Safer, Easier Emergency Contraception
One-Dose "Morning-After" Regimen Works
Dec. 5, 2002 -- Now morning-after birth control is easier and safer than ever, a World Health Organization study suggests. It finds that one-time treatment with a hormone commonly used in birth-control pills -- taken up to five days after unprotected sex -- prevents pregnancy.
Women seeking emergency contraception after rape or unprotected sex currently have three options. One is Mifeprex, better known as RU-486, which can be used in larger doses to induce abortion. The second option is two 0.75 mg doses of the hormone levonorgestrel, sold in the U.S. as Plan B. Plan B is more difficult to use, as the two doses must be taken exactly 12 hours apart. The third option is even more difficult to use and should only be tried under a doctor's supervision. It uses regular birth control pills -- but which ones and how many depend on the type of birth control a woman is using.
Now a team led by WHO researcher Helena von Hertzen, MD, finds that both doses of Plan B can be taken at the same time -- with no more side effects than either Mifeprex or the two-dose regimen. The study also shows that if Mifeprex is used, only a tiny 10 mg dose is needed. This is 60 times smaller than the dose needed to induce abortion.
"We were surprised this double dose of levonorgestrel at one time worked so well," von Hertzen tells WebMD. "Women who took it earlier in their menstrual cycle had earlier menstruation, so they didn't have to wait so long to find out they weren't pregnant. That is the advantage of levonorgestrel, because [Mifeprex] can make the cycle longer."
This is good news to David M. Plourd, MD, assistant professor of obstetrics/gynecology at the Naval Medical Center, San Diego. Plourd frequently lectures on post-coital contraception -- a term he prefers to emergency contraception -- for the American College of Gynecology. Plourd says ACOG has lobbied the FDA to give these drugs over-the-counter status. Currently they are available only by prescription, although some states allow pharmacists to prescribe them under a doctor's supervision.