Environmental impact of contraceptive use: an overview of available evidence

This paper, which is based on experience from a recent, large, social‐marketing intervention to improve reproductive health in Orissa, India, reviews evidence of harmful effects of improper disposal of male condoms, e.g. ingestion by cattle, effects on humans (e.g. rag pickers), length of time to biodegrade, drain blockage, screen‐cleaning and disposal costs to waste‐water treatment systems. Evidence of impact on the aquatic environment, of hormones from oral contraceptive pills excreted in urine was examined. Given the dearth of published and anecdotal data on the subject, it is concluded that further evidence of the magnitude and severity of the problem in Orissa and similar places in less developed countries is required to facilitate planning of mitigation actions that can be incorporated into social marketing of reversible contraceptives.