New Contraceptive Methods To Bring More Choices

TRENTON, New Jersey, Jul 07, 1999 (AP Worldstream via COMTEX) -- The most popular birth control pill in the United States just got a new look -- a more ''discreet'' case resembling a makeup compact -- and other packaging changes to make it easier to use.

Along with cosmetic changes to the Ortho Dialpak dispenser holding Ortho-McNeil Pharmaceutical's nine oral contraceptive brands, women will have additional birth control choices in the near future.

Those include the return of the Today Sponge, which startup drug company Allendale Pharmaceuticals bought from the previous maker and plans to begin selling by mid-fall. A monthly contraceptive injection called Lunelle, made by Pharmacia and Upjohn, could hit the market by year's end.

And Allendale, located in the northern New Jersey town of the same name, hopes by early next year to begin selling a contraceptive film that dissolves inside the vagina.

Yet more revolutionary methods remain far off -- something family planning experts say is a serious problem in a country where half of the 6.3 million pregnancies each year are unplanned and the last new method, the female condom, was introduced six years ago.

''The United States has gone from being the undisputed world leader in contraceptive development to being in the backwaters,'' with women in Europe, Canada and elsewhere having more contraceptive choices, said Dr. David Grimes of the nonprofit research organization Family Health International.

Grimes and other experts say that's largely because of ''skittish drug companies and a very hostile legal climate'' inflating liability costs with class action lawsuits over such products as the Dalkon Shield IUD. The device was blamed for painful infections and even deaths before sales were banned in 1975.

Other roadblocks cited are limited federal funding, politics and public opinion, with conservative groups opposing methods that work after fertilization. That's why RU-486, the pill that induces abortion up to seven weeks into pregnancy, is available in Europe and China but not in the United States.

Some contraception researchers, though, are hopeful that changing public attitudes will spur more drug companies to develop products.

''I think in the U.S. we're entering a spurt of new interest and acceptance of contraception,'' said Dr. Kirtly Parker Jones, a reproductive endocrinologist at the University of Utah. ''For the first time we actually have oral contraception advertised on TV.''

Those ads are for Ortho Tri-Cyclen, which with sister brand Ortho-Cyclen went on sale June 1 in a sleek, beige compact far less obtrusive than the widely recognized blue case bearing the Ortho logo.

The line's first packaging overhaul in 20 years includes changes to limit mistakes: The dial only turns in one direction, each pill is numbered, and the medication can be started any day, rather than just Sunday. The other seven Ortho brands will switch to the new Dialpak over the next two years.

By then, some contraceptives still in testing may be crowding pharmacy shelves.

Among the first should be Lunelle, a monthly injection of low doses of the same hormones in the pill. In a 60-week test, none of the 782 women taking it became pregnant. Some researchers expect it will eventually be available in a form women can inject themselves just under the skin, eliminating monthly doctor visits.

A contraceptive ring that slowly releases hormones just finished testing and manufacturer Organon plans to seek federal approval at the year's end. Women insert the flexible device, remove it after three weeks to allow menstruation and then discard it.

While safe IUDs have been on the market for years, a seven-year one that prevents uterine fibroids and limits cramps, sold in Europe as ''Mirena,'' could be marketed in 18 months by Berlex Laboratories.

Also on the horizon are a hormone patch, a disposable diaphragm, oral contraceptives taken continuously so menstruation -- and cramps -- are eliminated, and an improved Norplant that has fewer rods and is easier to remove from the arm.

However, manufacturer Wyeth-Ayerst Laboratories, a division of American Home Products, hasn't announced plans to sell its Norplant 2, apparently stung by lawsuits by some women who had painful removals of the original version.

There is far less in the pipeline for male-controlled methods.

''There are no hormonal methods that will be available for men in the next 10 years in the United States,'' said Dr. Robert A. Hatcher, professor of gynecology and obstetrics at Emory University School of Medicine.

He believes vasectomy and condoms, though, remain great methods. Vasectomy is a safe, cheap operation with a failure rate of only 0.1 percent, compared to 3-5 percent for female sterilization, and condoms are ''reasonably effective'' and the only good protection from sexually transmitted diseases, Hatcher said.

He expects several brands of polyurethane condoms to be sold in the next two years. They don't cause allergic reactions, as latex condoms sometimes do, will have a longer shelf life, don't deteriorate when used with lubricants and transmit heat better,

enhancing sensation.