Progestin‐based contraceptive on the same day as medical abortion

Park, Jeanna; Robinson, Nuriya; Wessels, Ursula; Turner, James M.; Geller, Stacie E.

doi:10.1016/j.ijgo.2015.08.025

Cited by 9 publications

(2 citation statements)

References 10 publications

(18 reference statements)

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“…In a retrospective study, Park et al [198] demonstrated that the administration of a progestin-based contraceptive such as an ENG implant or DMPA injection on the same day as mifepristone for medical abortion did not alter the successful abortion rates [198]. In a recent systematic review and meta-analysis, Schmidt-Hansen et al [199] showed that after abortion, the risk of subsequent unintended pregnancy was lower for patients treated with the etonogestrel implant simultaneously with mifepristone compared to delayed treatment both after three (risk ratio = 0.10; 95% CI, 0.01 to 1.94; p = 0.13) and six months (risk ratio = 0.22; 95% CI, 0.06 to 0.78; p = 0.02).…”

Section: Post-abortion Implant Placementmentioning

confidence: 99%

Safety and Benefits of Contraceptives Implants: A Systematic Review

et al. 2021

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Progestin-only contraceptive implants provide long-acting, highly effective reversible contraception. We searched the medical publications in PubMed, CENTRAL, and EMBASE for relevant articles on hormonal implants published in English between 1990 and 2021. Levonorgestrel (LNG) 6-capsule subdermal implants represented the first effective system approved for reversible contraception. The etonogestrel (ENG) single rod dispositive has been widely employed in clinical practice, since it is a highly effective and safe contraceptive method. Abnormal menstrual bleeding is a common ENG side effect, representing the main reason for its premature discontinuation. Emerging evidence demonstrated that it is possible to extend the use of the ENG implant beyond the three-year period for which it is approved. The ENG implant could be an effective and discrete alternative to the IUD in young girls, such as post-partum/post-abortion. Implants should be inserted by trained skilled clinicians who previously provide adequate counselling about their contraceptive effect, benefits, and any possible adverse events. More studies are needed to validate the extended use of the ENG implant for up to 5 years.

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Section: Post-abortion Implant Placementmentioning

confidence: 99%

Safety and Benefits of Contraceptives Implants: A Systematic Review

et al. 2021

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“…52 Progesterone is necessary to induce the progesterone receptors, and different agonists and antagonists have been developed for progesterone receptors. The important applications of ligand that can interact with the PRs are hormone replacement therapy, 53 developing contraceptives, 54,55 maintaining or even ending pregnancy, [55][56][57][58] as well as developing medications for controlling breast cancers or uterus fibroids. 59,60 Human Epidermal Growth Factor Receptor 2 (HER2)…”

Section: Progesterone Receptormentioning

confidence: 99%

An Assay on the Possible Effect of Essential Oil Constituents on Receptors Involved in Women’s Hormonal Health and Reproductive System Diseases

Sakhteman

Pasdaran

Afifi

et al. 2020

J Evid Based Complementary Altern Med

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Aromatic herbal remedies, hydrosols, and essential oils are widely used for women’s hormonal health. Scientific investigation of their major constituents may prevent unwanted infertility cases, fetal abnormalities, and drug-herb interactions. It also may lead to development of new medications. A list of 265 volatile molecules (mainly monoterpenes and sesquiterpenes) were prepared from a literature survey in Scopus and PubMed (2000-2019) on hydrosols and essential oils that are used for women’s hormonal and reproductive health conditions. The PDB (protein data bank) files of the receptors (136 native PDB files) that involve with oxytocin, progesterone, estrogen, prolactin, acetyl choline, androgen, dopamine, human chorionic gonadotropin, luteinizing hormone, follicle-stimulating hormone, aromatase, and HER2 receptors were downloaded from Protein Data Bank. An in silico study using AutoDock 4.2 and Vina in parallel mode was performed to investigate possible interactions of the ligands with the receptors. Drug likeliness was investigated for the most active molecules using DruLiTo software. Aristola-1(10),8-diene, bergapten (5-methoxypsoralen), α-bergamotene, bicyclogermacrene, α-bisabolol oxide A, α-bisabolone oxide, p-cymen-8-ol, 10-epi elemol, α-elemol, β-eudesmol, 7- epi-β-eudesmol, ficusin, β-humulene, methyl jasmonate, nerolidol, pinocarvone, (+)-spathulenol, and thujone had better interactions with some androgen, aromatase, estrogen, progesterone, HER2, AChR, and/or dopamine receptors. Most of these molecules had an acceptable drug likeliness except for α-bergamotene, bicyclogermacrene, β-humulene, and aristola-1(10),8-diene. Some volatile natural molecules can be considered as lead compound for drug development to treat hormonal conditions.

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Contraception after medication abortion in the United States: results from a cluster randomized trial

Rocca

Goodman

Grossman

et al. 2018

American Journal of Obstetrics and Gynecology

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BACKGROUND Understanding how contraceptive choices and access differ for women having medication abortions compared to aspiration procedures can help to identify priorities for improved patient-centered postabortion contraceptive care. OBJECTIVE The objective of this study was to investigate the differences in contraceptive counseling, method choices, and use between medication and aspiration abortion patients. STUDY DESIGN This subanalysis examines data from 643 abortion patients from 17 reproductive health centers in a cluster, randomized trial across the United States. We recruited participants aged 18–25 years who did not desire pregnancy and followed them for 1 year. We measured the effect of a full-staff contraceptive training and abortion type on contraceptive counseling, choice, and use with multivariable regression models, using generalized estimating equations for clustering. We used survival analysis with shared frailty to model actual intrauterine device and subdermal implant initiation over 1 year. RESULTS Overall, 26% of participants (n = 166) had a medication abortion and 74% (n = 477) had an aspiration abortion at the enrollment visit. Women obtaining medication abortions were as likely as those having aspiration abortions to receive counseling on intrauterine devices or the implant (55%) and on a short-acting hormonal method (79%). The proportions of women choosing to use these methods (29% intrauterine device or implant, 58% short-acting hormonal) were also similar by abortion type. The proportions of women who actually used short-acting hormonal methods (71% medication vs 57% aspiration) and condoms or no method (20% vs 22%) within 3 months were not significantly different by abortion type. However, intrauterine device initiation over a year was significantly lower after the medication than the aspiration abortion (11 per 100 person-years vs 20 per 100 person-years, adjusted hazard ratio, 0.50; 95% confidence interval, 0.28–0.89). Implant initiation rates were low and similar by abortion type (5 per 100 person-years vs 4 per 100 person-years, adjusted hazard ratio, 2.41; 95% confidence interval, 0.88–6.59). In contrast to women choosing short-acting methods, relatively few of those choosing a long-acting method at enrollment, 34% of medication abortion patients and 53% of aspiration abortion patients, had one placed within 3 months. Neither differences in health insurance nor pelvic examination preferences by abortion type accounted for lower intrauterine device use among medication abortion patients. CONCLUSION Despite similar contraceptive choices, fewer patients receiving medication abortion than aspiration abortion initiated intrauterine devices over 1 year of follow-up. Interventions to help patients receiving medication abortion to successfully return for intrauterine device placement are warranted. New protocols for same-day implant placement may also help patients receiving medication abortion and desiring a long-acting method to receive one.

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Progestin‐based contraceptive on the same day as medical abortion

Cited by 9 publications

References 10 publications

Safety and Benefits of Contraceptives Implants: A Systematic Review

Safety and Benefits of Contraceptives Implants: A Systematic Review

An Assay on the Possible Effect of Essential Oil Constituents on Receptors Involved in Women’s Hormonal Health and Reproductive System Diseases

Contraception after medication abortion in the United States: results from a cluster randomized trial

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