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On demand contraceptive pill, what if it really works?

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On demand contraceptive pill, what if it really works?

This is nothing new, and just as the contraceptive “pill” has been chasing for years for the male, the same interest the research places him for an on demand pill for women. Therefore, to be used not regularly but only when you think you really need it to avoid unwanted pregnancy. A promising candidate – preliminary research published in BMJ Sexual & Reproductive Health – is a combination of two well-known drugs, capable of disturbing ovulation and thus preventing pregnancy: ulipristal acetate, currently used in emergency contraception within 5 days of unprotected sexual intercourse, together with a NSAID, a non-steroidal anti-inflammatory drug, Meloxicam. Together, according to research, they seem to be very effective in preventing ovulation at the stage of the cycle where the risk of pregnancy is greatest.

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I study

The researchers studied ten women between the ages of 18 and 35, all with regular periods. Each of them was monitored for two cycles, the first as a starting cycle to identify the normal course of ovulation and then a course of treatment, with the intake of 30 mg of ulipristal acetate and 30 mg of meloxicam. Blood tests (with key hormones) and ultrasound were used for monitoring. Of the ten women examined, nine were included in the final analysis.

The results

And here are the results: ovulation was stopped in six women, the majority achieved incomplete ovulation. Obviously, the smallness of the sample requires other studies, both on the efficacy and safety of the combined therapy. But – according to the researchers – these first data give hope for a therapy that could be a candidate as a pericoital oral contraceptive. “By comparing the results of ovulation interruption between our studies and the previous ones we relied on for our protocol, the combination of the two drugs was able to interrupt ovulation at each stage of the fertility window more than any other drug studied. and indeed reinforces the hypothesis that adding meloxicam can increase efficacy as an emergency contraceptive, “they stated.

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Of course, the idea of ​​the on-demand pill is fascinating in itself. But Emilio Arisi, a great specialist in contraception and currently president of Smic, the Italian medical society for contraception, is inclined to skepticism. For more than one reason. The first, of course, is the number of women treated, very few. Insufficient to hypothesize any therapeutic attitude. “Already other studies – he recalls – have analyzed the effectiveness of ulipristal, a drug that is known to be an effective tool in interfering with ovulation, so much so that it is used as an emergency contraceptive. This study analyzes the combination of the two drugs, but it is not taken for granted that unity is strength. Moreover, logically, contraception on demand is already an emergency one “.

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The regularity of the cycle

Furthermore, there is the question of when to take the drugs, as not all women have regular cycles. “On average, ovulation occurs between the 14th and the 16th day of the cycle, but to be sure you should take a blood test, and it becomes cumbersome. It is. Besides, we do not know the safety impact, even in terms of side effects, having to use these drugs even only 5 or 6 times a month “.

In short, the idea is fascinating, but the practicality and above all the absence of risk, not to mention the real contraceptive efficacy, still seem distant goals.

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