MEDICINE AND HEALTH

Emergency contraception is more effective when taken with anti-inflammatory drugs


Levonorgestrel is a widely used emergency contraceptive Credit: Kristoffer Tripplaar / Alamy Stock Photo

A clinical trial found that a widely used emergency contraceptive pill was more effective when taken with anti-inflammatory drugs.

Levonorgestrel is one of the cheapest and most widely used emergency contraceptive pills in the world. But this drug is only effective until the egg is released from the ovaries. One study found that taking the drug within 49~72 hours after unprotected sex was only 58% effective in preventing pregnancy.

Anti-inflammatory drugs usually work by inhibiting prostaglandins, a chemical with hormone-like effects that affect reproductive processes such as ovulation and fertilization. Kristina Gemzell Danielsson of the Karolinska Institute in Sweden suspects that these drugs could further reduce the likelihood of unwanted pregnancies.

To test this, Gemzell Danielsson and colleagues conducted a randomized experiment. The experiment, conducted at a family planning clinic in Hong Kong, involved 860 women who were required to have emergency contraception for 72 hours of unprotected sex between August 2018 and 2022. Participants did not include any transgender or non-binary people.

Half of the participants took levonorgestrel, the latter being an anti-inflammatory used to treat arthritis, and piroxicam, while the other half took levonorgestrel and a placebo. Neither the participants nor the healthcare professionals knew which participants took which medication.

The results showed that only one woman became pregnant in the anti-inflammatory group and seven in the placebo group, with no difference in side effects between the two groups.

According to the expected pregnancy model after unprotected sex, 95% of expected pregnancies were prevented in the anti-inflammatory group, compared with only 63% in the placebo group.

The experiment only involved women who did not take any hormonal contraceptives, as the researchers wanted to explore the effects of these drugs on women who were most likely to have unwanted pregnancies.

Gemzell Danielsson said it’s unclear how this anti-inflammatory can help stop unwanted pregnancies. “We know that prostaglandins are important for the reproductive process, but more mechanistic studies are needed to determine what exactly happens,” she said.

She hopes that this finding will soon have an impact on the prescription of emergency contraception by medical professionals worldwide. Piroxicam is inexpensive, widely available, and prescribing it along with levonorgestrel, she said.

Gemzell Danielsson said combining piroxicam with ulipristal, another widely used emergency contraceptive pill, could also be effective because the latter works in a similar way to levonorgestrel, but this has not been tested.

Judith Stephenson, of University College London, said the findings could lead to significant changes in clinical practice, but she hopes other studies will confirm the results. “Although this experiment is well designed, it is only one trial, so it is more reassuring to confirm these results in another study,” she said. ”

She also stressed the importance of knowing if this combination of drugs works for people who occasionally miss their daily contraceptive pills.

The researchers reported the findings in the August 16 issue of The Lancet. (Source: China Science News Guo Yueying)

Related paper information:https://doi.org/10.1016/S0140-6736(23)01240-0



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