By Denise Mann Health Day Reporter
TUESDAY, April 26, 2022 (HealthDay News) — Imagine a birth control pill a woman can take before having sex that prevents pregnancy for the next three to five days.
It could become a reality, according to a small new study.
“Many people still have unmet contraceptive needs,” said study author Dr. Erica Cahill, an obstetrician-gynecologist at Stanford University. “This is especially true for people looking for a method they only have to use when they are sexually active, more effective and less intrusive than condoms, diaphragms, withdrawal or spermicide, only pericoital available. [used at the time of sex] or methods on demand at this time.”
This experimental contraceptive taken by women combines ulipristal acetate, currently used as a morning after medication, and meloxicam, a nonsteroidal anti-inflammatory drug, to disrupt ovulation when the risk of conception is highest.
Women’s luteal thrust occurs just before ovulation, and that’s when it’s hardest to disrupt ovulation and easiest to get pregnant, Cahill explained.
Ulipristal acetate disrupts ovulation when luteal thrust begins, while meloxicam can disrupt ovulation even after luteal thrust begins, the researchers noted.
For the study, nine women between the ages of 18 and 35 were followed for two menstrual cycles. During one cycle, they received a combined dose of 30 mg of ulipristal acetate and 30 mg of meloxicam at the time of their luteal thrust to see if this on-demand method of contraception is feasible.
The researchers measured key hormones and reviewed ultrasound scans to identify luteal surge and determine whether ovulation had occurred or was disrupted when the women took the drug combo.
Ovulation was completely disrupted in six women, the study showed.
Treatment cycles lasted about three days longer when women took the combination regimen, which may also be important for fertility monitoring.
There is a need for on-demand contraception, Cahill said. “People are already using emergency contraceptive pills as pericoital contraception, with no studies showing effectiveness or best practices,” she said.
Many people are interested in methods that do not involve going to the clinic for injections or implants and/or that do not contain the hormone estrogen.
The new regime would tick those important boxes, Cahill said. The next step is to evaluate this combination in a larger real-time usage study.
The results appear in the April 25 issue of BMJ Sexual and Reproductive Health.
Dr. Mary Jane Minkin is Clinical Professor of Obstetrics, Gynecology, and Reproductive Sciences at Yale University School of Medicine.
“I think we’re a long way from releasing something like this for regular use, and I would be concerned that women would use it regularly with every sexual encounter,” said Minkin, who was not involved in the study.
The more contraceptive choices, the better, she says. “I regularly discuss day-after contraception, and always emphasize that while it is safe to use, I strongly encourage women to speak with their gynecologist or health care provider about a method that is in effect all the time so women don’t have to think about contraception,” Minkin noted.
There are many long-acting reversible contraceptives available today. “If someone doesn’t want to use hormones, we have a copper IUD that lasts over 10 years,” she said. There is also a hormonal contraceptive ring that the woman inserts and removes herself every month and lasts for a year.
Plus, “we have hormone-coated IUDs that last five years and can make periods lighter and more comfortable,” Minkin added.
SOURCES: Erica Cahill, MD, obstetrician-gynecologist and assistant professor, obstetrics and gynecology, Stanford University, Stanford, Calif.; Mary Jane Minkin, MD, clinical professor, obstetrics, gynecology, and reproductive sciences, Yale University School of Medicine, New Haven, Conn. ; BMJ Sexual and Reproductive HealthApril 25, 2022
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