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• W2035248001 abstract "Rodrigues, Grou, and Joly1Rodrigues I Grou F Joly J Effectiveness of emergency contraceptive pills between 72 and 120 hours after unprotected sexual intercourse.Am J Obstet Gynecol. 2001; 184: 531-537Abstract Full Text Full Text PDF PubMed Scopus (145) Google Scholar have made an important and welcome contribution by showing that the Yuzpe regimen of emergency contraceptive pills is effective when administered more than 3 days after an act of unprotected intercourse. However, to conclude from their data that “effectiveness was equally as good before and after 72 hours” would clearly be inappropriate. Only 179 women were included in the selected subgroup, and only 2 pregnancies were observed among these women. The relative risk of pregnancy when the pills were taken after 72 hours compared with administration within 72 hours was 0.95 with 95% confidence limits of 0.1 to 9.0 (calculated with an asymptotic method that likely produces too narrow an interval in this case). Thus, under conventional statistical assumptions, the data from this study would be entirely consistent with the possibility that the pregnancy risk could be as much as 9 times higher if treatment is delayed for 4 days or longer after intercourse. Published results on the relationship between timing of treatment and treatment effectiveness are mixed.2Trussell J Ellertson C Rodriguez G The Yuzpe regimen of emergency contraception: how long after the morning after?.Obstet Gynecol. 1996; 88: 150-154Crossref PubMed Scopus (44) Google Scholar However, the largest single trial of emergency contraceptive pills, which included 997 women using the Yuzpe regimen, showed that the pregnancy rate was more than twice as high among women treated on the third day after intercourse as it was among women treated on the first day.3Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception Task Force on Postovulatory Methods of Fertility Regulation.Lancet. 1998; 352: 428-433Abstract Full Text Full Text PDF PubMed Scopus (706) Google Scholar It is difficult to imagine a plausible mechanism of action that would not result in a decline in effectiveness with a delay of treatment. The new data certainly imply that women should not be denied access to emergency contraceptive pills if they request it more than 3 days after intercourse. Nevertheless, we agree with the authors that, until we have clear evidence to the contrary, women should be encouraged to seek treatment as soon as possible after the need arises. In the past several years, a variety of programs have been implemented to assist women in obtaining emergency contraceptive pills quickly. These programs have included a national information hotline and Web site (www.not-2-late.com ), distribution of pills or prescriptions in advance of need, telephone and Internet prescription services, and distribution by pharmacists without prescription through collaborative drug therapy agreements. In addition, numerous organizations, including the American College of Obstetricians and Gynecologists and the American Medical Association, have publicly advocated a switch of emergency contraceptive pills to over-the-counter status. This new evidence that the time frame for effective treatment is longer than previously thought should not be an excuse for complacency in these efforts. 6/8/118849" @default.
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• W2035248001 title "Timing of emergency contraception" @default.
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• W2035248001 doi "https://doi.org/10.1016/s0002-9378(02)70241-x" @default.
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