Emergency contraception: past, present and future.
Women have been using emergency contraception (EC) for decades. Population studies have not shown that increased access to EC decreases abortion rates this is likely because of inconsistent and infrequent use even when it is available. Special populations, such as adolescents, have been shown to be just as good as their adult counterparts in comprehending EC instructions, and its use does not lead to more risky sexual practices or behaviors. There is little evidence on the administration of EC to victims of sexual assault, but what is available reveals more women who are victims of sexual assault should be offered EC as an option. Methods of EC include high doses of ethinyl estradiol; DES; Danzaol; combination ethinyl estradiol with a progestin; progestin alone and copper IUDs. This review describes the history of EC as well as newer medications such as the antiprogestins (gestrinone and uliprisatal acetate) and cyclooxygenase inhibitors(meloxifam). These methods have been added to the armamentarium and may prove to be more effective than current regimens. Finding a product that is highly effective with minimal side effects is a worthy goal, for it presents a woman with her last chance to prevent an unwanted pregnancy.
Cremer
M
M
Beth Israel Hospital, NY, USA. Miriam.cremer@gmail.com
Masch
R
R
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D044363:Contraception, Postcoital / Q000379:methods / Q000639:trends*; D003282:Contraceptives, Postcoital, Hormonal / Q000627:therapeutic use*; D003283:Contraceptives, Postcoital, Synthetic / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D007434:Intrauterine Devices / Q000639:trends; D010353:Patient Education as Topic; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D011902:Rape; D018570:Risk Assessment
D003282:Contraceptives, Postcoital, Hormonal; D003283:Contraceptives, Postcoital, Synthetic