China has a high contraceptive prevalence rate, but the usage rate of oral contraceptives remains relatively low. Oral hormonal contraceptives primarily prevent pregnancy by regulating endocrine hormones. Progestins inhibit ovulation by suppressing the luteinizing hormone (LH) surge, thicken cervical mucus, and alter the endometrial lining. Estrogens inhibit follicle-stimulating hormone (FSH) synthesis, preventing dominant follicle development and enhancing the contraceptive effect while reducing irregular bleeding.
According to The Lancet’s July 2022 Global Contraceptive Report, China’s contraceptive prevalence rate (CPR) and modern contraceptive prevalence rate (mCPR) are 79.2% and 78.4%, respectively, both higher than global averages. Unmet contraceptive needs in China are only 2.9%, significantly below the global average. Regarding specific methods, intrauterine devices (IUDs) are the most common (44.2%), while oral contraceptives account for only 2.8%, and contraceptive injections for 0.6%.
Common oral contraceptives are categorized into emergency, short-acting, and long-acting formulations. Emergency contraceptives are used for post-intercourse prevention but can disrupt the endocrine system. Short-acting oral contraceptives have fewer side effects and high efficacy but require daily administration, leading to adherence challenges. Long-acting contraceptives do not require daily dosing but are associated with more side effects.
Data from World Contraception Day indicates approximately 13 million unintended pregnancies in China end in abortion annually, highlighting the importance of effective contraceptive choices. Although the use of oral hormonal contraceptives has increased in recent years, it remains much lower than in developed regions. In 2023, the market size for oral hormonal contraceptives in China reached 5.54 billion yuan.
The market prospect for compound short-acting oral contraceptives is promising. With updated expert consensus and clinical guidelines, awareness among healthcare professionals and the public is increasing. This is expected to boost the usage rate of compound short-acting contraceptives, driving market growth and shifting preference from emergency to daily-use options.
Popular short-acting compound oral contraceptives include Marvelon, Yasmin, Diane-35, and YAZ. The reference product is Bayer’s YAZ (containing drospirenone 3mg and ethinylestradiol 0.02mg). Compared to Yasmin, YAZ has a lower estrogen content, resulting in milder initial side effects such as nausea, bloating, and breast tenderness. Drospirenone and ethinylestradiol tablets (II) are currently the only compound oral contraceptive approved by the NMPA for both contraception and moderate acne vulgaris.
Conclusion
The Chinese oral hormonal contraceptive market exhibits significant potential, characterized by high overall contraceptive use but low adoption of oral methods. The market is poised for growth, driven by increasing awareness and a shift towards short-acting compound formulations. Future expansion will likely focus on improving education and accessibility to bridge the gap with developed markets.
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