Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception

Da, Grimes; Hertzen, Helena von; Piaggio, Gilda; Look, PFA Van; Peregoudov, S.; Vucurevic, M; Roberts, H; Sc, Wu; Sn, Bagshaw; Ja, Otubu; Ok, Ogedengbe; Pretnar-Darovec, A.; Kirkman, RJ; Ding, JH; Mittal, Suneeta; Leavesley, G; Kl, Austin; Creinin, Mitchell D.; Oo, Adetoro; Guilbert, Édith; Jk, Chen; Bygdeman, M.; Bartfai, G; Khomassuridze, Archil; Cheng, Wei; Amindavaa, Oyunbileg; Sparrow, Margaret; Reg, Task Force Postovulatory Methods Fertility

doi:10.1016/s0140-6736(98)05145-9

Cited by 619 publications

(10 citation statements)

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“…21 The efficacy of this synthetic drug, which replicates the natural hormone progesterone and works by interrupting ovulation, 20 depends on the time interval between intercourse and ingestion, with accepted rates of efficacy based on a multicenter double-blind randomized clinical trial by the World Health Organization. 22 Levonorgestrel has a short half-life (eTable 3 in the Supplement), and there is little to no evidence of its effectiveness if it is taken more than 72 hours after unprotected intercourse. 23 Hence, the clinical and therapeutic guidelines for pharmaceutical dispensation of EHC, which are based on observed efficacy levels at relevant time intervals (eTable 3 in the Supplement), restrict levonorgestrel to 1.5 mg administered within 72 hours after unprotected intercourse.…”

Section: Methodsmentioning

confidence: 99%

Pharmacist Compliance With Therapeutic Guidelines on Diagnosis and Treatment Provision

et al. 2019

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Key Points Question Are therapeutic guidelines effective mechanisms for ensuring compliance in the provision of over-the-counter pharmaceuticals for symptom-based requests and product-based requests in Australian pharmacies? Findings In this quality improvement study using standardized patients in scenarios of requests for emergency hormonal contraception and medication for conjunctivitis, 57.6% of pharmacies followed dispensing behavior compliant with the protocol, while 31.3% involved some form of overtreatment or overselling of medication. There was also evidence of an interaction between sex of the standardized patient and pharmacist. Meaning Given the unintended adverse effects of overtreatment, this study suggests the advisability of regulatory intervention (and further behavioral research) to ensure compliance with professional protocols.

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Section: Methodsmentioning

confidence: 99%

Pharmacist Compliance With Therapeutic Guidelines on Diagnosis and Treatment Provision

et al. 2019

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“…Nausea and vomiting were significantly higher in the Yuzpe group. 36 A further WHO trial compared mifepristone 10 mg, versus two doses of LNG 0.75 mg 12 hours apart and a single dose of LNG 1.5 mg (Plan-B©, Barr Pharmaceuticals Montvale, New Jersey, USA) within 72 hours of unprotected coitus. The pregnancy rates were 1.5% for both the mifepristone and single dose of 1.5 mg LNG and 1.8% for the two 0.75 mg doses of LNG.…”

Section: Comparative Studiesmentioning

confidence: 99%

Emergency contraception from historical myth to modern reality: a historical timeline and updated interpretation

Goldstuck

2022

F1000Res

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Introduction: Emergency contraception is the use of a birth control method after coitus has taken place and there is a fear that it may lead to a pregnancy. Historical attempts were more likely to be harmful rather than effective. Oral estrogens, progestins, anti-progesterone, and partial agonist/antagonists of progesterone have all been used with varying degrees of efficacy. Currently ethinyl estradiol/levonorgestrel combinations, levonorgestrel alone, ulipristal acetate, and mifepristone are the usual oral methods depending on availability. Copper carrying and more recently levonorgestrel releasing intrauterine devices have also been used successfully. The intrauterine devices appear to be more effective than the oral methods and are also regular contraceptive methods and in addition have therapeutic properties. Background: The evolution from longer duration oral treatments with side effects to the current single tablet of levonorgestrel, ulipristal acetate, or mifepristone with low side effects and reasonable efficacy is described. The role of the highly effective copper intrauterine device and now also the levonorgestrel intrauterine device for emergency contraception is examined. Conclusion: Oral emergency contraception is a short term solution. Expanding emergency contraception to include the levonorgestrel releasing intrauterine device may provide long term contraception and health benefits as well as providing emergency contraception.

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“…Sperm can be retrieved from the fallopian tubes within 5 min to 2 h after insemination in the vagina (Kunz et al 1996) and the isthmic region of the tube forms a reservoir that enables sperm to stay vital and maintain their fertilizing capacity for several days up to ovulation (Suarez & Pacey 2006). Therefore, the effect of UPA on the oviduct could alter sperm interaction with the oviductal epithelium.…”

Section: R142mentioning

confidence: 99%

Mechanisms involved in the contraceptive effects of ulipristal acetate

et al. 2020

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The use of emergency contraception (EC) methods is increasing worldwide as it constitutes an effective way to prevent unplanned pregnancy after unprotected sexual intercourse. During the last decade, ulipristal acetate (UPA), a selective progesterone receptor modulator, has emerged as the most effective EC pill, and it is now recommended as first-line hormonal treatment for EC in several countries. Its principal mechanism of action involves inhibition or delay of follicular rupture, but only when administered during the follicular phase before the luteinizing hormone (LH) peak. However, considering the high efficacy of UPA, it is possible that it also exerts contraceptive effects besides ovulation. In the present review, we summarize and discuss the existing evidence obtained on the effect of UPA on sperm function and post-ovulatory events as potential additional mechanisms to prevent pregnancy. The bulk of evidence collected so far indicates that UPA would not affect gamete function; however, it could impair embryo–uterine interaction. Thus, besides the described effects on ovarian function, UPA contraceptive effectiveness might also be attributed to post-ovulatory effects, depending on the moment of the female cycle in which the drug is administered.

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Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception

Cited by 619 publications

References 10 publications

Pharmacist Compliance With Therapeutic Guidelines on Diagnosis and Treatment Provision

Pharmacist Compliance With Therapeutic Guidelines on Diagnosis and Treatment Provision

Emergency contraception from historical myth to modern reality: a historical timeline and updated interpretation

Mechanisms involved in the contraceptive effects of ulipristal acetate

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