Emergency contraceptive pills: A review of the recent literature

Current Opinion in Obstetrics and Gynecology

Volumn 16, Issue 5, 2004, Pages 389-395

  Conard, Lee Ann E ^a   Gold, Melanie A ^b  

^a WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b CHILDREN S HOSPITAL OF PITTSBURGH   (United States)

Author keywords

Advance provision; Emergency contraception; Levonorgestrel; Morning after pill; Post coital contraception; Yuzpe regimen

Indexed keywords

LEVONORGESTREL; MIFEPRISTONE; NON PRESCRIPTION DRUG; NORETHISTERONE; ORAL CONTRACEPTIVE AGENT; POSTCOITUS CONTRACEPTIVE AGENT;

ABDOMINAL PAIN; AWARENESS; CLINICAL TRIAL; CONTINUING EDUCATION; DRUG DOSE REGIMEN; DRUG EFFICACY; DRUG MECHANISM; DRUG SAFETY; DRUG USE; ECTOPIC PREGNANCY; EMERGENCY CONTRACEPTION; HEALTH CARE ACCESS; HUMAN; MEDICAL LITERATURE; MENSTRUATION; NAUSEA; NONHUMAN; PATIENT ATTITUDE; PATIENT COMPLIANCE; PATIENT EDUCATION; PHARMACIST; PHYSICIAN ATTITUDE; PRESCRIPTION; PRIORITY JOURNAL; REVIEW; SEXUAL BEHAVIOR; SIDE EFFECT; VOMITING; ATTITUDE TO HEALTH; DRUG ADMINISTRATION; FEMALE; HEALTH CARE DELIVERY; PREGNANCY; UNPLANNED PREGNANCY;

CONTRACEPTIVES, POSTCOITAL; DRUG ADMINISTRATION SCHEDULE; FEMALE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH SERVICES ACCESSIBILITY; HUMANS; PREGNANCY; PREGNANCY, UNPLANNED; SEXUAL BEHAVIOR;

EID: 16644381605     PISSN: 1040872X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001703-200410000-00006     Document Type: Review

References (38)

1. Tripathi R, Rathore AM, Sachdeva J. Emergency contraception: knowledge, attitude and practices among health care providers in North India. J Obstet Gynaecol Res 2003; 29:142-146. Healthcare providers and clients were surveyed, with data only from providers because clients were not familiar with EC.
2. Babaee G, Jamali B, Ali MM. Investigating the knowledge, attitude and its relationship with the mean of using emergency contraception. J Sex Marital Ther 2003; 29:269-275. A survey of women in Iran, many of whom have positive attitudes towards EC, although most had never been counseled about it.
3. Nguyen L, Bianchi-Demicheli F, Lüdicke F. Women's knowledge and opinions of emergency contraception. Int J Gynaecol Obstet 2003; 82:229-230. A short report on the knowledge of EC in Switzerland, where women had some erroneous ideas about the use of EC.
4. Romo LF, Berenson AB, Wu ZH. The role of misconceptions on Latino women's acceptance of emergency contraceptive pills. Contraception 2004; 69:227-235. An interesting survey of Latina women in Texas that assessed misconceptions about EC, associated with willingness or unwillingness to use the method.
5. Abbott J, Feldhaus KM, Houry D, et al. Emergency contraception: what do our patients know? Ann Emerg Med 2004; 43:376-381. A survey of inner city women presenting to an emergency department, many of whom had heard of EC, with more than half willing to use EC in the future.
6. Aziken ME, Okonta PI, Ande AB. Knowledge and perception of emergency contraception among female Nigerian undergraduates. Int Fam Plan Perspect 2003; 29:84-87. Undergraduate women in Nigeria were surveyed, and many knew about EC, but this study shows that few knew the correct time frame for the use of EC.
7. Larsson M, Eurenius K, Westerling R, et al. Emergency contraceptive pills over-the-counter: a population-based survey of young Swedish women. Contraception 2004; 69:309-315. An interesting study of women in Sweden, one year after EC went OTC. This study evaluated both positive and negative attitudes about EC as well as knowledge about EC in the OTC environment.
8. Perslev A, Rerbye C, Boesen C, et al. Emergency contraception: knowledge and use among Danish women requesting termination of pregnancy. Contraception 2002; 66:427-431.
9. Harper CC, Minnis AM, Padian NS. Sexual partners and use of emergency contraception. Am J Obstet Gynecol 2003; 189:1093-1099. A unique study that investigates the role of male sexual partners in the use of EC, and finds some determinates that differ from those that are seen with other contraceptive methods.
10. Chuang CH, Waldman LJ, Freund KM, et al. Emergency contraception: prescribing practices of general internists compared with other primary care physicians. Contraception 2004; 69:43-45. An evaluation of the prescribing practices related to EC of primary care physicians practising general internal medicine, family medicine, obstetrics and gynecology.
11. Khan Y, Sbrocca N, Stanojevic S, et al. Exposure to emergency contraception in an undergraduate medical curriculum. J Obstet Gynaecol Can 2003; 25:391-395. A survey of Canadian medical students that assessed classroom and clinical clerkship experiences with reproductive health issues.
12. Croxatto HB, Oritz ME, Müller AL. Mechanisms of action of emergency contraception. Steroids 2003; 68:1095-1098. This is a concise review of the known mechanisms of action of EC. It also increases knowledge by adding new information from recent animal studies.
13. Marions L, Cekan SZ, Bygdeman M, et al. Effect of emergency contraception with levonorgestrel or mifepristone on ovarian function. Contraception 2004; 69:373-377. A small study that evaluated the effect of EC on ovarian function with ultrasound and hormonal assays.
14. Trussell J, Ellertson C, Dorflinger L. Effectiveness of the Yuzpe regimen of emergency contraception by cycle day of intercourse: implications for mechanism of action. Contraception 2003; 67:161-171. A secondary analysis of five data sets was completed using a new algorithm for conception probabilities. This important work shows that inhibition of implantation is not the primary mechanism of action of EC.
15. Nielsen CL, Miller L. Ectopic gestation following emergency contraceptive pill administration. Contraception 2000; 62:275-276.
16. Jian Z, Linan C. Ectopic gestation following emergency contraception with levonorgestrel. Eur J Contracept Reprod Health Care 2003; 8:225-228. This report of two cases focuses on two ectopic pregnancies after OTC use of levonorgestrel EC, and stresses the importance of information dissemination among users.
17. Sheffer-Mimouni G, Pauzner D, Maslovitch S, et al. Ectopic pregnancies following emergency levonorgestrel contraception. Contraception 2003; 67:267-269. This case series documents ectopic pregnancy in women with no risk factors who used levonorgestrel EC.
18. Gainer E, Méry C, Ulmann A. Letter to the editor. Contraception 2004; 69:83-84. This letter to the editor reviews EC use and the safety of the method with regard to ectopic pregnancy. Based on their estimates, they believe that there is no increased risk of ectopic pregnancy with the use of EC.
19. Xiao B, Zhao H, Piaggio G, von Hertzen H. Expanded clinical trial of emergency contraception with 10 mg mifepristone. Contraception 2003; 68:431-437. This large study confirms the efficacy and safety of mifepristone for use as EC, and therefore provides another option in addition to the Yuzpe and levonorgestrel regimens.
20. Piaggio G, Heng Z, von Hertzen H, et al. Combined effectiveness of mifepristone 10 mg in emergency contraception. Contraception 2003; 68:439-446. An important large trial of mifepristone as a regimen for EC. This study shows that mifepristone is effective and has few side-effects.
21. Webb A, Shochet T, Bigrigg A, et al. Effect of hormonal emergency contraception on bleeding patterns. Contraception 2004; 69:133-135. This brief study reports incidence rates of spotting and provides data about timing of the next menses and pregnancy outcome based on spotting. This is important information because of the number of questions that providers receive.
22. Ellertson C, Webb A, Blanchard K, et al. Modifying the Yuzpe regimen of emergency contraception: a multicenter randomized controlled trial. Obstet Gynecol 2003; 101:1160-1167. An important study that shows that variations of the Yuzpe method (norethindrone substituted for ethinyl estradiol, and first dose only of standard Yuzpe) work approximately as well as the standard regimen, and can be used if the standard Yuzpe regimen is not available.
23. Ellertson C, Evans M, Ferden S, et al. Extending the time limit for starting the Yuzpe regimen of emergency contraception to 120 hours. Obstet Gynecol 2003; 101:1168-1171. An excellent article that provides evidence for use of EC up to 120 h after unprotected intercourse.
24. von Hertzen H, Piaggio G, Ding J, et al. Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomized trial. Lancet 2002; 360:1803-1810.
25. Piaggio G, von Hertzen H, Heng Z, et al. Meta-analysis of randomized trials comparing different doses of mifepristone in emergency contraception. Contraception 2003; 68:447-452. Meta-analyses of various doses of mifepristone showed that the 10 mg dose is effective and inexpensive and has a lower side-effect profile than the 25 mg dose.
26. Trussed J, Ellertson C, von Hertzen H, et al. Estimating the effectiveness of emergency contraceptive pills. Contraception 2003; 67:259-265. This article uses new estimates of conception probabilities to estimate the effectiveness of EC, and finds that absolute effectiveness and cost-effectiveness may be overstated. There was conflicting evidence with regard to declining effectiveness with treatment delay.
27. Raymond E, Taylor D, Trussell J, Steiner M. Minimum effectiveness of the levonorgestrel regimen of emergency contraception. Contraception 2004; 69:79-81. This study uses large data sets to estimate the effectiveness of levonorgestrel EC assuming the Yuzpe regimen was ineffective (placebo). The authors expressed concern that standard estimates of efficacy (based on the proportion of pregnancies averted by treatment) are not appropriate for women using EC, because the standard is based on women using no contraception, and many EC users are using some method of birth control.
28. Bissell P, Anderson C. Supplying emergency contraception via community pharmacies in the UK: reflections on the experiences of users and providers. Soc Sci Med 2003; 57:2367-2378. An evaluation of a free EC distribution project, in which both pharmacists and users were interviewed.
29. Jackson RA, Schwarz EB, Freedman L, Darney P. Advance supply of emergency contraception: effect on use and usual contraception - a randomized trial. Obstet Gynecol 2003; 102:8-16. This study assessed the advance provision of EC to postpartum young women and the impact of advance provision on contracepting behaviors. They found that advance provision was associated with the increased use of EC without adversely affecting the use of routine contraception.
30. Gold MA, Wolford JE, Smith KA, et al. The effects of advance provision of emergency contraception on adolescent women's sexual and contraceptive behaviors. J Pediatr Adolesc Gynecol 2004; 17:87-96. An excellent study that assessed sexual and contracepting behaviors in adolescent women, and found that the advance provision of EC allowed participants to use EC sooner and did not negatively impact sexual or contracepting behaviors.
31. Bennett W, Petraitis C, D'Anella A, et al. Pharmacists' knowledge and the difficulty of obtaining emergency contraception. Contraception 2003; 68:261-267. A study using 'mystery shoppers' to obtain information about EC from pharmacists showed that many pharmacists do not have sufficient information about EC and few keep EC in stock.
32. Espey E, Ogburn T, Howard D, et al. Emergency contraception: pharmacy access in Albuquerque, New Mexico. Obstet Gynecol 2003; 102:918-921. Researchers in New Mexico presented prescriptions for dedicated EC products to pharmacies and found that few pharmacies stock the medication. They also determined the common reasons why EC is not stocked.
33. Raymond EG, Spruyt A, Bley K, et al. The North Carolina DIAL EC project: increasing access to emergency contraceptive pills by telephone. Contraception 2004; 69:367-372. An interesting article that describes a telephone prescription service for EC. This unique service provided easy access to EC and increased awareness of EC.
34. Kumar AS, Hall LC, LePage A, et al. Providing emergency contraceptive pills 'behind-the-counter': opinions among Minnesota healthcare providers. Contraception 2003; 68:253-259. A survey of healthcare providers that assessed support for collaborative practice agreements to improve access to EC. More physicians than mid-level practitioners favored improved EC availability 'behind the counter'.
35. Killick SR, Irving G. A national study examining the effect of making emergency hormonal contraception available without prescription. Hum Reprod 2004; 19:553-557. Women requesting EC after it was made available from pharmacists without a prescription were surveyed. The timely use of EC was improved, and women preferred to obtain EC in this manner.
36. Gainer E, Blum J, Toverud E, et al. Bringing emergency contraception over the counter: experiences of nonprescription users in France, Norway, Sweden and Portugal. Contraception 2003; 68:117-124. A multi-national study of women who felt that OTC status allowed rapid access to EC, although they had both positive and negative experiences with the pharmacists who provided EC.
37. Golden MR, Whittington WL, Handsfield HH, et al. Failure of family-planning referral and high interest in advanced provision emergency contraception among women contacted for STD partner notification. Contraception 2004; 69:241-246. Women were surveyed about their interest in advance provision EC and family planning appointments. A large number of women were interested in EC, but few were interested in the family planning clinic appointments.
38. Glasier A, Fairhurst K, Wyke S, et al. Advance provision of emergency contraception does not reduce abortion rates. Contraception 2004; 69:361-366. An interesting community intervention with advance provision of EC, which showed increased use of EC, but no decrease in the abortion rate.