Morning-after pill. The newest contraceptive is taken after intercourse. It’s an “emergency contraceptive” called Preven, on the market since last year. Basically a federally approved version of an old off-label use of the pill, Preven’s dose of hormones keeps a fertilized egg from implanting in the uterine wall. It’s available only by prescription, but it’ll stop a pregnancy 72 hours after sex. “For women who use less-effective methods, like condoms or diaphragms, it’s important they have this available,” says Rod Mackenzie, CEO of Preven’s maker, Gynetics.
New IUDs. The intrauterine device has a bad rep. Fewer than 1 million American women use them, but they almost never fail. Once a physician has inserted one, it’s trouble-free. New IUDs don’t cause fatal pelvic inflammatory disease like the Dalkon Shield of the 1970s. One available inEurope releases the hormone levonorgestrol, controlling the cramping and bleeding IUDs can cause. A soft, “frameless” IUD may also be free of these side effects.
Topical gels. Several smaller pharmaceutical companies are working on these, which ideally would kill sperm and germ alike. Applied to the vagina, they wouldn’t have the side effects (weight gain, nausea, headaches and depression) that hormone-based methods like the pill and Depo-Provera often do, but they’d be way more effective than today’s spermicidal gels. They can be applied just before intercourse, so they also promise to be more effective than the pill-27 percent of women use it, but it has a 4 to 7 percent failure rate (mostly because women forget to take it). Among the possibilities is ReProtect LLC’s BufferGel, now being tested, which maintains the vagina’s relatively high acidity during intercourse, killing sperm and making it tougher for germs to survive. And Biosyn Inc. is testing a gel called Savvy, which punches holes in the membranes of both sperm and pathogens, killing them.
Vaccines. Researchers have had less luck with drugs that confer immunological resistance to pregnancy. Still, Zonagen Pharmaceuticals is working on a vaccine to make the zona pellucida, the outer layer of the egg, impenetrable to sperm, and another vaccine against human chorionic gonadotropin, a hormone integral to pregnancy. Both are still being tested in animals.
Naturally, no method will be perfect for every woman. And while some of the contraceptives might not be that different from the ones in Margaret Sanger’s time, bit by bit women are getting access to a wider range of choices.
