New emergency contraception pills may prevent pregnancy if taken within five days

Pills not mentioned even in physicians' professional journals, so neither the GPs nor the public know about them

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By Satu Kaaria
     
      Emergency contraception (EC) or emergency postcoital contraception is a hot potato - even in Finland.
     
A new postcoital contraception pill - EllaOne - was launched in November.
      If taken up to five days after sexual intercourse, the new pill is claimed to prevent pregnancy.
     
The”traditional” pill can prevent pregnancy as effectively as the new product only if used up to three days after sex.
      However, the new pill must not be advertised - not even in publications targeting physicians.
      The manufacturer of the new pill, Leiras, a Nycomed Group company, has interpreted the advertising ban as strictly as possible, which is why not many doctors have the foggiest idea of the existence of the new drug - let alone those women who might need it.
      The new pill is a prescription medicine, and it would be vital for doctors to know it well.
     
Following considerable resistance, the ”traditional” postcoital contraception pill containing levonorgestrel was released for OTC markets in 2002.
      However, the advertising of the drug was banned, even though all other OTC medicines can be freely advertised.
      The drug can also be sold only from under the counter and only one packet at a time. It must not be placed on the shelves at a pharmacist’s.
     
At the beginning of 2000, it was feared that the free over-the-counter sales of postcoital pills could lead to reckless sexual behaviour among young people, with the suggestion that such pills would replace other contraceptive methods.
      However, this did not happen.
      According to Dan Apter, the Chief Physician and Director of of the Family Federation, the marketing ban could just as well be lifted along with the sales restrictions.
      The good points and bad points of the levonorgestrel-based postcoital pill have been heavily exaggerated.
      The product is not very effective, as 2% of users get pregnant in spite of the drug.
      Emergency contraception may also be associated with some false beliefs and urban myths.
     
The emergency contraception pill has often been called an abortion pill - on completely false grounds: the levonorgestrel emergency contraception drug can prevent ovulation but it has no effect on pregnancies if taken after implantation, explains Dan Apter, who has been working on emergency contraception for around 15 years.
     
The new 5-day postcoital contraception drug may stir up yet more uproar, as it contains ulipristal, which could probably prevent the implantation of a fertilised egg in the womb. However, the mechanism is not known entirely.
     
Emergency contraception continues to suffer from an "immoral" reputation.
      For example, in newspaper articles emergency pills are still often called "penance pills".
      The joint archives of Helsingin Sanomat and Ilta-Sanomat reveal that over the past 20 or so years, the journalists of the two newspapers have written about ”penance pills” two or three times as often as about ”emergency contraception pills” or ”emergency contraception tablets”.
     
Things are no different elsewhere: for all that the term "emergency contraception" exists, one is much more likely in England to hear the treatment described as "the morning-after pill", containing a none-too-subtle reference between the lines to the increased libido brought on by a few drinks.
     
     
Helsingin Sanomat / First published in print 7.12.2009


Previously in HS International Edition:
  Over half of Finnish abortion seekers do not use contraception (7.2.2005)

Links:
  Emergency Contraception (Wikipedia)
  Leiras

SATU KAARIA / Helsingin Sanomat
satu.kaaria@hs.fi