Overcoming contraceptive discontinuation by overcoming side-effects: paving the way for personalized contraception in Ethiopia (360G-Wellcome-210211_Z_18_Z)

In the developing world, millions of women discontinue hormonal contraception due to the experience of debilitating physiological side-effects (e.g. excessive and irregular bleeding), yet the causes of these adverse effects is not known. This project will be the first to test the hypothesis that side-effects are caused by unnecessarily high dosage of exogenous hormones in hormonal contraceptives (e.g. injectables) compared with women’s endogenous hormones, with the aims of accumulating primary evidence for optimizing contraception to communities and individuals. The research will focus on the use of injectables in Ethiopia, where unmet needs for contraception reach the highest levels in Africa. The PI will build on both an interdisciplinary team of researchers in anthropology, population health, epidemiology, microbiology and medicine and a long-term collaboration with the Institute of Development and Policy Research of Addis Ababa University to implement and run the project. The findings will act as a stepping stone to both engage pharmaceuticals and scale-up the research to produce a statistical model for delivering contraception, predicting, given a woman’s context, the range of contraceptive doses minimizing side-effects whilst still suppressing ovulation. This predictive model will be taken to stakeholders worldwide to stimulate transformational innovations for designing and delivering variable-dose contraceptives.