Predictions About the Future of Contraceptive Research
Perspectives published articles in the 1980s, 1990s and 2000s that examined the current state of contraceptive research and highlighted the methods in development that seemed to be the most promising. Read together, these articles track the evolution of the conversation on contraceptive research.
In a 1980 assessment, Linda Atkinson and colleagues noted that the success of the pill and the IUD in the 1960s led researchers to believe that a contraceptive revolution was on the horizon. The goal? One perfect method that would be “highly effective, safe, acceptable, inexpensive, and simple to administer and distribute.” At the time, the need for contraception was driven by high population growth in the developing world. The authors highlighted five methods in development that they believed had the potential to revolutionize contraceptive practice: nonsurgical female sterilization, a reversible method for men, an antipregnancy vaccine, a menses inducer and a postpartum IUD. Through their careful analysis of yearly expenditures, the authors concluded that although the potential for new products had been great, decreased government spending in the 1970s and lack of interest from the private sector (because of low potential for profits) meant less research, which hindered product development.
Michael Klitsch, writing in 1995, noted that only three methods gained approval in the 1990s (the implant, the injectable and the female condom). He, like the earlier authors, pinpointed money—the lack of it from both the public and the private sectors—as the main issue impeding progress. However, Klitsch also identified some new problems: By the 1990s, media-driven reports about the side effects of the pill and IUD had begun to influence contraceptive use, and drug manufacturers had to deal with product liability litigation and regulatory issues. It is disheartening to know that the sponge was taken off the market (prompting Elaine’s citywide search in a famous Seinfeld episode) not because of safety or efficacy issues, but because the manufacturer did not want to pay for required factory changes. Many of the methods in development described in the 1980 assessment remained on the list in 1995, and spermicides, barrier methods and vaginal rings were added. Klitsch noted that research was accelerating in the 1990s to make up for time lost in the 1970s and 1980s, and that there was recognition that men needed to be more involved in fertility regulation. He suggested that progress depends on “greater private-public collaboration in the funding and conduct of research,” and concluded that in the future, the change in contraceptive methods will be “evolutionary,” rather than “revolutionary.”
A 2002 review by Jill L. Schwartz and Henry L. Gabelnick began with the idea that women and men need contraceptive choices to be able to fulfill their needs, and stressed the importance of listening to users’ voices. Many of the products in development represented, as predicted by Klitsch, the evolution of older methods, rather than the creation of new ones. Variations on the diaphragm, refinements in female hormonal methods and improvements in currently available male methods were being examined. However, the authors noted that the HIV epidemic refocused contraceptive research by creating the need for a contraceptive that also protected against STDs. They concluded that the HIV crisis had “sparked renewed interest in the development of contraceptives that will revitalize the search for a variety of new and innovative methods.” The search continues.