The morning after: novel hormonal approaches to postcoital interception

Post-coital contraceptive agents from extracts of Sri Lankan alcyonacean soft corals--I

Dichloromethane-methanol (1:1) extracts of ten species of alcyonacean soft corals were screened for post-coital interceptive effects on female rats, using oral administration, from day 1 to day 7 of pregnancy. Significant suppression of fertility was observed in the animals treated with the crude extracts of Sarcophyton ehrenbergi (250 mg/kg/day, P less than 0.05; 500 mg/kg/day, P less than 0.001), Sinularia crispa (500 mg/kg/day, P less than 0.05; 1000 mg/kg/day, P less than 0.001), Sinularia abrupta (1000 mg/kg/day, P less than 0.001), Sinularia spp--III (500 mg/kg/day, P less than 0.05). This antifertility effect appears to be due to interruption of embryonic events during implantation and/or pre-implantation periods.

Interception II: postcoital low-dose estrogens and norgestrel combination in 633 women

The new low-dose hormonal postcoital method, a combination of 200 mcg ethinylestradiol and 2 mg norgestrel was used in 633 women, and a statistically significantly lower observed pregnancy rate was found compared to the expected number of pregnancies if no contraception was used. Patterns of menstruation, its onset and duration, after use of this morning-after pill, are documented in respect to follicular, midcycle and luteal administration. Individual side effects such as nausea, vomiting and mastalgia are noted, but antiemetics did not reduce the incidence. Though efficacy of this technique is not found to be favorable in comparison to the 5 mg ethinylestradiol treatment, the low-dose of steroid, the one-day treatment and its lesser side effects show this alternative morning-after pill suitable for use as a first choice in case of an unprotected sexual encounter.

A comparison of high-dose estrogens versus low-dose ethinylestradiol and norgestrel combination in postcoital interception: a study in 493 women

Ethinylestradiol (EE), at a dosage of 5 mg/day for 5 consecutive days (5 mg EE), has generally been used for interception. A combination of 200 micrograms EE and 2 mg dl-norgestrel (EE + NG) was proposed as an effective alternative. Efficacy and tolerance of these methods were compared in a randomized, double-blind study. A group of 465 women was studied with a follow-up rate of 94.3%. In the 5 mg EE group a pregnancy rate of 0.9% was observed, and in the EE + NG group a rate of 0.4% was found. These rates differ significantly from the expected rates (P less than 0.0005, in both series). Nausea was noted in 59.1% of the 5 mg EE group and in 54.0% of the EE + NG series. Nausea and vomiting occurred in 20.8% and 15.8%, respectively. The efficacy of both methods as alternative morning-after medication was confirmed. The new method is preferable because treatment is limited to only 1 day.