New strategies for providing hormonal contraception in developing countries

Townsend, John W.; Sitruk-Ware, Régine; Williams, Katherine; Askew, Ian; Brill, K.

doi:10.1016/j.contraception.2010.08.015

Cited by 25 publications

(26 citation statements)

References 3 publications

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“…Recently, there has been an increased emphasis on hormonal‐based LAFP such as Jadelle and Implanon in developing countries (Townsend et al. ). Compared with younger women, women over 35 years old have less access to information about LAFP because they are generally less educated and communicate less with their husbands about FP.…”

Section: Discussionmentioning

confidence: 99%

Patterns and predictors of non‐use of family planning methods in Ethiopian women: a panel survey

Lee

Shin

et al. 2013

International Nursing Review

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Section: Discussionmentioning

confidence: 99%

Patterns and predictors of non‐use of family planning methods in Ethiopian women: a panel survey

Lee

Shin

et al. 2013

International Nursing Review

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“…Despite the progress made in recent decades in fertility reduction in developing countries, up to 120 million (10–12%) married women in most regions and more than 24% in sub-Saharan Africa, continue to report an unmet need for contraception [1]. The Millennium Development Goals (MDG) target of universal access to reproductive health reaffirms the need for contraceptive options as well as access to other key reproductive health services, including safe abortion, to reduce maternal mortality (MDG 5) and achieve gender equity (MDG 3).…”

Section: Introductionmentioning

confidence: 99%

Contraception technology: past, present and future

2013

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Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as well as interactions between spermatozoa and ova. It is hoped that the introduction of new methods with additional health benefits would help women and couples with unmet needs to obtain access to a wider range of contraceptives with improved acceptability.

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“…Use of ring and implant based contraception in the United States and globally is growing. Increased access to highly effective and longer acting methods such as Implanon® and the NuvaRing® is a crucial area to address the globally unmet needs for contraception[9]. …”

Section: Introductionmentioning

confidence: 99%

A UPLC-MS/MS Method for Therapeutic Drug Monitoring of Etonogestrel

Thomas

Petrie

Shim

et al. 2013

Therapeutic Drug Monitoring

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Introduction Etonogestrel is a progestin used in the contraceptive vaginal ring NuvaRing and the subdermal implant Implanon. A sensitive method for measuring etonogestrel is useful for further investigating the progestin’s pharmacokinetics with these alternative contraceptive formulations as well as generating important information about possible continued efficacy or potential failure to remove the subdermal implant. Methods Standards and serum samples were spiked with D8 progesterone (internal standard) and subsequently extracted with dichloromethane, dried, and reconstituted in 25% methanol with formic acid. Etonogestrel was analyzed by positive electrospray ionization in multiple reaction monitoring mode with a run time of 5.5 minutes using a C18 BEH column. The mobile phase was a gradient of water:acetonitrile, with 0.1% formic acid. The method was applied successfully to study the pharmacokinetics of etonogestrel during vaginal ring use. The method was also used in routine patient care to assess etonogestrel levels. Results The method is linear from 50pg/ml to 2000pg/ml. The limit of detection and quantification (LOD and LOQ) are 25 and 50pg/ml respectively. There was no observed ionization suppression within the linear range of the assay and the average recovery was 87%. Serum etonogestrel levels of n=3 subjects were all within the linear range of the assay for a total study period of 42 days after insertion of the ring. Of n=20 patients with non-palpable subdermal implants, n=13 had etonogestrel levels > 25 pg/mL, while n=7 had levels < 25 pg/mL. Conclusions We developed a rapid, sensitive, and robust UPLC-MS/MS method for the quantification of etonogestrel in serum that is useful to study the progestin’s pharmacokinetics and inform physicians about successful implantation or potential failure to remove a subdermal device.

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New strategies for providing hormonal contraception in developing countries

Cited by 25 publications

References 3 publications

Patterns and predictors of non‐use of family planning methods in Ethiopian women: a panel survey

Patterns and predictors of non‐use of family planning methods in Ethiopian women: a panel survey

Contraception technology: past, present and future

A UPLC-MS/MS Method for Therapeutic Drug Monitoring of Etonogestrel

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