The World Health Organization has issued new global guidelines expanding recommended contraceptive methods, including longer-lasting oral pills and implants, while publishing its first blueprint to develop reversible male contraceptives within the next decade to address a persistent gap in family planning options.
Millions of people worldwide who want to avoid or delay pregnancy still lack access to methods that fit their lives. An estimated 164 million women face this barrier, prompting the World Health Organization to issue updated guidance designed to broaden access and give individuals more flexibility in how they manage reproductive health.
Extended Schedules for Pills and Five-Year Implants
The updated publication, WHO guidelines on expanding contraceptive options
, introduces alternative schedules for existing methods to reduce the logistical burden on users. Under the new recommendations, combined oral contraceptive pills can be taken continuously for up to one year or in extended periods of up to six months, replacing traditional cyclical use. Additionally, the global health body supports contraceptive implants for up to five years, a change intended to cut down on frequent clinic visits, replacement procedures, and associated costs.
Emergency contraception options also broaden under the framework. The organization recommends mifepristone at doses of 10 to 50 milligrams as an additional emergency contraceptive method, to be taken as soon as possible and within five days of unprotected sex. Evidence cited by the agency indicates that mifepristone at these doses performs comparably in safety and effectiveness to existing emergency options.
At the same time, the agency draws strict lines regarding evidence. Officials called for further research into ormeloxifene before considering it for family planning programs due to limited safety data, and explicitly recommended against adding quinestrol-containing contraceptive pills to national programs following reports of serious adverse events.
“Choice is a gender equality issue, 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, behaviour, reliability and accessibility. Real choice means the confidence and control to choose a method, change it, or stop it.”
Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing
Target Product Profiles and the Push for New Male Contraceptives
While expanding female-centered methods, the organization is turning its focus toward broadening choices for men, who currently rely largely on condoms, withdrawal, and vasectomy. Although those choices remain limited, about 30 percent of couples already rely on a male method. To encourage innovation, the agency has published its first Target Product Profile for male contraceptives, setting benchmarks for safety, effectiveness, acceptability, and affordability to guide developers and researchers.
Several hormonal and non-hormonal candidates are currently under investigation in advanced clinical trials. The framework outlines three primary approaches: suppressing sperm production, inhibiting sperm function, and blocking sperm transport. Among these are RISUG, which has completed Phase 1 and Phase 2 studies in India, and ADAM, a hydrogel-based method in Phase 1 trials. Hormonal options under study include nestorone/testosterone gel, dimethandrolone undecanoate, and 11β-methyl-19-nortestosterone dodecylcarbonate.
For methods that suppress sperm production, the framework sets a minimum target for 90 percent of men to reach sperm concentrations of 1 million or fewer per milliliter within 12 weeks, paired with a 12-month cumulative pregnancy rate of no more than 7 percent. Optimal targets call for 95 percent of users to reach that concentration within eight weeks and a pregnancy rate of 3 percent or less.
Survey Data and Market Demand for Male Birth Control
Past development in male birth control often stalled over the assumption that men would refuse new contraceptives and that women would not trust their partners to use them. Recent survey data challenges that assumption.
With advanced trials underway, the agency estimates that new reversible male contraceptives could reach the market within the next five to 10 years, potentially transforming how couples divide the responsibilities and costs of family planning.