How a Common Painkiller Can Enhance Emergency Contraception

Emergency contraception is a method of preventing pregnancy after unprotected sex. It can be used in situations such as condom breakage, missed pills, or sexual assault. However, not all emergency contraceptive pills are equally effective, and some may fail to prevent ovulation or fertilization.

A new study published in The Lancet has found that combining a common painkiller called piroxicam with the levonorgestrel emergency contraceptive pill can significantly reduce the risk of pregnancy compared to taking levonorgestrel alone.

What is piroxicam and how does it work?

Piroxicam is an anti-inflammatory drug that is often prescribed for arthritis pain. It belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs), which also include ibuprofen and aspirin.

How a Common Painkiller Can Enhance Emergency Contraception
How a Common Painkiller Can Enhance Emergency Contraception

Piroxicam works by blocking the production of prostaglandins, which are chemicals that cause inflammation and pain. Prostaglandins also play a role in ovulation and implantation, which are the processes that allow pregnancy to occur.

By inhibiting prostaglandins, piroxicam may interfere with ovulation and implantation, and thus enhance the effectiveness of emergency contraception.

What did the study find?

The study was conducted by researchers from The University of Hong Kong and the Family Planning Association of Hong Kong. It involved 1,000 women who requested levonorgestrel emergency contraception within 72 hours of unprotected sex.

The women were randomly assigned to receive either levonorgestrel 1.5 mg plus piroxicam 40 mg, or levonorgestrel 1.5 mg plus a placebo pill. They were followed up for four weeks to check for pregnancy and side effects.

The results showed that 95% of pregnancies were prevented following combined treatment with levonorgestrel and piroxicam, compared to 63% of pregnancies being prevented when levonorgestrel was taken alone.

This means that piroxicam reduced the pregnancy rate by more than half, from 3.7% to 1.5%. The difference was statistically significant and clinically meaningful.

The side effects of piroxicam were minimal and similar to those of placebo. The most common side effects were nausea, headache, and menstrual changes.

What are the implications of the study?

The study is the first to suggest that a readily available and safe medication can boost the efficacy of levonorgestrel emergency contraception when taken together. The researchers hope that these findings will lead to further research and ultimately changes in clinical guidelines to enable women around the world to access more effective emergency contraception.

The study also highlights the need for more awareness and education about emergency contraception, especially among women who live in areas where access to health services is limited or where abortion is restricted or illegal.

Emergency contraception can prevent up to over 95% of pregnancies when taken within five days after intercourse, according to the World Health Organization. However, many women do not know about it or do not use it correctly or in time.

The researchers urge women who need emergency contraception to seek help as soon as possible and to consider using a copper intrauterine device (IUD) as an alternative option. A copper IUD is the most effective form of emergency contraception available and can also provide long-term contraception.

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