The objective of this study is to make the public aware of progress, safety, effectiveness of use, acceptance, and over-the-counter availability of emergency contraception (EC). Data were extracted from the literature for the period 2000-2006 via MEDLINE using a keyword, and also from some pre-2000 journals. Randomised trials, reviews, surveys, clinical investigations, and articles relevant to the subject matter are considered in this review. Approximately 85%, 57% and 84% of unintended pregnancy could be prevented by using levonorgestrel, the Yuzpe regimen (levonorgestrel plus ethinylestradiol), and mifepristone, respectively, as EC. Levonorgestrel was more effective than the Yuzpe regimen in preventing pregnancy. A dose of 1.5 mg levonorgestrel seemed to have similar effectiveness as that of split doses (0.75 mg twice) at 12 h apart, and that of a low-dose (10 mg) of mifepristone. Nausea and vomiting, dizzy spells and fatigue were less frequent in women using levonorgestrel only than in those receiving the Yuzpe regimen. The mode of action of EC is associated primarily with inhibition of ovulation. EC acts before implantation and hence does not amount to abortion. Teenagers are more likely to be repeat users of EC. Easy access to EC over the counter is likely to increase its use but will widen the chance of misuse or abuse. Both adolescents and health care providers need to be adequately educated and informed about EC to make this method successful. Over the counter supply of EC without prescription but with pharmacists' counselling may increase reduction of unintended pregnancy and abortion. The controversy surrounding, and opposition to, EC may subside with more awareness and knowledge among the public about its mode of action, safety and effectiveness. Educational programmes on EC and further studies on the psychosocial aspects of its use may resolve hurdles for implementation of 'advance provision' or 'over the counter supply' of EC in the community.

The aim of this study is to elucidate and review the risk of sexually transmitted infections (STIs) among condom users. Men and women of reproductive age are the subjects of this study. Data were extracted from the literature through the MEDLINE service for the period 2000-2006. Female condoms (0.1%) were reported to be less liable to break than male condoms (3.1%), while slippage occurs more often with female condoms (5.6%) than with male condoms (1.1%). The nonlatex condoms have a higher frequency of breakage or slippage during intercourse or withdrawal (4%) than latex ones (1.3%). Adolescents having multiple sexual partners and/or having sex with someone they met on that same day are about 80% more likely to report condom failure. Condom breakage or slippage is associated with never having received instructions on correct condom use, more than one sexual partner and more frequent condom use. Ineffective condom use is common among young adults. A younger age, primary partner, lack of partner support, multiple recent sexual partners and use of condoms for contraception are positively associated with delayed condom use. However, condoms do offer 30-90% protection against STIs and HIV passed in the semen and 0-30% protection against diseases due to skin-to-skin contact. This inversely implies that there is always a risk of contacting Chlamydia, gonorrhoea and HIV, or genital herpes and warts even when using a condom during sexual intercourse. Only correct -rather than consistent -condom use reduces the risk of STIs and HIV during intercourse. Therefore, condom users need to be cautioned that some risks are involved with the use of this method.

Plasma level of norethindrone (NET) and in vivo release of norethindrone acetate (NETA) were studied in three groups of albino rabbits (5 animals/group) after insertion of one, two and four subcutaneous implants, each containing 40 mg crystalline NETA over a period of 24 weeks. The ratios of the in vivo release rate of steroid were 1, 1.9 and 3.9 in the animals of group 1 (one implant), group II (two implants) and group III (four implants) respectively.Thus, the in vivo release rate in group II and III showed an increase which was almost twice and four times as great as that of group I. However, the mean ratios of the serum NET levels were 1, 1.2 and 2.4 in animals of group I, II and III respectively.Thus, interestingly, the serum NET level did not show the expected twofold and fourfold increase and lacked correlation with the in vivo release. Although the insertion of multiple implants gives multiple increases in the in vivo steroid release, it does not give rise to a multiple increase in the serum levels of the steroid. It is possible that there is a kind of a threshold of steroid concentration in the animals when they are loaded with exogenously administered steroid.When the steroid concentration tends to cross the threshold level, pharmacokinetic or pharmacodynamic processes of the animal work maximum to hold down the steroid level in blood plasma.

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