Postcoital Contraception

Abstract

Yuzpe AA (Dept of Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada). Postcoital contraception. Int J Gynaecol Obstet 16: 497–501, 1979 The evolution of postcoital contraception has led to the development of emergency measures to be used following a single unprotected act of intercourse and to ongoing methods, such as the administration of a contraceptive steroid agent following every coital exposure. In emergency situations, the most commonly employed hormonal steroids are the synthetic, conjugated and natural estrogens, administered in large doses for five days. Recently, a combination of an estrogen and a progestin has been employed for the same purpose. A copper‐bearing intrauterine device (IUD), inserted within seven days of coitus, has also been utilized with success. Progestins alone have been utilized as an ongoing method of postcoital contraception. Failure rates have been found to vary with the dosage, the specific progestin employed and the frequency of intercourse. The major role of postcoital contraception in the developed world appears to be as an emergency measure. Ease of availability, a high degree of efficacy and a low incidence of side effects are essential for patient and physician acceptance.

Postcoital contraception

“…The combined regimen was shown by Ling et al to produce asynchronous development of the glandular and stromal elements of the endometrium, with the glands lagging behind the stroma [56]; this has been confirmed by others [20]. At a cellular level, following combined therapy, a significant reduction in endometrial oestrogen and progesterone receptors is demonstrated [60,61].…”

“…A combination of ethinyloestradiol and norgestrel has been in use since the early seventies [20]. A combination of ethinyloestradiol and norgestrel has been in use since the early seventies [20].…”

Emergency contraception: the journey so far

“…First described by Yuzpe and Lancee 32 , this combination therapy is often referred to as the Yuzpe regimen. The oestrogen–progestin regimen consists of two doses of a combination of 100 μg of ethinyl estradiol and 0.5 mg of levonorgestrel each, the first dose taken within 72 hours of intercourse and the second dose 12 hours later 33–37 . This is the most commonly used emergency contraceptive.…”

The ‘frameless’ intrauterine system for long‐term, reversible contraception: A review of 15 years of clinical experience

“…Copper IUDs for emergency contraception are more effective in preventing unwanted pregnancy (pregnancy rate <0.1%) than postcoital pills, such as levonorgestrel emergency contraceptive pills, since efficacy decreases more rapidly with time 51 . When efficacy is a priority, the IUD is the emergency contraceptive of choice 52 …”