending a wider range of contraceptive choices, including another emergency contraception option and longer use of existing methods, as researchers develop new ways for men to share responsibility for preventing pregnancy.

An estimated 164 million women who want to delay or avoid pregnancy are not using contraception, highlighting the need for services that offer practical choices backed by reliable evidence. The new publication, WHO guidelines on expanding contraceptive options, is designed to help countries broaden access and support informed decisions about starting contraception, choosing a method, switching to another option or stopping its use.

More Flexibility With Existing Methods

The guidelines recommend alternative schedules for combined oral contraceptive pills, allowing extended use for up to six months or continuous use for up to one year as alternatives to cyclical use. WHO also supports contraceptive implant use for up to five years, potentially reducing replacement procedures, clinic visits and associated costs, making contraception less demanding for people who face difficulties reaching services or paying for care.

Mifepristone is recommended as an additional emergency contraception option, taken as soon as possible and within five days of unprotected sex. According to the evidence described by WHO, doses of 10–50 mg are likely to be as safe and effective as other emergency contraceptive methods, expanding the choices that countries can consider making available through their health services.

Real Choice Needs Reliable Safety Evidence

Pascale Allotey, Director of WHO's Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing, described contraceptive choice as a gender equality issue. Her message reflects the everyday differences that shape people's decisions: a method's reliability matters, but so do accessibility, convenience, invasiveness and the behaviour required to use it effectively, with meaningful choice depending on the freedom to change or stop a method.

Expanding access also requires recognising where evidence remains insufficient. WHO has called for more research into ormeloxifene before its inclusion in family planning programmes because current safety evidence is limited, and recommends against adding quinestrol-containing contraceptive pills to national programmes because of limited evidence and reports of serious adverse events. These distinctions place safety and the quality of research at the centre of decisions about which methods to offer.

New Male Methods Could Share Responsibility

Men currently have few contraceptive methods under their control, principally condoms, withdrawal and vasectomy, although around 30% of couples rely on a male method. WHO research challenges the assumption that men would reject additional options: more than 75% of surveyed couples said they would be willing to use a new male contraceptive, and more than 85% of women said they would trust their male partners to take responsibility for contraception.

WHO has developed its first Target Product Profile for male contraceptive methods, outlining expectations for safety, effectiveness, acceptability and affordability to give researchers, funders and developers clearer direction. Hormonal and non-hormonal approaches are being investigated, with several promising candidates in advanced clinical trials, raising the possibility that new reversible male contraceptives could reach the market within five to ten years rather than establishing a guaranteed arrival date.

WHO's wider effort is to help countries update family planning policies and services using the best available science, connecting research advances with choices people can actually access. For individuals and couples, that could mean fewer replacement visits, greater flexibility with familiar methods and a broader opportunity to share contraceptive responsibility according to their needs and preferences.