January 2019. The International Federation of Gynecology and Obstetrics (FIGO) and the International Consortium for Emergency Contraception (ICEC), launch the 4th edition of “Emergency Contraceptive Pills: Medical and Service Delivery Guidance”.
The guidance is designed to serve as a key reference and training document for service provision. It includes a range of medical and service delivery issues in an easy to use format (from mechanisms of action, dosages, and counseling to EC pill regimens) and a two-page clinical summary available in English and Spanish.
The document can be translated and adapted as necessary to comply with national requirements. Get in touch with us if you are interested in using this guidance in your work.
December 2018. The World Health Organization (WHO) recently launched two new Apps for healthcare providers advising women on contraception.
- The “Humanitarian settings contraception” App, is intended for front-line health care providers to help women initiate contraception in humanitarian and emergency settings. More information here.
- The “WHO MEC” App, will facilitate the task of family planning providers recommending safe, effective and acceptable contraception methods, for women with medical conditions or medically-relevant characteristics. More information here.
Emergency contraceptive methods (Cu-IUD, LNG EC pills, UPA EC pills and the combined regimen) are included in the “Additional information” section of both Apps. Check them out and let your colleagues know.
“Emergency contraception methods” (the EC wheel), a counselling tool for pharmacists and health providers published in May 2016 by ECEC, is now available in French, and can be used from tablets, cellphones and computers (on and off line).
This tool is inspired in the WHO Medical eligibility criteria for contraceptive use (MEC) wheel, and based on the WHO MEC 2015 and the UK Faculty of Sexual and Reproductive Healthcare recommendations for EC use. The methods included are the Cooper IUD, Levonorgestrel EC pills and Ulirpristal Acetate EC pills. Read more in our Resources page or contact us for further information on how to use this tool in your country. Visit this pages to access the on-line wheel in English and French here.
Over the past year, there have been discussions around whether hormonal contraception should be resumed immediately after the intake of UPA EC. The concern is that using a progestin-containing contraceptive could counteract the effects of UPA EC. UPA is an anti-progestin that works by delaying or inhibiting ovulation; if a progestin-containing contraceptive is administered at the same time, it might cancel out the effects of UPA, thereby putting the woman at risk of pregnancy from the act of intercourse that already occurred. Until recently, there was no published evidence addressing this question. However, in an article recently published by Dr. Vivian Brache and colleagues in Human Reproduction in which woman were given UPA EC and started a desogestrel-only daily pill on the same day, they found that ovulation occurred within 5 days in 45% of cycles in which the desogestrel-only pill was taken daily, starting on the same day as UPA; among women taking UPA followed by a placebo, ovulation occurred in only 1 cycle (3%). This indicates that taking this type of oral contraceptive pill can indeed make UPA ineffective in some woman, but the sample is small and the results might not apply to all hormonal contraceptives. Dr. Anna Glasier also published a commentary discussing the available evidence and recommending that women not start a new pack of oral contraceptives within 5 days of taking UPA. The UK Faculty of Sexual and Reproductive Healthcare released new guidance, making a similar recommendation. This is an important issue, because women presenting for EC at a clinic or doctor’s office may miss a crucial opportunity to begin ongoing contraception if they are told not to start their pills right away, or if they are told to come back in 5 days for a long-acting method.
HRA Pharma announced that the European Commission, in a historic ruling, has authorized the emergency contraceptive ellaOne® to be accessible directly from pharmacies without the need for a prescription from a doctor. This is the first ever decision of its type regarding any oral contraceptive product applicable to all EU member states, according to national implementation procedures. This new ruling will empower over 120 million women across the entire EU to gain direct access to emergency contraception.
This legally-binding decision follows an earlier positive opinion from the European Medicines Agency (EMA) Committee for Medicinal Products for Human Use (CHMP), which concluded that ellaOne® works best if used during the first 24 hours and can be used safely without a medical prescription. Today’s decision is a further testament to the acceptance of the need for women to be offered improved access to superior emergency contraceptive options such as ellaOne®.
ellaOne® will first be available in pharmacies without a prescription in some European countries beginning next month (February 2015), with a full launch program taking place across the EU during the rest of the year.
To read the full press release from HRA Pharma, please click here.
On November 21st 2014, the European Medicines Agency (EMA) recommended that the EC pill containing ulipristal acetate, be made available without the need for a prescription in all European Union countries. EMA recommendation should be implemented in a few months, once it has been endorsed by the European Commission. For further information, please read EM’As press release here.
The European Medicines Agency (EMA) released the following statement today:
“The European Medicines Agency has concluded its review of emergency contraceptives containing levonorgestrel or ulipristal acetate to assess whether increased bodyweight affects the effectiveness of these medicines in preventing unintended pregnancy following unprotected sexual intercourse or contraceptive failure. The Agency’s Committee for Medicinal Products for Human Use (CHMP) recommends that these emergency contraceptives can continue to be used in women of all weights as the benefits are considered to outweigh the risks.”
To read the full statement, click here.
Beginning in January 2014, the European Medicines Agency (EMA) started reviewing emergency contraceptives to assess whether increased body weight and body mass index (BMI) reduce the efficacy of these medications. Based on the results of this review, EMA will assess whether any changes should be made to the product information for emergency contraceptives containing levonorgestrel or ulipristal acetate. For further information, read the EMA press release.
ECEC has published an article in WHO’s Entre Nous European Magazine for Sexual and Reproductive Health. In it, ECEC outlines the unequal EC access situation in Europe and advocates for the standardization of EC guidelines across the continent to help reduce these inequalities. Ultimately, ECEC recommends that every woman seeking EC be informed of the methods available to her so she can truly exercise choice concerning her reproductive health. ECEC would like to extend a special thank you to all of the informants who helped us collect and validate this valuable data!
Do you want to know more about access to emergency contraception in a specific country? In cooperation with national experts, ECEC is developing country profiles. Click here to learn more about EC accessibility, prescription status, cost, guidelines, common practices, and use in European countries.