Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel

Glasier, Anna; Cameron, Sharon; Blithe, Diana L.; Scherrer, Bruno; Mathe, Henri; Lévy, Delphine; Gainer, Erin; Ulmann, André

doi:10.1016/j.contraception.2011.02.009

Cited by 273 publications

(152 citation statements)

References 27 publications

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“…135,136 In addition, on the basis of recent data about lower efficacy of levonorgestrel EC, ulipristal may be more effective in people who weigh more than 165 pounds. 137,138 Placement of a copper-bearing IUD is less commonly used for EC in adolescents but is the most effective EC method, with a failure rate of less than 1%. 139 The recommended dosage of levonorgestrel is a single 1.5-mg dose.…”

Section: Emergency Contraceptionmentioning

confidence: 99%

Contraception for Adolescents

Braverman¹,

Adelman²,

Alderman³

et al. 2014

Pediatrics

311

107

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Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report.

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Section: Emergency Contraceptionmentioning

confidence: 99%

Contraception for Adolescents

Braverman¹,

Adelman²,

Alderman³

et al. 2014

Pediatrics

311

107

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show abstract

“…Data suggest that ulipristal acetate, approved by the FDA in 2010, may have increased effectiveness over oral levonorgestrel at the end of the 5-day window of use and in heavier women. [208][209][210] On the basis of data demonstrating that the levonorgestrel EC pill loses effectiveness in women who weigh more than 165 pounds and is ineffective in women who weigh more than 176 pounds, the levonorgestrel EC pill is undergoing revised labeling in Europe, and the FDA is considering whether to require similar revisions in the United States. 211 Unlike ulipristal, which is pregnancy category X, levonorgestrel does not have teratogenic or other adverse effects on the fetus, 212 and a pregnancy test is not necessary before prescribing levonorgestrel EC.…”

Section: Male Condomsmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

245

133

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A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians’ long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.

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“…As of 2016, three brands of progestin-only EC were available: Plan B ® (the most widely used and well known) and two generic brands (NextChoice ® and Option 2 ® ). In response to recent studies suggesting that progestin-only EC may be less or not at all effective when used by heavier women (Glasier et al 2011;Kapp et al 2015;Gemzell-Danielsson et al 2015), in 2014, Health Canada issued a warning stating that progestin-only EC may be less effective in women weighing 165 pounds or more and ineffective in women weighing over 176 pounds (Eggertson 2014). Health Canada subsequently requested that the labels for all progestin-only EC products in Canada incorporate this warning (Health Canada 2014).…”

Section: Introductionmentioning

confidence: 99%

The not so over-the-counter status of emergency contraception in Ontario: A mixed methods study with pharmacists

Chaumont

Foster

2017

FACETS

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Introduction: In Canada, the progestin-only dedicated pill is the most widely used method of emergency contraception (EC). This method gained over-the-counter status in Ontario in 2008. Our mixed methods study explored the progestin-only EC knowledge, attitudes, and provision practices of Ontario pharmacists. Methods: From June 2015 to October 2015, we collected 198 mailed surveys from Ontarian pharmacy representatives and conducted 17 in-depth interviews with a subset of respondents. We analyzed these data using descriptive statistics and for content and themes. Results: Results from our English/French bilingual survey indicate that respondents' knowledge is generally accurate, but confusion persists about the mechanism of action and the number of times the drug can be used in one menstrual cycle. Nearly half (49%) of our survey respondents indicated that progestin-only EC pills are only available behind the counter. Interviewees strongly supported the introduction and promotion of more effective methods of EC in Ontario. Conclusion: Continuing education focusing on both the regulatory status of progestin-only EC and information about the medication appears warranted. Health Canada's recent approval of ulipristal acetate for use as a post-coital contraceptive may provide a window of opportunity for engaging with health service providers, including pharmacists, about all available modalities of EC in Canada.

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Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel

Cited by 273 publications

References 27 publications

Contraception for Adolescents

Contraception for Adolescents

Contraception for Adolescents

The not so over-the-counter status of emergency contraception in Ontario: A mixed methods study with pharmacists

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