Postcoital interception with steroids.
At present there is a high demand for PCI. The psychological distress experienced by women after unprotected intercourse while awaiting the onset of her next menses could be avoided with effective postcoital treatment. As demonstrated in countries with good health services, the availability of PCI leads to low abortion rates. PCI is designed for use as an emergency method after unprotected intercourse as an isolated incident. Women who have frequent intercourse however, do better to use a regular, very effective, method of contraception such as a combined oral contraceptive. Postcoital progestagens can well be used in infrequent intercourse since they are to be taken after each coitus, if applicable several times a month. Such use however leads to menstrual cycle disturbances and irregular bleedings. The estrogen-only and the estrogen-progestin combination are recommended, but need to be given within 2 or 3 days after the event of unprotected intercourse, preferably periovulatory. The latest development of the anti-progestins as a morning-after pill is promising. Taken from day 27 through 30 of the menstrual cycle it induces menstruation at the expected day. Side effects are minimal and the efficacy is good. Because of the imperfectness of PCI to prevent all pregnancies, sofar this regimen cannot be recommended for monthly use and does not replace regular oral contraceptives. PCI has a definite place in family-planning and fertility regulation. Since different methods are available today careful assessment of individual needs can help to decide for the best suitable method for the individual person.
van Santen
M R
MR
State University Hospital, Dept. Obst. & Gyn., Utrecht, The Netherlands.
Haspels
A A
AA
D003281:Contraceptives, Postcoital / Q000627:therapeutic use*; D003282:Contraceptives, Postcoital, Hormonal / Q000627:therapeutic use*; D003283:Contraceptives, Postcoital, Synthetic / Q000627:therapeutic use; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D006801:Humans; D011247:Pregnancy
D003281:Contraceptives, Postcoital; D003282:Contraceptives, Postcoital, Hormonal; D003283:Contraceptives, Postcoital, Synthetic