We have all heard about Plan B . The Plan B One-step consists of one pill containing 1.5 mg (in case you want to know the dose) of a synthetic progestin , levonorgestrel . This is a progestin that is found in lower doses in many birth control pills. Id taken within 72 hours of unprotected intercourse it prevents or deregulates ovulation nd fertilisation and hence prevents pregnancy by up to 89%. If it is taken within 24 hours it is 95% effectiv. We also know about the controversy that has become a political issue reguardng those younger than 17. Currently girls under the age of 17 have to get a doctor’s prescription to obtain emergency contraception. (Many young women cannot get to a physician within the first few days of unprotected intercourse , and are too embarrassed to even attempt to do so….So should they be punished for their youth? The mistake was already made! Moreover multiple studies have shown that access to or knowledge of emergency contraception does not increase sexual activity in teens and young adults. I guess you know how I feel. And I won’t even begin to voice my protests about the issue of payment for contraception…. of course it should be covered by all health plans.)
There is another emergency contraceptive, which has been approved by the FDA as of June 2010. It’s called ellaOne. The generic name is Ulipristal; it is a selective progesterone-receptor modulator. Essentially it sits on the receptors of progesterone and blocks the action of the hormone. It is available as a 30mg pill that is taken once and can decrease pregnancy by two-thrds if taken with 72 hours and 50% for up to 120 hours (5 days) after unprotected intercourse. It works by delaying the release of an egg thus preventing ovulation. It is currently available by prescription.
The very same medication, but in smaller doses, has now been shown to be effective for treating fibroids, at least prior to surgery.
This was the conclusion of a recent article published in The New England Medical Journal, titled (sorry I know this may not be necessary but it keeps my author credentials valid) “Ulipristal Acetate versus Placebo for Fibroid Treatment before Surgery”. The investigators from several centers in Belgium, Hungary, the Ukraine and the United Kingdom randomly assigned 242 women who had symptomatic fibroids that caused excessive bleeding to either 5 mg of ulipristol, 10 mg of the medication or placebo daily for 13 weeks before they underwent surgery. They found that even the smaller dose of ulipristol controlled bleeding in 91% of the women (whereas only 19% had less bleeding on placebo) and that up to 82% on the higher dose stopped having periods altogether (amenorrhea) compared to 6% on placebo.They also found that the volume of the fibroids decreased up to 21% in the women treated with daily ulipristol, whereas the volume increased during those 13 weeks by at least 3% in the women given placebo.
The authors did point out that the treatment was given for only 13 weeks and before planned surgery. But treatment with ulipristol may become one of the nonsurgical options that are available for women who have symptomatic fibroids. I’ll end this promising statement with the usual “more long-term studies are needed.”