scholarly journals Ulipristal acetate. An emergency contraceptive?

2011 ◽  
Vol 60 (2) ◽  
Author(s):  
Justo Aznar ◽  
Julio Tudela
Keyword(s):  
Chemical Composition ◽  
Emergency Contraception ◽  
Contraceptive Efficacy ◽  
Ulipristal Acetate ◽  
Human Love ◽  
Fundamental Part ◽  
Contraceptive Measure ◽  
Unwanted Pregnancies ◽  
Emergency Contraceptive ◽  
The Right

Il forte aumento delle gravidanze e degli aborti negli adolescenti sembra giustificare l’adozione di misure per prevenirli. Sebbene la giusta soluzione al problema è senza dubbio l’educazione dei giovani ad un uso corretto della sessualità, e soprattutto in una considerazione di quest’ultima come parte fondamentale di qualcosa di molto più ampio come l’amore umano, alcuni intendono risolvere il problema implementando l’uso della contraccezione d’emergenza come unica misura contraccetiva. Uno degli ultimi farmaci in commercio per questo scopo è Ulipristal acetato, che ha cominciato ad essere distribuito in alcuni paesi europei dal novembre del 2009. Questo articolo fa riferimento alla composizione chimica di Ulipristal acetato, la sua efficacia contraccetiva, gli effetti collaterali, che non sono molto significativi, e in particolare al meccanismo d’azione con cui questo farmaco impedisce le gravidanze indesiderate, giungendo alla conclusione che per almeno il 60% del tempo esso agisce secondo un meccanismo antiimpianto, anche se ciò dipende in larga misura dal giorno in cui la donna lo assume entro il suo ciclo riproduttivo, e dal tempo trascorso dal rapporto sessuale. ---------- The large increase in pregnancies and abortions in adolescents appears to justify taking measures to prevent them. Although the right solution to the problem is undoubtedly through educating young people in the proper use of sexuality, and especially in considering it as a fundamental part of something much wider like human love, certain classes advocate resolving it by implementing the use of emergency contraception as the only contraceptive measure. One of the latest drugs marketed for this purpose is Ulipristal acetate, which began to be distributed in some European countries in November 2009. This paper refers to the chemical composition of Ulipristal acetate, its contraceptive efficacy, the side effects, which are not very significant, and especially to the mechanism of action by which this drug prevents unwanted pregnancies, concluding that at least 60% of the time it acts by an anti-implantation mechanism, although this depends to a large extent on the day on which the woman takes it, within her reproductive cycle, and on the time from sexual intercourse until she takes the drug.

scholarly journals Ulipristal acetate. A new emergency contraceptive. Ethical aspects of its use

2010 ◽  
Vol 59 (1) ◽  
Author(s):  
Justo Aznar
Keyword(s):  
Sexual Intercourse ◽  
Mechanism Of Action ◽  
Emergency Contraception ◽  
Ethical Aspects ◽  
Unprotected Sexual Intercourse ◽  
Ethical Assessment ◽  
Ulipristal Acetate ◽  
Unwanted Pregnancies ◽  
Emergency Contraceptive ◽  
First Time

Così come si presenta la pillola del giorno dopo può essere utilizzata in modo efficace fino a 72 ore dopo il rapporto sessuale non protetto. Tuttavia, in alcuni casi, questo periodo può essere troppo breve. Per tale motivo, è stata commercializzata per la prima volta una pillola, l’acetato ulipristal (Ellaone), per la contraccezione d’emergenza post-coitale fino a 120 ore (5 giorni) dopo i rapporti sessuali non protetti o nel caso di insuccesso del contraccettivo. Un aspetto importante da considerare nella valutazione etica di un farmaco usato per la contraccezione d’emergenza è il suo meccanismo d’azione, in quanto tale valutazione sarà molto diversa se il farmaco agisce inibendo o ritardando l’ovulazione o impedendo l’impianto della blastocisti nell’utero materno, dal momento che in quest’ultimo caso eserciterebbe la sua azione portando a termine la vita di un embrione in vita, secondo dunque un meccanismo abortivo. In relazione al meccanismo d’azione dell’Ellaone, quando la pillola è assunta cinque giorni prima dell’ovulazione la sua azione sarà fondamentalmente anticoncezionale, e lo stesso se è assunta quattro giorni prima. Se assunta tre giorni prima dell’ovulazione, può essere anticoncezionale o anti-impiantatorio, ma da allora in poi, il meccanismo attraverso cui l’Ellaone è in grado di prevenire le gravidanze indesiderate sarà anti-impiantatorio o, in altre parole, abortivo. In sintesi, tra il 50% e il 70% del tempo, Ellaone agirà secondo un meccanismo abortivo. Ci sembra che questa sia la realtà oggettiva circa il meccanismo d’azione dell’acetato ulipristal (Ellaone), e quindi il suo effetto anti-impiantatorio dovrà essere preso in considerazione per l’elaborazione di un giudizio etico sul suo uso. ---------- Current presentations of the morning-after pill can be used effectively for up to 72 hours after unprotected sexual intercourse. However in some cases, this period can be short. For that reason, a pill, ulipristal acetate (Ellaone), which is licensed for post-coital emergency contraception up to 120 hours (5 days) following unprotected sexual intercourse or contraceptive failure, has now been marketed for the first time. An important aspect to consider in the ethical assessment of any drug used in emergency contraception is its mechanism of action, as this assessment will be very different if the drug acts by inhibition or delaying the ovulation or by preventing the implantation of the blastocyst in the maternal uterus, since in the latter case it would exert its action by terminating the life of an already living embryo, i.e. by an abortive mechanism. In relation to the Ellaone’s mechanism of action, when the pill is taken five days before ovulation its action will be basically anticonceptive, and the same if it is taken four days beforehand. When it is taken three days before ovulation, it may be anticonceptive or by prenventing implantation, but from then on, the mechanism by which Ellaone may prevent unwanted pregnancies will be by an anti-implantation mechanism, in other words, abortive. In summary, between 50% and 70% of the time, Ellaone will act by an abortive mechanism. It seems to us that this is the objective reality about the mechanism of action of ulipristal acetate (Ellaone), and therefore its anti-implantation effect will have to be taken into consideration when issuing an ethical judgement on its use.

scholarly journals Uterine flushings from women treated with levonorgestrel affect sperm functionality in vitro

Reproduction ◽  
2017 ◽  
Vol 154 (5) ◽  
pp. 607-614 ◽  
Author(s):  
Mayel Chirinos ◽  
Marta Durand ◽  
María Elena González-González ◽  
Gabriela Hernández-Silva ◽  
Israel Maldonado-Rosas ◽  
...  
Keyword(s):  
Tyrosine Phosphorylation ◽  
Emergency Contraception ◽  
Acrosome Reaction ◽  
Binding Capacity ◽  
Human Sperm ◽  
Contraceptive Efficacy ◽  
Serum Luteinizing Hormone ◽  
Emergency Contraceptive ◽  
Testosterone Derivative

Levonorgestrel (LNG), a synthetic 19 nor-testosterone derivative, is widely used for emergency contraception. It is well known that LNG prevents ovulation only when given prior to the surge of serum luteinizing hormone (LH) during the periovulatory phase of the menstrual cycle. This observation suggests that LNG, given its contraceptive efficacy, has additional effects other than those affecting ovulation. In this study, we have evaluated the effects on human sperm functionality of uterine flushings (UF) obtained from women at day LH + 1 of a control cycle (CTR-LH + 1) and after receiving LNG (LNG-LH + 1) two days before the surge of LH. Human sperm from normozoospermic donors were incubated with UF and protein tyrosine phosphorylation, sperm motility, acrosome reaction as well as zona pellucida (ZP) binding capacity were assessed. A significant decrease in total motility and tyrosine phosphorylation accompanied by an increase on spontaneous acrosome reaction was observed when sperm were incubated in the presence of LNG-LH + 1. None of these effects were mimicked by purified glycodelin A (GdA). Moreover, the addition of UF obtained during the periovulatory phase from LNG-treated women or the presence of purified GdA significantly decreased sperm-ZP binding. The data were compatible with changes affecting sperm capacitation, motility and interaction with the ZP. These results may offer evidence on additional mechanisms of action of LNG as an emergency contraceptive.

scholarly journals Mechanism of Action, Efficacy and Safety of Emergency Hormonal Contraception (levonorgestrel and ulipristal acetate) and Attitudes of Pharmacists

2014 ◽  
Vol 31 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Jelena Milosavljević ◽  
Katarina Ilić ◽  
Dušanka Krajnović
Keyword(s):  
Clinical Trials ◽  
Mechanism Of Action ◽  
Emergency Contraception ◽  
Hormonal Contraception ◽  
Published Data ◽  
Ulipristal Acetate ◽  
Attitudes And Practices ◽  
History Of ◽  
Emergency Contraceptive ◽  
History Of Use

Summary Emergency hormonal contraception is used to prevent unintended pregnancy postcoitally. The mechanism of action of the most frequently used hormonal preparations for emergency contraception, levonorgestrel (LNG) and ulipristal acetate (UPA), is still not fully known, but clinical trials indicate that they act by inhibiting or delaying ovulation. LNG has a long history of use for emergency contraception, proven safety and high efficacy if administered in the preovulation period. The newest emergency contraceptive, UPA, available only with a prescription, is indicated within this period of 120 hours after sexual intercourse and the data indicate that UPA does not lose efficacy within this period. Clinical trials showed its noninferiority versus LNG and its effect on the potentially occurring pregnancy is being additionally monitored. However, many misconceptions and controversial opinions about emergency contraception are still present, even among pharmacists. A search of Medline database identified 20 papers published from January 1993 to December 2012, on pharmacists’ knowledge, attitudes and practices related to emergency contraception. In these papers, the attitudes of pharmacists pertaining to the dispensing regime of emergency contraception were different. Research in Australia has shown that personal attitudes and religious convictions influence the practice of dispensing emergency contraception. In the research conducted in New Mexico, 30% of pharmacists were against prescribing emergency contraception for religious or moral reasons. There were no published data in regards to pharmacists’ knowledge, attitudes and dispensing practice in Serbia and such research is highly recommended.

scholarly journals Emerging Options for Emergency Contraception

2013 ◽  
Vol 7 ◽  
pp. CMRH.S8145 ◽  
Author(s):  
Atsuko Koyama ◽  
Laura Hagopian ◽  
Judith Linden
Keyword(s):  
Emergency Contraception ◽  
Intrauterine Device ◽  
Over The Counter ◽  
Oral Contraceptive Pills ◽  
Ulipristal Acetate ◽  
Emergency Contraceptive Pills ◽  
Contraceptive Pills ◽  
Emergency Contraceptive ◽  
Clinical Considerations ◽  
Copper Intrauterine Device

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.

VIRGINITY TESTING PRACTICES: THE BEST OF BOTH WORLDS

2016 ◽  
Vol 26 (1) ◽  
Author(s):  
Sheila Mokoboto-Zwane
Keyword(s):  
South Africa ◽  
Cultural Beliefs ◽  
Cultural Practice ◽  
Bodily Integrity ◽  
Sexually Transmitted ◽  
Young Females ◽  
Unwanted Pregnancies ◽  
The Right ◽  
Democratic Elections ◽  
Virginity Testing

Controversy continues to surround the age-old practice of virginity testing, which in South Africa made a visible comeback around the time of the country’s first democratic elections when most South Africans began to feel free to practise their cultural beliefs without fear. It coincided with the period when the HIV pandemic began to take hold. It is practised mainly in some countries of Asia and Africa, and in South Africa it is practised mainly amongst amaZulu. It is believed that this practice prevents unwanted pregnancies and sexually transmitted diseases (STDs), especially HIV/AIDS, as well as engendering a sense of pride in teenage and young females, in particular. However, some individuals, organisations and sectors of the community frown upon the practice because it violates constitutional laws that protect the right to equality, privacy, bodily integrity and sexual autonomy. The purpose of this article is to present current discourse on the cultural practice of virginity testing and the controversies surrounding this discourse. This article draws its arguments from the existing literature on virginity testing.

Finding the right face for advanced provision of emergency contraception

Contraception ◽  
2010 ◽  
Vol 82 (6) ◽  
pp. 579
Author(s):  
Courtney A. Schreiber ◽  
Sarah Ratcliffe ◽  
Kurt T. Barnhart
Keyword(s):  
Emergency Contraception ◽  
The Right

Current dispensing and practice use patterns of ulipristal acetate 30mg (Ella®), as emergency contraception in British Columbia, Canada

2020 ◽  
Vol 42 (5) ◽  
pp. 671
Author(s):  
Michelle Chan ◽  
Judith Soon ◽  
Laura Schummers ◽  
Sarah Munro ◽  
Parkash Ragsdale ◽  
...  
Keyword(s):  
British Columbia ◽  
Emergency Contraception ◽  
Ulipristal Acetate ◽  
Use Patterns

scholarly journals Clinical Pharmacology of Hormonal Emergency Contraceptive Pills

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Celia M. J. Matyanga ◽  
Blessing Dzingirai
Keyword(s):  
Clinical Pharmacology ◽  
Health Professionals ◽  
Emergency Contraception ◽  
Healthcare Professionals ◽  
Unwanted Pregnancy ◽  
Contraceptive Methods ◽  
Emergency Contraceptive Pills ◽  
Contraceptive Pills ◽  
Emergency Contraceptive ◽  
Emergency Contraceptives

Emergency contraceptives play a major role in preventing unwanted pregnancy. The use of emergency contraceptives is characterized by myths and lack of knowledge by both health professionals and users. The main objective of this paper is to summarize the clinical pharmacology of hormonal methods of emergency contraception. A literature review was done to describe in detail the mechanism of action, efficacy, pharmacokinetics, safety profile, and drug interactions of hormonal emergency contraceptive pills. This information is useful to healthcare professionals and users to fully understand how hormonal emergency contraceptive methods work.

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