No abstract available.
Contraception, Postcoital* ; Emergencies*

No abstract available.
Contraception, Postcoital* ; Emergencies*

OBJECTIVE: To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). METHODS: We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. RESULTS: In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. CONCLUSION: Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA.
Ambulatory Care Facilities ; Contraception ; Contraception, Postcoital ; Emergencies ; Female ; Follow-Up Studies ; Gynecological Examination ; Gynecology ; Humans ; Levonorgestrel ; Pregnancy ; Republic of Korea ; Retrospective Studies

Intrauterine device (IUD) is a safe and efficient method of contraception in comparison with the efficacy of tubal sterilization, yet remains underutilized due to biased or outdated information about IUD. It is currently believed that the mechanism of action for IUDs is the production of an intrauterine environment that is spermicidal. IUD does not increase a woman's risk for pelvic infection, ectopic pregnancy, or subsequent infertility. IUD insertion in nulliparous or unmarried women is not contra-indicated. IUD is also a useful contraceptive method for those women without increasing the risk of ascending pelvic infection. The other benefit of IUD beyond contraception includes lowering the risk of endometrial cancer. The levonorgestrel-releasing intrauterine system reduces massive menstrual bleeding and dysmenorrhea. The copper IUD is the most effective method for emergency contraception. The careful patient selection and pre-insertion counseling are crucial to the success of IUD.
Bias (Epidemiology) ; Contraception ; Contraception, Postcoital ; Copper ; Counseling ; Dysmenorrhea ; Endometrial Neoplasms ; Female ; Hemorrhage ; Humans ; Infertility ; Intrauterine Devices ; Levonorgestrel ; Patient Selection ; Pelvic Infection ; Pregnancy ; Pregnancy, Ectopic ; Single Person ; Sterilization, Tubal

PURPOSE: The purpose of this study was to analyze the effect of emergency contraceptive pill on adolescent sexuality and contraceptive behaviors through a meta - analysis of intervention studies on advance provision of emergency contraceptives. This study aimed to provide objective data on the transition of general medicines to be discussed in relation to the reclassification of emergency contraceptive pills. METHODS: Using electronic database, 1,820 studies written in Korean or English without limitation of the year were reviewed and for analysis, 5 studies were selected, in which emergency contraceptives were provided to adolescents. RESULTS: The advance provision of emergency contraceptives has increased their use and shortened the time it takes to take contraceptive pills after unprotected sex. There was no change in the frequency of engaging in sexual intercourse and unprotected sex or in existing contraceptive behavior, pregnancy rates decreased, but there was no increase in sexually transmitted infection. CONCLUSION: The results of this study provide objective grounds for the reclassification of emergency contraceptive pills and propose effective interventional programs on contraceptive education, such as on efficacy and side effects of the contraceptive drug and its proper use among the youth who engage in sexual activity, to improve their reproductive health.
Adolescent* ; Coitus ; Contraception Behavior ; Contraceptives, Postcoital* ; Education ; Emergencies* ; Humans ; Pregnancy Rate ; Reproductive Health ; Sexual Behavior* ; Sexuality ; Sexually Transmitted Diseases ; Unsafe Sex

Postcoital contraception or emergency contraception(EC), commonly known as the "morning after pills", prevents pregnancy after unprotected intercourse. A comprehensive definition of EC is as follows : "specific contraceptive methods that can be used as emergency measures to prevent pregnancy after unproteted intercourse". Both drugs and certain devices can be used for emergency contraception. The best-studied regimen(Yuzpe) consists of an ordinary combination of oral contraceptives containing ethinyl estradiol and norgestrel. Conventional clinical guidelines recommend a first dose within 72 hours after unprotected intercourse and a second dose 12 hours thereafter. These drugs are most effective when taken as soon as possible after the intercourse. The Yuzpe regimen reduced the risk of unintended pregnancy by at least 75% in clinical trials. The most common side effects of the Yuzpe method are nausea and vomiting. Levonorgestrel is the synthetic progesterone. The major benefits of levonorgestrel are the decreased side effects and greater contraceptive efficacy than Yuzpe regimen. Mifepristone (RU486) is a synthetic steroid that prevents progesterone from binding to the progesterone receptors and glucocorticoid receptors. It has been used extensively in Europe as an abortifacient and also has been used as an effective EC. Its common side effect is a delay in the onset of menses, leading to anxiety for the user. The intrauterine contraceptive device(IUCD) is the only method of emergency contraception available to women presenting beyond 72 h and within 5 days from unprotected intercourse. EC is not protective against infections such as STD(sexually transmitted diseases). There are many situations where EC is indicated, including condom rupture or slip, unplanned unprotected intercourse, incidental misuse of regular contraceptive methods, and sexual assault. Emergency contraceptive pills can prevent ovulation, but an alternative major mechanism of action is to prevent uterine implantation of the embryo at the endometrial level. A 3-week follow-up visit should be scheduled to assess the result and to counsel for regular contraception. EC provides a second chance at preventing undesired pregnancies. but it should not be used as a routine birth control method, because it is actually less effective and needs a higher dose at preventing pregnancies than most types of oral contraceptives. Widespread and appropriate use of EC will provide a promising means to reduce the incidence of unplanned pregnancy and to contribute to the women's health.
Anxiety ; Condoms ; Contraception ; Contraception, Postcoital ; Contraceptives, Oral ; Embryonic Structures ; Emergencies ; Ethinyl Estradiol ; Europe ; Female ; Follow-Up Studies ; Humans ; Incidence ; Levonorgestrel ; Methods ; Mifepristone ; Nausea ; Norgestrel ; Ovulation ; Pregnancy ; Pregnancy, Unplanned ; Progesterone ; Receptors, Glucocorticoid ; Receptors, Progesterone ; Rupture ; Vomiting ; Women's Health

Asoprisnil, a member of the selective progesterone receptor modulators, exerts high progesterone receptor selectivity, endometrial targeted advantages and significant anti-implantation effect in rats. The purpose of this study was to confirm the anti-implantation effect of asoprisil, investigate the ultrastructural changes of the peri-implantation endometrium in mice and explore the effect of asoprisnil on endometrial receptivity and its targeted contraceptive proficiency. Post-coitus mice were administered with different dosages (0.2, 0.1, 0.05 mg·g(-1)·day(-1)) of asoprisnil from day 1 of pregnancy to day 3. Then 3 animals in each group were killed on day 5 of pregnancy, and uteri were collected to examine the ultrastructural changes of endometria under a transmission electron microscope (TEM). A total of 80 animals were sacrificed on day 8 of pregnancy, and the uterine horns were examined for the presence or absence of nidation sites and the number of implantation embryos. The results showed that the implantation rate and the average number of implantation embryos in asoprisnil groups were statistically significantly decreased as compared with the vehicle control group (P<0.05). The TEM results revealed that, in vehicle control group, the tight junction between the luminal epithelia cells was short and straight, the gap was wide; the luminal epithelia cells were covered with plenty of short, clavate and neatly arranged microvilli; the endometril stromal cells were large with plenty of cytoplasm, and showed significant decidual change; there was more than one nucleus in stromal cells, and the karyotheca was integrity. In low dosage and high dosage asoprisnil groups, the tight junction was longer and more curve than in the vehicle control group; microvilli were uneven and asymmetrically distributed in luminal epithelia; the stromal cells were small and the decidual change was not significant; there were karyopyknosis and karyolysis in stromal cells; there were abnormal thick-wall vessels in the endometrium. It was suggested that asoprisnil changed the ultrastructure of the endometrium in implantation window, disturbed the endometrial receptivity and finally resulted in embryo implantation failure.
Animals ; Contraception, Postcoital ; methods ; Embryo Implantation, Delayed ; drug effects ; physiology ; Endometrium ; drug effects ; physiology ; ultrastructure ; Estrenes ; administration & dosage ; Female ; Mice ; Oximes ; administration & dosage ; Oxytocics ; administration & dosage ; Pregnancy ; Pregnancy, Animal ; Treatment Outcome