Contraception: A review

Abstract

Recent years have seen a dual development in contraception: on the one hand, advances in technology have widened the choice for women; on the other, the right of women to informed and free choice has been reaffirmed. The need to provide contraceptive users with impartial and up-to-date advice was highlighted by the pill scare of 1995. The extreme safety of the pill when used by low risk women was confirmed in several reports. However, interest in long-acting systemic non-oral methods continues to increase as providers seek methods with minimal compliance requirement and therefore higher efficacy which, in the case of the hormone releasing intrauterine system (IUS) and injectable progestogens, approach the efficacy of female sterilisation. Globally the intrauterine device (IUD) had topped the league of reversible contraceptives for many years but had had mixed fortunes in some developed countries, especially the US. A revival of the IUD is on the way, mainly because of the impressive performance of the IUS and the recent introduction of a frameless device, the GyneFix.