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PubMed1993

Six years of clinical experience using postcoital contraception in college women.

Postcoital contraception (PCC), also known as the "morning-after pill," has been used at the University of Rochester Health Service for several years. In 1985, the healthcare providers developed a formal protocol for dispensing PCC to female students presenting with the complaint of unprotected intercourse within the previous 72 hours. Patients are screened for any absolute contraindications to using birth control pills, are asked to sign a consent form, and are told to schedule a follow-up visit to evaluate pregnancy status and contraceptive options. Data from 1985 to 1991 is presented and include total number of times PCC was dispensed, side effects of medication, patient profiles, and predicted and actual pregnancy rates. The authors compare the data from the University of Rochester with data described in the literature and discuss recommendations for practice.

Adult↗
PubMedDate not supplied

[Steroid and nonsteroid postcoital contraceptives].

It has been shown experimentally that a combined use of estrogen-norsteroids prostaglandins and neurotropic substances during preimplantation period produces the most potent contraceptive effect. Analysis of the action mode of combined small doses of steroids, prostaglandins and neurotropic drugs suggests that the contraceptive action is underlain by the inhibitory effect on incretion produced by the luteinizing hormone, this effect being in its turn a reason for variation in the amount and condition of the developing fetuses.

Animals↗
PubMed1997

Hormonal postcoital contraception.

Wide availability of hormonal postcoital contraception (HPC) is likely to reduce the incidence of unplanned pregnancies. The two most common indications for HPC are unprotected intercourse and 'condom accidents'. The combined estrogen/progestogen HPC described by Yuzpe is the most widely used method. It is given within 72 h of unprotected intercourse. The efficacy of combined HPC is high. The crude failure rate is 1-5 per 100 woman-months while the true reduction in pregnancy risk is over 75%. Efficacy is not influenced by the exposure-treatment interval within the 72-h 'window'. The mechanisms of action is multifocal and depends on the cycle phase at which treatment is instituted. Data are presented suggesting a consistent endometrial effect. None of the side-effects of HPC are serious. When HPC fails, there is so far no evidence of an adverse effect of the treatment on the outcome of pregnancy. Counselling should include all the above together with discussion of possible side-effects such as nausea and vomiting. The clinician should ensure that the woman uses an effective contraceptive thereafter. There is renewed interest in progestogen-only postcoital contraception. Varying doses of levonorgestrel have been used. The efficacy of some regimens is similar to that of the combined HPC. Danazol has not proved to be as effective. Antiprogestins hold the greatest promise of emergency contraception with high efficacy and low side-effects.

Condoms↗
PubMed1984

[Experiences with levonorgestrel in postcoital contraception].

To examine levonorgestrel as a postcoital contraceptive, 77 women received an oral dose of 0.4 mg per coitus for 1011 cycles and 27 women were administered 0.75 mg per coitus for 226 cycles. In the first dose group seven women became pregnant (Pearl's index 8.3), while two pregnancies resulted in the second group, one of the latter because of faulty drug intake (uncorrected Pearl's index 10.6; corrected Pearl's index 5.3). Menstrual irregularities (chiefly break-through bleedings and oligomenorrhea) were observed in 84.4% and 88.9% of the women, respectively. The number of cycle disorders increased with increasing intake rate and diminished when the drug was applied in excess of six months. The experiments undertaken to test the mechanisms of action indicated an influence on both cervical factor and endometrium, whereas the occurrence of LH-peaks and biphasic basal body temperature patterns suggested the presence of ovulations. Application of levonorgestrel for postcoital contraception failed to be a reliable routine method of hormonal contraception because of insufficient efficacy and considerable menstrual irregularities. The drug should be administered only after unprotected sexual intercourse as might happen, to women with very low frequency of intercourse, or in periods of reduced fertility.

Adolescent↗
PubMed1995

Postcoital contraception: present and future options.

PURPOSE: This article reviews information on currently available postcoital contraceptives, and discusses recent advances in postcoital contraception, mostly notably RU 486. METHODS: Postcoital contraceptives, or "morning after pills," are currently available in the form of high dose estrogens, oral contraceptives, danazol and intrauterine devices. These methods are plagued by high incidences of side effects and less than optimal success rates. RESULTS: Currently, their primary use in the adolescent age group is for victims of sexual assault, but they may also be used as back-up for consensual unprotected intercourse. RU 486, best known as a first trimester abortifacient, has a number of potential uses, including that of a postcoital contraceptive. Two recently published studies from the UK showed RU 486 to have a very low pregnancy rate and fewer side effects when compared with current methods. RU 486 may someday replace high doses of oral contraceptives as the method of choice for postcoital contraception.

Adolescent↗