Doctor of Women's Health

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Wednesday, August 3, 2016

Emergency Contraception pills

There area unit 3 sorts of ECPs: combined ECPs containing each sex hormone and steroid hormone,
progestin-only ECPs, Associate in Nursingd ECPs containing an antiprogestin (either abortifacient or ulipristal
acetate). All 3 area unit obtainable within the us. Progestin-only ECPs have currently mostly
replaced the older combined ECPs as a result of they're more practical and cause fewer aspect
effects. though this medical aid is often called the prophylactic device, the term is
misleading; ECPs is also initiated before the morning when—immediately after unprotected
intercourse—or later—for a minimum of one hundred twenty hours when unprotected intercourse.
Combined ECPs contain the hormones sex hormone and steroid hormone. The hormones that are
studied extensively in clinical trials of ECPs area unit the sex hormone ethinyl oestrogen and also the steroid hormone
levonorgestrel or progestogen (which contains 2 isomers, just one of which—levonorgestrel—is
bioactive). One combined, dedicated (meaning it had been specially prepackaged to be used as global organization) EC product
(Preven) was approved by the bureau in 1998 however withdrawn from the market in 2004. This
combination of active ingredients employed in this manner is additionally generally referred to as the Yuzpe methodology,
after the Canadian medical practitioner United Nations agency 1st delineated  the program. once dedicated ECPs aren't
available, sure normal contraception pills are often employed in such mixtures as emergency
contraception. In either case, the program is one dose followed by a second dose twelve hours later,
where every dose consists of one, 2, 4, 5, or 6 pills, looking on complete. Currently, twenty six brands of
combined oral contraceptives area unit approved within the us to be used as emergency
contraception (see Table 1). analysis has incontestable  the protection and effectivity of an alternate
regimen containing ethinyl oestrogen and also the steroid hormone norethindrone;6 this result suggests that
oral contraceptive pills containing progestins nonetheless levonorgestrel may be used for
emergency family planning.
Progestin-only ECPs contain no sex hormone. solely the steroid hormone levonorgestrel has been
studied for detached use as Associate in Nursing emergency contraceptive. the initial treatment schedule
was one 0.75 mg dose inside seventy two hours when unprotected intercourse, and a second zero.75 mg
dose twelve hours when the primary dose. However, studies have shown that one dose of one.5 mg is
as effective as 2 zero.75 mg doses twelve hours apart.7,8 one amongst these studies showed no distinction
in aspect effects between the 2 regimens,7 whereas the opposite found larger levels of headache
and breast tenderness (but not alternative aspect effects) among study participants taking one.5 mg of
levonorgestrel promptly.8 progressively, levonorgestrel is marketed internationally in an exceedingly one-dose
formulation (one one.5 mg pill) instead of the two-dose formulation (two zero.75 mg tablets, taken
12 hours apart). (Another study found that 2 zero.75 mg doses twenty four hours apart were even as
effective as 2 zero.75 mg doses twelve hours apart.9
) The progestin-only merchandise obtainable within the
United States embody area unit set up B ballroom dancing (1.5 mg), approved by the bureau in July 2009 (Table 1),
and several generic styles of set up B ballroom dancing together with Next alternative One Dose, My Way, Take
Action and AfterPill; two-dose LNG global organization pills are not any longer sold-out within the United States of America.
The second-generation antiprogestin ulipristal acetate (30 mg in an exceedingly single dose) has been
studied to be used as emergency family planning and has been found to be extremely effective and welltolerated.10-
13 it's been marketed to be used as emergency family planning in Europe since
October 2009; it had been approved by the bureau in August 2010 and is offered available by
prescription solely, marketed underneath the name ella. Ulipristal acetate global organization (sold as ellaOne) is
available while not prescription in Europe.
The Associate in Nursingtiprogestin abortifacient has conjointly been extensively studied to be used as an emergency
contraceptive pill. abortifacient could be a first-generation Lipo-Lutin receptor modulator that's
approved to be used in several countries for early first-trimester medication abortion. abortifacient
has been shown to be extremely effective to be used as emergency family planning, with few aspect
effects (delayed emission following the administration of abortifacient is one notable aspect
effect.)
14 However, the utilization of abortifacient as Associate in Nursing aborticide could limit its widespread
acceptability to be used for emergency family planning, and it's presently obtainable solely in Hayastan,
China, Russia, and Vietnam.
Meloxicam (a cyclooxygenase inhibitor) thirty mg given for 5 consecutive days within the late vesicle
phase seems to be an efficient emergency contraceptive choice. This program doesn't alter
the endocrine profile of the cycle and causes no catamenial disturbance.15,16 (In distinction, the
COX-2 inhibitor Cox-2 inhibitor seems to possess no potential for emergency family planning.17)

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