| Beyond the Pill |
|
|
|
|
MAKE LOVE, not unplanned pregnancies#that could be the slogan of our times. In 1994, half of all pregnancies were unintended, and the highest rate of such conception was among young women of color, according to the Alan Guttmacher Institute. Why#with greater birth-control options than our mothers had #are we slipping up? "It has to do with not being educated about all the contraceptive options, as well as with inconsistent use," says Valerie Montgomery Rice, M.D., director of the division of reproductive endocrinology and infertility at University of Kansas Medical Center. But there are signs that we're taking control. Between 1982 and 1995, the proportion of Black women who were having intercourse but not using birth control fell by almost half. Furthermore, the birth rate for unmarried Black women is lower now than in any year since 1969. New contraceptive options will continue to make it easier for us to plan parenthood. "During the next two years there will be a record launch of birth-control products in the United States," says Elof Johansson, M.D., Ph.D., vice-president and director of the Population Council's Center for Biomedical Research. Below, a look at birth-control products emerging in the new millennium. [Turn the page for a comprehensive listing of existing contraceptives.] WHAT'S NEW FOR HER Greater convenience and fewer side effects characterize many of the new female birth-control options. * Lunelle You've heard of Depo Provera, a shot given every three months to prevent pregnancy. A new shot, Lunelle, is taken each month. Containing the same hormones as the Pill, it's as effective as sterilization. Unlike Depo, Lunelle impairs fertility for only a month after the last injection; Depo prevents pregnancy for three more months. Lunelle, expected to be approved by the Food and Drug Administration (FDA) soon, is not recommended for women with heart problems. * Norplant 2 The original Norplant, the contraceptive device consisting of six thin capsules inserted just beneath the skin, prevents pregnancy for five years by releasing the hormone levonorgestrel. Norplant 2, a two-rod implant, offers protection for three years. It has been approved by the FDA but is not now marketed in the United States. Caution: Sisters using Norplant may develop keloids (thick scarring) from insertion and removal, says Yvonne S. Thornton, M.D., M.P.H., clinical professor of obstetrics and gynecology at the University of Medicine and Dentistry in Newark, New Jersey. * Mirena Billed as a better IUD (intrauterine device), Mirena is expected to be approved for use in the United States within the next two years. The contraceptive releases levonorgestrel directly into the uterus, so less hormone is needed, reducing risk of negative side effects. It prevents pregnancy for up to five years. * Lea's Shield Diaphragms have been around for decades, but a new version, Lea's Shield, is headed our way. The one-size-fits-all device is made of silicone rubber. The Shield is inserted like a diaphragm and covers the cervix. A one-way valve allows secretions to flow out without letting sperm in. It is expected on the market by early next year. * Vaginal ring This flexible donut-shaped silicone-rubber device fits comfortably into the vagina, slowly releasing hormones into surrounding tissues. It can be inserted by the wearer instead of a physician and will be available in about five years, * Gels, patches Researchers are working on gels and patches that are applied to a woman's abdomen and deliver hormones into the bloodstream through the skin. They can be used to prevent pregnancy or as hormone-replacement therapy for menopausal women. Expect a patch in about two or three years. WHAT'S COMING FOR HIM Partly because of physiology, men have far fewer birth-control options than women. But brothers may soon have alternatives that resemble those now available to sisters. * No-scalpel vasectomies About 500,000 men#one out of every hundred men between ages 25 and 49#choose a vasectomy every year, and about a third are undergoing a new no-scalpel technique. How it works: A surgeon makes a tiny puncture in the scrotum to reach the sperm tubes, which are then cut and sealed. No stitches are required. The procedure, which takes about ten minutes, costs between $240 and $1,000 and may be covered by insurance. * A male pill Researchers are developing an oral contraceptive for men that dramatically reduces sperm production. This contraceptive, which contains the hormone progestin, will be taken in combination with an injection or patch containing testosterone. It doesn't inhibit sexual desire or ability to function and will probably be on the market in five to ten years. * Implants Like Norplant for women, a single implant is placed under the skin of the upper arm. It releases a synthetic male hormone that suppresses sperm production without impairing sex drive. These implants are being developed to prevent pregnancy for up to one, two or three years. Implants will be on the horizon in about seven to ten years. * Immunocontraceptives This method works by stimulating antibodies that inactivate a hormone essential to sperm and testosterone production. Immunocontraception, which may be delivered by injection or in an implant, provides continuous contraception for up to one year. It may be available in ten to 15 years. DIABETES UPDATE: If you have type-2 diabetes, talk to your physician about Avandia (rosiglitazone maleate), a new oral diabetes treatment recently approved by the Food and Drug Administration. Unlike other diabetes drugs, Avandia lowers blood-sugar levels by targeting insulin resistance, an underlying cause of type-2 diabetes. This helps the body's own insulin work more effectively. Though well tolerated in clinical trials, the most commonly reported side effects were upper-respiratory-bract infection and headache. Other side effects included weight gain, anemia and edema.
SOURCE: All About Birth Control: The Compete Guide by Planned Parenthood (Three Rivers Press, $12). Deborah L. Shelton is a public health and science reporter. She lives in Chicago.3
COPYRIGHT 1999 Essence Communications, Inc.             |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Next > |
|---|