Yet there are many obstacles to good compliance. Not only do women have to remember to take a tablet at more or less the same time every day, but in any new relationship those who have stopped using the pill during a period of sexual inactivity must also restart in time. The observation that so many unintended conceptions occur at the start and finish of relationships implies that many women also fail to meet the challenge to use their brain and their sexual organs at the same time. That is, instead of requiring repeated decisions to avoid conception, such a method would require only one such decision when the user was sure he or she wanted to remain child-free for a number of years. After acting on that decision, individuals would be free of all contraceptive responsibility and nothing else would need to be done until they were good and ready for conception.
Contraceptive utopia is inhabited by perfect users of perfect methods.
Implants, IUDs and the new levonorgestrel-releasing intrauterine system for women are current methods that point the way forward. They are not therefore usually methods of first choice for teenagers. Thus, we particularly need more methods that are both usable by adolescents and completely forgettable once instituted. Innovative compounds such as antiprogestins and new slow-release technologies will be necessary. But they are most likely to be implantables of one kind or another, ideally with instant user-reversibility.