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[摘要]：Introduction: Contraception made profound contributions to women's health in the twentieth century and has the potential to help achieve each of the eight millennium development goals in the twenty-first. However, contraception has not met its full potential, in large part due to inconsistent use. Choice is uniquely important to contraceptive success, so continued innovation in all aspects of birth control is needed.Areas covered: First, we will review recent advances in the introduction of new methods of birth control. Then we will report recent developments in areas that strongly influence contraceptive use, including non-contraceptive benefits, ways to minimize side effects and practice protocols designed to encourage ready access to various methods. In the second half of the paper we will discuss methods that are in development, but not yet available, as well as new research into non-contraceptive benefits, new approaches to reduce side effects and new ways to provide contraceptives so that users can be more successful.Expert opinion: The goal of being planned and prepared for pregnancies is still only an abstract concept. Significant barriers to success from traditional sources (ambivalence, cultural and societal beliefs, the status of women, poverty) persist and are now joined by many other emerging structural problems. The consolidation of pharmaceutical companies reduces competition. The loss of profitability for contraceptives due to short-lasting patents, growing demand for generics and growing challenges from product liability reduce incentives for innovation. Healthcare reform in the US may further discourage new product development. However, new advances may still be possible from small start-up companies, philanthropic foundations and governmental research efforts. Other advances may be made by providing contraception in innovative ways and in the techniques we use to motivate patients to be more successful contraceptors. |
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