A nonhormonal model for emergency contraception: prostaglandin synthesis inhibitor effects on luteal function and lifespan, a pilot study.
OBJECTIVE
The purpose of this study is to determine if the use of a specific prostaglandin endoperoxide-2 inhibitor will prevent luteal development in women.


METHODS
Ovulatory reproductive-aged women not using or needing hormonal contraception were prospectively followed for three menstrual cycles. Women were randomized into two groups using a crossover design [Group 1: control cycle, placebo cycle, active drug (celecoxib 400 mg orally) cycle; Group 2: control cycle, celecoxib cycle, placebo cycle]. Study drug was dosed daily until the onset of the next menses. Demographics, menstrual cycle length and twice-weekly progesterone (P) levels during the placebo and active drug cycles were recorded. End points included the change in luteal phase P levels and menstrual cycle length (days) during active drug exposure.


RESULTS
A total of 11 women completed the study (Group 1, n=7; Group 2, n=4). No demographic differences were found between groups [age, race, body mass index (BMI), control cycle length]. A comparison of the control and active drug cycles for all participants demonstrated a trend toward a longer menstrual cycle with active drug exposure [control, 27.2 days (SD, 2.4); study drug, 28.5 days (SD, 2.5), p=.09]. Five women had a delay in the rise of their luteal phase P levels, two women had lower peak P levels and two women had no elevation of luteal phase P levels during active drug cycle as compared to placebo cycle.


CONCLUSIONS
Daily administration of a prostaglandin synthesis inhibitor may delay the timing of luteal events and, therefore, fertility in women. PTGS2 inhibitors may hold potential as an emergency contraceptive.
Edelman
Alison B
AB
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon 97239, USA. edelmana@ohsu.edu
Jensen
Jeffrey T
JT
Hennebold
Jon D
JD
D000328:Adult; D000068579:Celecoxib; D044363:Contraception, Postcoital / Q000379:methods*; D003338:Corpus Luteum / Q000187:drug effects* / Q000502:physiology; D018592:Cross-Over Studies; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008183:Luteal Phase / Q000097:blood / Q000187:drug effects*; D008597:Menstrual Cycle / Q000097:blood / Q000187:drug effects; D010865:Pilot Projects; D011374:Progesterone / Q000097:blood; D011720:Pyrazoles / Q000008:administration & dosage / Q000494:pharmacology*; D013449:Sulfonamides / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D011374:Progesterone; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D000068579:Celecoxib
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