Emerging contraceptive options

May 18, 1999
Web posted at: 5:35 p.m. EDT (2135 GMT)

In this story: The birth control vaccine The four-month pill New delivery systems The new IUDs Male contraceptives Smaller steps RELATED STORIES, SITES

(CNN) -- Researchers say the dearth of new birth control options is about to end. A number of new choices are expected to hit the market in the next year and a half to two years. Others may not be seen until the end of the next decade, but they'll differ vastly from current options.

Here is a glimpse of the contraceptive choices of the future:

• Vaccines that provide pregnancy protection for one, three or five years.
• A birth control pill that gives women only four menstrual periods a year.
• Contraceptives that deliver hormones through a patch, gel or vaginal ring.
• Intrauterine devices (IUD) that are smaller and can also deliver hormones.
• A male contraceptive. Its effectiveness can be checked privately with a test similar to the home pregnancy test.

Two laboratories at the University of Virginia are racing to create a new kind of birth control in the form of a vaccine for women.

The idea is to use antibodies that attack eggs or sperm.

"To date we haven't seen any negative effects in the 45 baboons we have studied," said John Herr, director of the Contraceptive Vaccine Center at the University of Virginia in Charlottesville.

Herr says the vaccine could be produced at a low cost and administered easily.

"We want a one-year, three-year and a five-year vaccine," said Herr, "and there is evidence the vaccines are reversible." Herr expects to seek approval for human trials from the U.S. Food and Drug Administration in the next year and a half.

Across the state at Eastern Virginia Medical School, researchers are studying a birth control pill that would give women just four menstrual periods a year.

With current oral contraceptive regimens, women take the pill for 21 consecutive days and have 13 periods a year.

With the new regimen, called Seasonale, women would take the pill for 84 consecutive days and have four periods a year.

"The likelihood of our success is based on the fact that so many women find oral contraceptives as an acceptable, perhaps even preferred method, because they can time their menses," said Gary Hodgen of the Jones Institute based at EVMS. "And there's no reason to think having four menses a year is any less healthy than having 13."

Eliminating menstrual periods is nothing new to doctors. It's been done for athletes during big events and for women who are getting married.

"We've also used birth control pills to eliminate periods in women suffering from endometriosis," said Dr. Sarah Berga, University of Pittsburgh School of Medicine.

"We also think this approach may be advantageous to women who suffer from anemia," said Hodgen, "and anecdotal experience and small studies suggest it will also help women with fibroids, dysfunctional uterine bleeding and PMS symptoms."

According to officials with Barr Laboratories, makers of Seasonale, studies should begin by the end of the year. At least 500 women will be enrolled at 20 centers across the United States.

Say you like oral contraceptives but can't tolerate the side effects of bloating, nausea and moodiness.

It may be possible to get the good effects of the pill, such as lighter periods and decreased menstrual cramps, with a contraceptive vaginal ring. Delivery methods that avoid the stomach produce fewer side effects.

The vaginal ring is used for three weeks out of the month. It works by releasing hormones similar to the birth control pill.

Studies of the ring, developed by Organon Pharmaceuticals, show it's as reliable as the pill in preventing pregnancy. The company plans to apply for FDA approval by the end of the year.

Researchers at the Population Council are studying a patch and a gel to deliver hormones to prevent pregnancy.

"We are just using the skin to get the hormones in, so the action is the same as with implants or pills," said Dr. Elof Johansson of the Population Council.

When you say "IUD," most people in the United States think of the Dalkon Shield, which failed miserably amid reports of harm and litigation in the 1970s.

But in other countries, the intrauterine device is widely used.

Doctors believe a new generation of IUDs will find favor among U.S. women -- among them, a device called Mirena, which releases the hormone levonorgestrel.

"Other IUDs can increase the blood loss during menstruation, while Mirena reduces blood loss and in many women produces no bleeding at all," says Johansson. "It appears to also reduce ectopic pregnancies."

Mirena is already available to European women. The Population Council plans to apply to the FDA for approval within two years.

Will the day come when there is a safe and effective birth control method, other than the condom, for men?

A number of researchers are committed to the cause, but it may be years before it's a reality.

Studies are under way using a daily pill and a bimonthly injection that manipulates both testosterone and another hormone called progestogen.

Another method involves a steroid hormone that's delivered through an implant, similar to Norplant for women.

Once researchers have success with a male contraceptive, researchers at the University of Virginia are standing by with a device called SpermCheck to test fertility.

"We think that the availability of such a device to test when the sperm count falls beneath fertile levels will help the male contraceptive be accepted," said Herr.

The next several years will see improvements in methods already available to women.

For instance, the Today contraceptive sponge is expected to make a comeback in November 1999. The popular device was taken off the market in 1995 due to manufacturing problems. A different company, Allendale Pharmaceuticals, will make the product.

Various companies are working on implant devices like Norplant. Organon's product involves a single implant. The Population Council is working on an implant that can be used by breast-feeding women.

"I think when we look backwards, there will be more launches in the next two years than there ever have been before," Johansson said.