New “morning after pill” works five days later

1st February 2010 - A new contraceptive pill could offer extra protection to women who’ve delayed seeking help after having unprotected sex, or those caught out by long Bank Holidays.

The emergency contraception pill ulipristal acetate has recently been licensed for use up to five days after intercourse. The usual pill, levonorgestrel, is only effective for three days after sex.

New research, published in the online edition of The Lancet, has shown that ulipristal acetate - which is only available on prescription - also prevents more pregnancies than its over-the-counter rival.

The British Pregnancy Advisory Service and the Family Planning Association have welcomed the development of the new emergency contraceptive pill.

Random trials

Professor Anna Glasier of the National Health Service in Lothian and colleagues carried out their own trial using data from 35 family planning clinics in the UK, Ireland and the United States.

1,694 women, who had asked for emergency contraception, were randomly prescribed either levonorgestrel or ulipristal acetate within 72 hours of having sex. Those taking part in the trial were not told which of the two “morning after pills” they’d been given.

There were 15 pregnancies (1.8%) in the group that received ulipristal acetate and 22 pregnancies (2.6%) amongst those who’d been given levonorgestrel. In 203 women who received emergency contraception between three and five days after sexual intercourse, there were three pregnancies, all in the levonorgestrel group.

To boost the reliability of their findings, the authors combined their research with that of another comparable trial.

Halving the risk

Based on the combined findings they concluded that ulipristal acetate almost halved the risk of becoming pregnant compared to levonorgestrel in women who received emergency contraception within five days of having sexual intercourse. If emergency contraception was used within 24 hours, the risk of pregnancy was reduced by almost two-thirds compared to levonorgestrel.

Ulipristal acetate was approved by the European Medicines Agency in May 2009.

More expensive

Ann Furedi, Chief Executive of the British Pregnancy Advisory Service, describes the new type of emergency contraceptive pill as “exciting”, and would like to see it more readily available. “Since this pill is not currently available over-the-counter and is significantly more expensive to buy than the traditional ‘morning after pill’, it may be that many women who could benefit from it are not able to access it,” she says in a press release.

Natika Halil, Director of Information for the Family Planning Association, comments in a statement:
“We’re really pleased to see another alternative for women to protect themselves from unplanned pregnancy, but it’s worth remembering that emergency hormonal contraception is never as reliable as a regular method.”

The report’s authors have declared that HRA Pharma, the manufacturers of ulipristal acetate, paid for the latest study.