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Network. 2003; 22(4):11.For female condom users, use of a new female condom for every act of sexual intercourse continues to be recommended by the World Health Organization (WHO). Likewise, the female condom (a potential alternative for the male condom) is approved only for one-time use by the U.S. Food and Drug Administration. Such positions by public health experts reflect, in part, concerns that women may be unable to clean the device adequately to make its reuse safe. However, female condom reuse has been reported in a number of settings, likely because many women cannot afford to buy multiple female condoms. Recognition that reuse is occurring -- and may be acceptable, feasible, and safe in some circumstances -- led WHO to declare in July 2002 that "the final decision on whether or not to support reuse of the female condom must ultimately be taken locally." (excerpt)
SCIENCE. 1992 Jun 26; 256:1754.Depo-Provera (DP) was unanimously recommended for approval as a contraceptive by a Food and Drug Administration (FDA) advisory committee. This had happened once before in the mid-1970s, but Congress raised concerns about DP's possible link to cervical cancer. DP has been in use for 20 years as a treatment for uterine cancer. DP is an injectable progesterone analog that induces infertility for 3 months in 99% of the women who use it. It is already in use in 90 countries and has annual sales of US$100 million. The 4 annual shots cost US$120 and is an economical alternative to Norplant. There are still many unanswered questions about its safety. A recent WHO study found that it increased breast cancer by 21%, which was almost statistically significant. However, in the <34 age group breast cancer was twice as common, which is statistically significant. DP was found to increase the number of breast cancer cases by 5.6/100,00; but, it reduced the number of uterine cancer cases by 19.2/100,000. A New Zealand Hospital study found that DP use reduced bone density by 7.5% in the lumber spine and 6.5% in the neck of the femur. Critics charge that Upjohn has had 20 years to compile data but has failed to do so. There is little or no data about its effect on developing fetuses, osteoporosis, or the mechanism that causes breast cancer. All these areas were recommended for follow-up study by the FDA advisory committee.