Morning-after tablet is more practical when taken with anti-inflammatory

Levonorgestrel is a broadly used emergency contraceptive tablet

Kristoffer Tripplaar / Alamy Inventory Photograph

A broadly used morning-after tablet is way more practical when taken alongside an anti-inflammatory drug, a medical trial has discovered.

Levonorgestrel is likely one of the least expensive and most generally used emergency contraceptives on the earth. However the drug solely works earlier than an egg is launched from one of many ovaries. One examine discovered that the drug is just 58 per cent efficient at stopping pregnancies when taken 49 to 72 hours after unprotected intercourse.

Anti-inflammatory medication typically work by inhibiting prostaglandins, chemical substances with hormone-like results that additionally play a job in lots of processes in copy corresponding to ovulation and fertilisation. Kristina Gemzell-Danielsson on the Karolinska Institute in Sweden suspected that these medication may additional cut back the probability of undesirable being pregnant.

To check this, Gemzell-Danielsson and her colleagues carried out a randomised trial involving 860 ladies who requested emergency contraception inside 72 hours of unprotected intercourse at a household planning clinic in Hong Kong between August 2018 and 2022. The members didn’t embrace any transgender or non-binary folks.

Half the ladies got levonorgestrel and piroxicam, an anti-inflammatory drug used to deal with arthritis, whereas the opposite half obtained levonorgestrel and a placebo tablet. Neither the members nor the healthcare professionals knew which members obtained which remedy.

Only one girl turned pregnant within the anti-inflammatory drug group, whereas seven ladies turned pregnant within the placebo group. There have been no variations in negative effects between the 2 teams.

Primarily based on a mannequin of anticipated being pregnant after unprotected intercourse, 95 per cent of anticipated pregnancies have been prevented within the anti-inflammatory drug group in contrast with simply 63 per cent within the placebo group.

The trial solely included ladies who weren’t on any hormonal contraceptives because the researchers needed to review the influence of the remedies on those that have been most vulnerable to an undesirable being pregnant.

Gemzell-Danielsson says it’s unclear precisely how the anti-inflammatory drug helps to cease undesirable pregnancies. “We all know that prostaglandin is vital for [reproductive] processes, however we have to do extra mechanistic research to know for positive what’s taking place,” she says.

She hopes that the findings have a fast influence on how healthcare professionals worldwide prescribe emergency contraceptives. Piroxicam is affordable and broadly out there, she says, and could be simple to prescribe alongside levonorgestrel.

Combining piroxicam with the opposite broadly used emergency contraceptive, ulipristal, can be more likely to be efficient as that contraceptive works in an identical strategy to levonorgestrel, says Gemzell-Danielsson, however this hasn’t but been examined.

Judith Stephenson at College School London says the findings may result in main modifications in medical apply, however she hopes different research will affirm the end result. “Although nicely designed, it’s only one trial, so it could be reassuring to have the findings confirmed in one other examine,” she says.

She additionally says it could be helpful to seek out out if the drug mixture works in individuals who have missed considered one of their each day contraceptive capsules.


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