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Using pharmacologic research to efficiently meet acute contraceptive needs

      Before the Covid-19 pandemic, reproductive health professionals had already determined that many patients wished for contraception with the ease of a long-acting reversible method, such as intrauterine and subdermal devices, but without the long-term commitment and the need to return to a healthcare provider for discontinuation. The current global pandemic has highlighted this need (
      • Katz M.
      • Newmark R.L.
      • Aronstam A.
      • O'Grady N.
      • Strome S.
      • Rafie S.
      • et al.
      An implementation project to expand access to self-administered depot medroxyprogesterone acetate (DMPA).
      ). More women than ever have been unable to access basic healthcare, including contraception, because of Covid-19 restrictions or loss of insurance as a result of unemployment. Before the start of this pandemic, efforts were already under way to create a new 6-month injectable contraceptive method (
      • Halpern V.
      • Stalter R.M.
      • Owen D.H.
      • Dorflinger L.J.
      • Lendvay A.
      • Rademacher K.H.
      Towards the development of a longer-acting injectable contraceptive: past research and current trends.
      ). These efforts stemmed directly from a strong demand for longer-acting injectable contraceptive methods among reproductive-age women, particularly in low-resource settings where the current 3-month injectable contraceptive, depot medroxyprogesterone acetate (Depo-Provera, DMPA; Pfizer, New York, NY), may be the only extended-duration or long-acting method available (
      • Halpern V.
      • Stalter R.M.
      • Owen D.H.
      • Dorflinger L.J.
      • Lendvay A.
      • Rademacher K.H.
      Towards the development of a longer-acting injectable contraceptive: past research and current trends.
      ). Subcutaneous injectable contraceptives can also be self-administered, further reducing the need to interact with the formal healthcare system (
      • Katz M.
      • Newmark R.L.
      • Aronstam A.
      • O'Grady N.
      • Strome S.
      • Rafie S.
      • et al.
      An implementation project to expand access to self-administered depot medroxyprogesterone acetate (DMPA).
      ), but they are currently available only for a 3-month duration of use (Depo-SubQ, 104 mg), leaving a gap in the contraceptive repertoire. The availability of a 6-month self-administered subcutaneous injectable contraceptive could provide a direct response to the healthcare disparities this pandemic has both exposed and exacerbated.
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