Yuzpe regimen: Difference between revisions
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→Description: the dose in mass units really should be in, not references to brand names and so on. |
500mg is really a very large dose, I suppose you meant 500 micrograms which translates to 0.5mg. Tags: Visual edit Mobile edit Mobile web edit |
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{{Short description|Method of emergency contraception}} |
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The '''Yuzpe Regimen''' is a method of [[emergency contraception|emergency hormonal contraception]] using a combination of [[estrogen]] and [[progesterone]] hormones and started within 72 hours of sexual intercourse. It has subsequently been superseded by a progesterone-only hormonal regimen. |
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The '''Yuzpe regimen''' is a method of [[emergency contraception]] that uses a combination of [[ethinyl estradiol]] and [[levonorgestrel]], specifically 1 mg of norgestrel (or 0.50mg of levonorgestrel) and 100 mcg of ethinyl estradiol ASAP and again in 12 hrs. It is less effective and less commonly used than a larger dose of levonorgestrel alone, a dose of [[ulipristal acetate]], or insertion of a [[Copper IUDs|copper intrauterine device]]. It is designed to be used within 72 hours of unprotected sexual intercourse because it works by inhibiting ovulation.<ref name=":0">{{Cite web|url=https://www.uptodate.com/contents/emergency-contraception|title=Emergency contraception|last=Kaunitz|first=Andrew M.|website=UpToDate}}</ref> |
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Typically, the Yuzpe regimen uses several doses of [[Combined oral contraceptive pill|combined oral contraceptive]] pills. It may be preferred in locations where other forms of emergency contraception are unavailable or accessing emergency contraception carries a societal stigma. In these places, people often self-administer combined oral contraceptives as emergency contraception.<ref name=":0" /> |
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The method was first developed by a [[Canadian]] Professor A. Albert Yuzpe who published the first studies demonstrating the method's safety and efficacy in [[1974]].{{ref|Yuzpe}} |
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Subsequently, the [[World Health Organization]] (WHO) undertook an investigation into the use of progestogen-only tablets as an Emergency Hormonal Contraceptive (i.e. without any estrogen component).<ref>{{cite journal |title=Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation. |journal=Lancet |date=8 August 1998 |volume=352 |issue=9126 |pages=428–33 |pmid=9708750|doi=10.1016/S0140-6736(98)05145-9 |s2cid=25085328 }}</ref> This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method. A single dose of 100 mg [[mifepristone]] is also more effective than the Yuzpe regime.<ref>{{cite journal |vauthors=Ashok PW, Stalder C, Wagaarachchi PT, Flett GM, Melvin L, Templeton A |title=A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception |journal=BJOG |volume=109 |issue=5 |pages=553–60 |date=May 2002 |pmid=12066946 |doi=10.1111/j.1471-0528.2002.01371.x|doi-access=free }}</ref> |
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==Description== |
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This [[wiktionary:regimen|regimen]] allows a woman who has had unprotected sex to avoid pregnancy by taking 12 hours apart two sufficient doses of estrogen and progestogen hormones. The sooner this is started, the more effective it is and the effectiveness more than 72 hours after sexual intercourse is greatly reduced. The licensing for emergency [[Intrauterine device]] (IUD) insertion allows for up to 5 days and it is highly effective for up to five days after the time of ovulation, which may extend more than five days after the relevant risky intercourse. |
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These hormones are usually administered either as a high number of regular-strength [[Oral contraceptive formulations#Combined Oral Contraceptive Pill|Combined Oral Contraceptive Pills]] (COCP), or as specific high-strength "Emergency contraceptive pills" (ECPs) (commonly known as "Morning-after pills"). Hence each dose can vary from 1 to 20 pills depending on the brand of medication being used. Patients concurrently taking certain regular medications (e.g. [[rifamycin]] and many [[anticonvulsant]] drugs) that enhance the liver's break down of other drugs, must use an even higher hormone dose and may be better advised to use as an alternative the insertion of an IUD. |
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The method was first developed by [[Canadian]] Professor of Obstetrics and Gynecology [[A. Albert Yuzpe]] as a method of reducing potential unwanted pregnancies, including [[pregnancy from rape]].<ref name="Haspels">{{cite journal | author = Haspels AA |date=Aug 1994 | title = Emergency contraception: a review | journal = [[Contraception (journal)|Contraception]] | volume = 50 | issue = 2| pages = 101–8 | pmid = 7956209 | doi=10.1016/0010-7824(94)90046-9}}</ref><ref name="yuzpe">{{cite journal | vauthors = Yuzpe AA, Smith RP, Rademaker AW | year = 1982 | title = A multicenter clinical investigation employing ethinyl estradiol combined with dl-norgestrel as postcoital contraceptive agent | journal = Fertil Steril | volume = 37 | issue = 4| pages = 508–513 | pmid = 7040117 | doi = 10.1016/S0015-0282(16)46157-1 | doi-access = free }}</ref> He published the first studies demonstrating the method's safety and efficacy in 1974.<ref>{{ref|Yuzpe}}{{cite journal|vauthors=Yuzpe AA, Thurlow HJ, Ramzy I, Leyshon JI|title=Post coital contraception—A pilot study|journal=J Reprod Med|volume=13|issue=2|pages=53–8|date=August 1974|pmid=4844513}}</ref> |
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The standard regime has each dose of two tablets each with 50 micrograms ethinyloestradiol and 0.25 mg levonorgestrel, to be repeated 12 hours later. |
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The method is not guaranteed to prevent pregnancy and whilst the hormones may make the subsequent period come a few days early or late, a pregnancy test should be carried out if the period is more than 3 days late. The Yuzpe Regimen does not protect against sexually transmitted diseases. |
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Subsequently, the [[World Health Organization]] (WHO) undertook an investigation into the use of progesterone-only tablets as an Emergency Hormonal Contraceptive (i.e. without any estrogen component). This showed greater efficacy with reduced side effects{{ref|WHO_EPOC}} and has therefore superseded the Yuzpe method. A single dose of 100 mg [[mifepristone]] is also more effective than the Yuzpe regime<ref>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12066946&dopt=Abstract</ref>. |
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==Side effects== |
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Some temporary, but usually minor, reactions include: |
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*Nausea and/or vomiting |
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*Breast tenderness |
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*Irregular Bleeding |
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*Headache or Dizziness |
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Should vomiting occur within 3 hours of taking a dose, then insufficient hormones may have been absorbed to provide the full contraceptive cover and an additional dose should be taken. Measures that may help to prevent nausea or vomiting include: |
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* Take the pills with food. |
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* Take Dramamine or Bonine an hour before taking the pills, if you are especially sensitive to or bothered by nausea -- however, this step is not necessary. |
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* Schedule your doses so that you take the second dose before bed. |
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==Formulations== |
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Many common [[oral contraceptive]] pills could be used for the Yuzpe regimen{{ref|PrincetonEC_dosages}}, although their manufacturers did not label the pills for this use. Such [[off-label use]] of approved medications is legal and commonplace in American medicine. Further, in February [[1997]], the [[United States]] [[Food and Drug Administration]] declared ECP use of birth control pills, following the Yuzpe regimen, as safe and effective. |
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The specific high-dose combined hormone formulations ('''Preven''' in US and '''Schering-PC4''' in UK) are generally no longer available since the introduction of progesterone-only ECPs ('''Plan B''' in US and '''Levonelle one-step/Levonelle 1500''' in UK). |
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==References== |
==References== |
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{{Reflist}}{{Birth control methods}} |
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# {{note|Yuzpe}} Yuzpe AA, Thurlow HJ, Ramzy I, Leyshon JI. Post coital contraception--A pilot study. J Reprod Med. 1974 Aug;13(2):53-8. PMID 4844513 |
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{{Hormonal contraceptives}} |
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# {{note|WHO_EPOC}} WHO Task Force on Postovulatory Methods of Fertility Regulation. Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Lancet 1998;352:428-433. ([http://www.thelancet.com/journals/lancet/article/PIIS0140673698051459/abstract Abstract]) |
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# {{note|PrincetonEC_dosages}} Princeton University's Emergency Contraception Website (not-2-late.com) list of All information regarding pill brands and dosage was provided by [http://ec.princeton.edu/questions/dose.html List of oral contraceptives that can be used for emergency contraception in the United States]. |
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== External links == |
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* General information on the Yuzpe Regimen was provided by [http://www.plannedparenthood.org/library/BIRTHCONTROL/EC.html plannedparenthood.org]. |
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* A [http://www.genesis-fertility.com/staff/yuzpe.htm biography of A. Albert Yuzpe] - Genesis Fertility Centre. |
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[[Category:Hormonal contraception]] |
[[Category:Hormonal contraception]] |
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Latest revision as of 19:45, 21 January 2024
The Yuzpe regimen is a method of emergency contraception that uses a combination of ethinyl estradiol and levonorgestrel, specifically 1 mg of norgestrel (or 0.50mg of levonorgestrel) and 100 mcg of ethinyl estradiol ASAP and again in 12 hrs. It is less effective and less commonly used than a larger dose of levonorgestrel alone, a dose of ulipristal acetate, or insertion of a copper intrauterine device. It is designed to be used within 72 hours of unprotected sexual intercourse because it works by inhibiting ovulation.[1]
Typically, the Yuzpe regimen uses several doses of combined oral contraceptive pills. It may be preferred in locations where other forms of emergency contraception are unavailable or accessing emergency contraception carries a societal stigma. In these places, people often self-administer combined oral contraceptives as emergency contraception.[1]
Subsequently, the World Health Organization (WHO) undertook an investigation into the use of progestogen-only tablets as an Emergency Hormonal Contraceptive (i.e. without any estrogen component).[2] This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method. A single dose of 100 mg mifepristone is also more effective than the Yuzpe regime.[3]
History
[edit]The method was first developed by Canadian Professor of Obstetrics and Gynecology A. Albert Yuzpe as a method of reducing potential unwanted pregnancies, including pregnancy from rape.[4][5] He published the first studies demonstrating the method's safety and efficacy in 1974.[6]
References
[edit]- ^ a b Kaunitz, Andrew M. "Emergency contraception". UpToDate.
- ^ "Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation". Lancet. 352 (9126): 428–33. 8 August 1998. doi:10.1016/S0140-6736(98)05145-9. PMID 9708750. S2CID 25085328.
- ^ Ashok PW, Stalder C, Wagaarachchi PT, Flett GM, Melvin L, Templeton A (May 2002). "A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception". BJOG. 109 (5): 553–60. doi:10.1111/j.1471-0528.2002.01371.x. PMID 12066946.
- ^ Haspels AA (Aug 1994). "Emergency contraception: a review". Contraception. 50 (2): 101–8. doi:10.1016/0010-7824(94)90046-9. PMID 7956209.
- ^ Yuzpe AA, Smith RP, Rademaker AW (1982). "A multicenter clinical investigation employing ethinyl estradiol combined with dl-norgestrel as postcoital contraceptive agent". Fertil Steril. 37 (4): 508–513. doi:10.1016/S0015-0282(16)46157-1. PMID 7040117.
- ^ [1]Yuzpe AA, Thurlow HJ, Ramzy I, Leyshon JI (August 1974). "Post coital contraception—A pilot study". J Reprod Med. 13 (2): 53–8. PMID 4844513.