Emergency contraception

Abstract

This review will focus on the available methods for emergency contraception (EC), efficacy, side effects and mechanisms of action. Copper intrauterine device (IUD) has been shown to be the most effective method for EC which can be continually used for regular contraception. However, this possibility is seldom used and may be little known. Among the hormonal EC methods 1.5 mg levonorgestrel is the most widely used EC pill while the more recently developed Ulipristal acetate (UPA) has been shown to be the most effective option. This is probably due to a more pronounced prevention of follicular rupture compared with other hormonal EC methods. Knowledge is needed to better advise lactating women and obese women on optimal EC method. Furthermore a possible interaction of UPA with regular hormonal contraception and possibilities for "bridging" from EC to regular contraception needs to be explored. To increase efficacy future studies should focus on EC methods that target the endometrium.

Pharmacy access to Ulipristal acetate in major cities throughout the United States

“…In 2010, a single 30 mg dose of ulipristal acetate (UPA) was approved as an emergency contraceptive pill (ECP) for use up to 120 h after unprotected sex. In contrast, levonorgestrel (LNG) is a single 1.5 mg dose ECP approved for use within 72 h after unprotected sex that maintains some efficacy to 120 h [1,2]. As an emergency contraceptive, LNG delays ovulation but has no effect once the level of luteinizing hormone (LH) begins to rise, triggering ovulation [1].…”

“…In contrast, levonorgestrel (LNG) is a single 1.5 mg dose ECP approved for use within 72 h after unprotected sex that maintains some efficacy to 120 h [1,2]. As an emergency contraceptive, LNG delays ovulation but has no effect once the level of luteinizing hormone (LH) begins to rise, triggering ovulation [1]. However, UPA remains effective in postponing ovulation if given prior to the LH peak [1].…”

“…As an emergency contraceptive, LNG delays ovulation but has no effect once the level of luteinizing hormone (LH) begins to rise, triggering ovulation [1]. However, UPA remains effective in postponing ovulation if given prior to the LH peak [1]. When a decision-analytic model was used to compare the cost-effectiveness of UPA and LNG, it was found that if UPA was used for the 4,176,572 estimated annual ECP uses in the United States (US), it would result in 37,589 fewer unintended pregnancies and save $116.3 million annually in healthcare costs compared to LNG ECPs [3].…”

Pharmacy access to ulipristal acetate in Hawaii: is a prescription enough?

“…Ulipristal acetate (UPA) is a second-generation selective progesterone receptor modulator US Food and Drug Administration approved in 2010 as a prescription emergency contraceptive to be taken within 120 h of unprotected intercourse [1,2]. Compared to levonorgestrel emergency contraceptive pills (LNG ECPs), UPA prevents more pregnancies when taken 1, 3 and 5 days after unprotected sex [3].…”

Emergency Contraception

“…Cu-T 380A'nın primer etki mekanizması fertilizasyonu engellemektir. Bu etkisini uterus ve fallop tüplerinde meydana getirdiği inflamatuar reaksiyonun sperm ve ovum üzerine toksik etkileri sayesinde gerçekleştirir 19,38 . Aynı yolla fertilizasyon sonrası embriyotoksik etkisiyle embriyonun implantasyon yeteneğini bozabilir 19 .…”