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ORIGINAL RESEARCH |
From Ibis Reproductive Health, Cambridge, Massachusetts; Abacus Centre for Contraception and Reproductive Health, Liverpool, United Kingdom; Population Council, Johannesburg, South Africa; Glasgow Centre for Family Planning and Sexual Health, Glasgow, United Kingdom; Planned Parenthood of Greater Iowa, Des Moines, Iowa; and Office of Population Research, Princeton University, Princeton, New Jersey.
Address reprint requests to: Charlotte Ellertson, Ibis Reproductive Health, 2 Brattle Square, Cambridge, MA 02138; E-mail: cellertson{at}ibisreproductivehealth.org.
OBJECTIVE: Emergency contraceptives can prevent unintended pregnancy after unprotected intercourse. The best-studied regimen ("Yuzpe") consists of ordinary combined oral contraceptives containing levonorgestrel and ethinyl estradiol. Women traditionally take one dose within 72 hours after unprotected intercourse, and a second dose 12 hours later. Historically, half experience nausea and a fifth vomit. The purpose of this study was to determine whether 1) women could use combined oral contraceptives other than those containing levonorgestrel and 2) eliminating the second dose improves comfort and convenience.
METHODS: Women presenting within 72 hours after unprotected intercourse were randomized to receive 1) standard two-dose Yuzpe, 2) a variant of Yuzpe substituting norethindrone for levonorgestrel, or 3) only the first dose of Yuzpe, followed 12 hours later by a placebo.
RESULTS: Perfect-use failure rates were low in all groups and did not differ in a statistically significant way (standard Yuzpe 2.0% [n = 589], norethindrone–ethinyl estradiol 2.7% [n = 547], single dose of Yuzpe 2.9% [n = 546]). Typical-use failure rates were slightly higher but similarly did not differ significantly. Side effects were similar across groups, except that women taking the single dose reported half the vomiting. Taking the pills with food did not seem to reduce nausea or vomiting, and the pills were not more effective when started sooner after unprotected intercourse.
CONCLUSION: Oral contraceptives containing norethindrone–ethinyl estradiol work approximately as well for emergency contraception as levonorgestrel–ethinyl estradiol formulations and should be offered when first-line therapies are not available.
This article has been cited by other articles:
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  Committee on Adolescence Contraception and Adolescents Pediatrics, November 1, 2007; 120(5): 1135 - 1148. [Abstract] [Full Text] [PDF]
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Committee on Adolescence Emergency Contraception Pediatrics, October 1, 2005; 116(4): 1026 - 1035. [Abstract] [Full Text] [PDF]
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 S.R. Killick and G. Irving A national study examining the effect of making emergency hormonal contraception available without prescription Hum. Reprod., March 1, 2004; 19(3): 553 - 557. [Abstract] [Full Text] [PDF]
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 Other articles noted Evid. Based Med., January 1, 2004; 9(1): 31 - 32. [Full Text] [PDF]
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 Other articles noted: 25 Jul 03 to 7 Nov 03 Evid. Based Nurs., January 1, 2004; 7(1): e1 - 1. [Full Text] [PDF]
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 C. Westhoff Emergency Contraception N. Engl. J. Med., November 6, 2003; 349(19): 1830 - 1835. [Full Text] [PDF]
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 C. Ellertson, M. Evans, S. Ferden, C. Leadbetter, A. Spears, K. Johnstone, and J. Trussell Extending the Time Limit for Starting the Yuzpe Regimen of Emergency Contraception to 120 Hours Obstet. Gynecol., June 1, 2003; 101(6): 1168 - 1171. [Abstract] [Full Text] [PDF]
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