The morning-after pill levonorgestrel is much more effective at preventing pregnancy when taken at the same time as the anti-inflammatory drug piroxicam.
Out clinical research, published in The Lancet, It turns out that the commonly used morning-after pill levonorgestrel is more effective when taken along with an anti-inflammatory drug.
Levonorgestrel is one of the cheapest and most widely used emergency contraceptives worldwide. A disadvantage is that the drug only works before an egg cell is released from one of the ovaries. Previous research shows that it is only 58 percent effective in preventing pregnancy if you take it between 49 and 72 hours after unprotected sex.
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anti-inflammatory
Anti-inflammatory drugs usually work by inhibiting prostaglandins. These are hormone-like substances that play a role in many reproductive processes, such as ovulation and fertilization. Professor of Gynecology Kristina Gemzell-Danielsson of the Karolinska Institute in Sweden suspected that these drugs could further reduce the risk of unwanted pregnancy.
To test this, Gemzell-Danielsson and colleagues conducted a randomized study of 860 women who requested a morning-after pill within 72 hours of having unprotected sex at a family planning clinic in Hong Kong. The participants did not include transgender or non-binary people.
Half of the women received levonorgestrel and piroxicam, an anti-inflammatory drug used to treat arthritis, which inhibits the production of prostaglandins. The other half of the women were given a placebo instead. None of the participants or the therapists knew which participant received which treatment.
Pregnancy
Only one woman got pregnant in the group given the anti-inflammatory drug, while seven women got pregnant in the placebo group. There were no differences in side effects between the two groups.
The researchers compared the results with a model that predicts pregnancies after unprotected sex. In the group that received the anti-inflammatory drug, 95 percent of the expected pregnancies were prevented, compared to only 63 percent in the placebo group.
According to Gemzell-Danielsson, it’s unclear how the anti-inflammatory drug helps prevent unwanted pregnancies. “We know that prostaglandin is important for reproductive processes, but more research is needed on the underlying mechanism to know for sure what’s happening,” she says.
Follow-up research
She hopes that doctors will soon take the new findings into account when prescribing emergency contraceptives. Piroxicam is cheap and readily available, she says, and doctors can easily prescribe it alongside levonorgestrel.
Gemzell-Danielsson suspects that the combination of piroxicam and ulipristal, another commonly used morning-after pill, is also effective. This contraceptive works in a similar way to levonorgestrel, but has not yet been tested in combination with piroxicam.
According to professor of reproduction Judith Stephenson from University College London, the findings could lead to big changes in clinical practice, but she hopes other studies confirm the results. “Although it’s well designed, it’s just one study, so it would be nice to see the findings confirmed in another study,” she says.
2023-08-26 10:11:45
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