Repeated use of pre- and postcoital hormonal contraception for prevention of pregnancy

Abstract

The studies of pericoital LNG regimens provided promising results but many had serious methodological issues. Most reports were decades old and provided limited information. However, we considered the evidence to be moderate quality because of the large number of participants from diverse populations, the low pregnancy rates, and the consistent results across studies. Rigorous research is still needed to confirm the efficacy and safety of pericoital use of LNG as a primary means of contraception among women with infrequent intercourse. If the method is shown to be efficacious, safe and acceptable, the results may warrant revision of the current World Health Organization recommendations and marketing strategies.

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

“…This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al. 2016; Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al.…”

“…Furthermore, women used the method as instructed, as their main form of contraception, and while the results were self-reported, repeat use appeared safe. This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al 2016;Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al (2016) and was observed throughout this study.…”

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

“…This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al. 2016; Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al.…”

“…Furthermore, women used the method as instructed, as their main form of contraception, and while the results were self-reported, repeat use appeared safe. This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al 2016;Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al (2016) and was observed throughout this study.…”

A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg

“…Previous studies of pericoital use using 0.75 mg of LNG (which is half the dose used in the present study) found similar or higher pregnancy rates ( Halpern et al , 2014 ; Taylor et al , 2014 ), which may be due to the difference in LNG dose, the characteristics of women included, the study sample size, or the difference in the number of sex acts per month during the period of observation. Different contraceptives have different characteristics that would fit into the needs of the woman.…”

A phase I study to assess safety, pharmacokinetics, and pharmacodynamics of a vaginal insert containing tenofovir alafenamide and elvitegravir

“…Halpern et al, 2008;Sarkar, 2011;Cover et al, 2013b;Cahill and Blumenthal, 2018), rather than a daily regimen or even a long acting regimen. Importantly, one study demonstrated that the pregnancy prevention efficacy of on-demand oral levonorgestrel was similar to that seen with typical use of daily oral contraceptive pills (Halpern et al, 2014). Key stakeholders and health care providers also agree that an event-driven method fills an important gap in women's reproductive health products (Cover et al, 2013a).…”

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

“…This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al. 2016; Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al.…”

“…Furthermore, women used the method as instructed, as their main form of contraception, and while the results were self-reported, repeat use appeared safe. This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al 2016;Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al (2016) and was observed throughout this study.…”

A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg

“…Previous studies of pericoital use using 0.75 mg of LNG (which is half the dose used in the present study) found similar or higher pregnancy rates ( Halpern et al , 2014 ; Taylor et al , 2014 ), which may be due to the difference in LNG dose, the characteristics of women included, the study sample size, or the difference in the number of sex acts per month during the period of observation. Different contraceptives have different characteristics that would fit into the needs of the woman.…”

A phase I study to assess safety, pharmacokinetics, and pharmacodynamics of a vaginal insert containing tenofovir alafenamide and elvitegravir

“…Halpern et al, 2008;Sarkar, 2011;Cover et al, 2013b;Cahill and Blumenthal, 2018), rather than a daily regimen or even a long acting regimen. Importantly, one study demonstrated that the pregnancy prevention efficacy of on-demand oral levonorgestrel was similar to that seen with typical use of daily oral contraceptive pills (Halpern et al, 2014). Key stakeholders and health care providers also agree that an event-driven method fills an important gap in women's reproductive health products (Cover et al, 2013a).…”

Feasibility and Acceptability of LNG 1.5 mg as an On‐Demand Pericoital Contraceptive in Ghana

“…This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al. 2016; Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al.…”

“…Furthermore, women used the method as instructed, as their main form of contraception, and while the results were self-reported, repeat use appeared safe. This aligns well with the findings of previous studies on LNG 1.5 mg (e.g., Festin et al 2016;Halpern, Raymond, and Lopez 2014), where most side effects were mild or tolerable, they did not seem to impact satisfaction, and incidents were not clearly related to the frequency of use. A change in bleeding patterns was an expected outcome in Festin et al (2016) and was observed throughout this study.…”

A prospective, open-label, single arm, multicentre study to evaluate efficacy, safety and acceptability of pericoital oral contraception using levonorgestrel 1.5 mg

“…Previous studies of pericoital use using 0.75 mg of LNG (which is half the dose used in the present study) found similar or higher pregnancy rates ( Halpern et al , 2014 ; Taylor et al , 2014 ), which may be due to the difference in LNG dose, the characteristics of women included, the study sample size, or the difference in the number of sex acts per month during the period of observation. Different contraceptives have different characteristics that would fit into the needs of the woman.…”

A phase I study to assess safety, pharmacokinetics, and pharmacodynamics of a vaginal insert containing tenofovir alafenamide and elvitegravir

“…Halpern et al, 2008;Sarkar, 2011;Cover et al, 2013b;Cahill and Blumenthal, 2018), rather than a daily regimen or even a long acting regimen. Importantly, one study demonstrated that the pregnancy prevention efficacy of on-demand oral levonorgestrel was similar to that seen with typical use of daily oral contraceptive pills (Halpern et al, 2014). Key stakeholders and health care providers also agree that an event-driven method fills an important gap in women's reproductive health products (Cover et al, 2013a).…”