Emergency contraceptionBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7393.775 (Published 12 April 2003) Cite this as: BMJ 2003;326:775
Even easier to prescribe, but users still need a holistic sexual health service
- Anne M C Webb, consultant in family planning and reproductive health (firstname.lastname@example.org)
- Abacus Clinics for Contraception and Reproductive Health, 40–46 Dale Street, Liverpool L2 5SF
Atrial by the World Health Organization published in 1998 established “levonorgestrel only” as the gold standard in hormonal emergency contraception.1 Over 80 countries have now approved dedicated emergency contraception products containing progestogen only, that are often available directly from pharmacies. Innovative strategies to improve access are also proliferating, expanding the ranks of those who can supply to nurses and other health workers, and offering supplies to women in advance. More recently, a further WHO trial has encouraged new flexibility in offering emergency contraception.2 Emergency contraception with levonorgestrel can now be given as “one stat” dose. However, women who need emergency contraception also have other needs, and a holistic sexual health service is essential.
The trial compared the effectiveness of the standard two dose regimen of 0.75 mg levonorgestrel repeated after 12 hours with the effectiveness of a double dose (1.5 mg levonorgestrel) taken all at once.2 Women in a third group took low dose (10 mg) mifepristone. Women could participate if they were able to start taking emergency contraception within 120 hours of unprotected intercourse, rather than just the traditional …