Morning After Contraceptive Pill Study Reveals Significant Effectiveness Increase

Combining Piroxicam with Levonorgestrel Emergency Contraceptive Pill Shows Promising Results

By [Author Name]

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Introduction

According to a randomized controlled trial recently published in The Lancet, combining the anti-inflammatory drug piroxicam with the levonorgestrel emergency contraceptive pill after unprotected intercourse results in fewer pregnancies compared to taking levonorgestrel alone.

Key Findings

• A recent study found that taking piroxicam with the levonorgestrel emergency contraceptive pill significantly prevents more pregnancies than levonorgestrel alone.
• 95% of pregnancies were prevented following combined treatment with levonorgestrel and piroxicam.
• Only 63% of pregnancies were prevented when levonorgestrel was taken alone.
• Minimal side effects were reported.
• Further studies are needed to understand piroxicam’s mechanism and its applicability to diverse populations.

Background

Two types of emergency contraceptive pills – levonorgestrel and ulipristal acetate – are widely used around the world. Levonorgestrel is available in more countries than ulipristal acetate. Both contraceptives work by preventing or delaying ovulation, and they are not effective post-ovulation.

Previous Efficacy of Levonorgestrel

The accepted effectiveness of levonorgestrel is based on a trial from 1998:

• 95% effectiveness if taken within 24 hours of unprotected sex
• 85% effectiveness if taken within 25-48 hours
• 58% effectiveness if taken within 49-72 hours

However, recent research suggests that the efficacy of levonorgestrel might be lower.

Researchers’ Comments

Dr. Sue Lo from the Family Planning Association of Hong Kong stated, “Finding out that there is a widely available medication that increases levonorgestrel’s efficacy when taken together is really exciting.”

Dr. Raymond Li from The University of Hong Kong added, “Our study is the first to suggest that a readily available and safe medication taken at the same time as the levonorgestrel pill can prevent more pregnancies than levonorgestrel alone. We hope these results will lead to further research and ultimately changes in clinical guidelines to enable women around the world to access more effective emergency contraception.”

Study Details

The study took place at a major community sexual and reproductive health service in Hong Kong between August 2018 and August 2022. Here are the key details:

• The participants were women who required levonorgestrel emergency contraception within 72 hours of unprotected sex.
• The women were randomized to receive a single supervised dose of levonorgestrel 1.5 mg plus either piroxicam 40 mg or a placebo pill.
• The participants and healthcare professionals were unaware of which treatment group received which medication.
• A follow-up appointment was scheduled one to two weeks after the next expected period to determine if pregnancy occurred.

Results

Out of the 836 women who were followed up:

• One pregnancy occurred among the women who took piroxicam and levonorgestrel.
• Seven pregnancies occurred among the women who took the placebo and levonorgestrel.
• The percentage of pregnancies prevented following piroxicam-levonorgestrel co-treatment was 95%.
• The percentage of pregnancies prevented following levonorgestrel alone was 63%.

Conclusion

The study suggests that taking piroxicam in combination with the levonorgestrel emergency contraceptive pill significantly increases its effectiveness in preventing pregnancies. Further research is needed to understand piroxicam’s mechanism of action and its applicability to different populations.

Reference: “Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial” by Raymond Hang Wun Li, Sue Seen Tsing Lo, Kristina Gemzell-Danielsson, Carol Ho Yi Fong, Pak Chung Ho and Ernest Hung Yu Ng, 16 August 2023, The Lancet. DOI: 10.1016/S0140-6736(23)01240-0.

This study was funded by, and conducted by researchers from, the Department of Obstetrics and Gynaecology, The University of Hong Kong.