November 2020. After using oral emergency contraception (EC), women remain at risk of unintended pregnancy, and thus subsequent use of effective contraception is advised. A study in the United Kingdom tested innovative strategies to bridge EC provision to the uptake of ongoing contraception methods. In this study, a supply of the progestogen-only pill, and an invitation to a sexual and reproductive health clinic, were provided to women who had presented to community pharmacies for emergency contraception. This intervention resulted in a clinically meaningful increase in the subsequent use of effective contraception.

The full article is available on The Lancet’s website: Cameron, S. T., Glasier, A., McDaid, L. M., Radley, A., Baraitser, P., Stephenson, J. M., Gilson, R., Battison, C., Cowle, K., Forrest, M., Goulao, B., Johnstone, A., Morelli, A., Patterson, S., McDonald, A., Vadiveloo, T., & Norrie, J. D. T. (2020). Use of effective contraception following provision of the progestogen-only pill for women presenting to community pharmacies for emergency contraception (Bridge-It): a pragmatic cluster-randomised crossover trial. Lancet, 396(10262), 1585-1594. https://doi.org/10.1016/S0140-6736(20)31785-2

November 2020. A study investigating timing of combined oral contraceptive pill (COC) restart after missed pills and use of ulipristal acetate emergency contraception (UPA EC), was recently published. According to the study (Banh C, Rautenberg T, Duijkers IJ, et al. The effects on ovarian activity of delaying versus immediately restarting combined oral contraception after missing three pills and taking ulipristal acetate 30 mg. Contraception 2020;102(3):145-151.), in the specific scenario in which established users of 30mcg EE/LNG COC in a 21/7 regimen restart pill-taking for 4 days after a pill-free interval, miss the next 3 consecutive pills, and take UPA EC, ovulation and theoretical risk of pregnancy later in the cycle is less likely if COC is restarted immediately after UPA-EC than if COC restart is delayed for 5 days after UPA-EC.

The UK Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit is the first scientific society to respond to this study. Read the Faculty’s statement and recommendations here: https://www.fsrh.org/news/the-fsrh-ceu-statement-regarding-delaying-versus-immediately/

November  2020. The European Society of Contraception and Reproductive Health (ESC) organises the webinar “Dilemmas in contraception”, which will include a discussion on what to do when emergency contraception pills are needed because of missed oral contraception pills. The webinar will take place on November 18 at 16h00 Central European Time. Register here: https://us02web.zoom.us/webinar/register/WN_xNT5kKbAQMSzet3u2rOHtA 

November 2020. A journalist from MaltaToday, recently conducted a phone survey to find out if the pharmacies who will be on-call in the coming 6 weekend and holidays (November until December 8th, 2020) stock EC pills or not. On Sundays and public holidays, only 20 pharmacies across the country’s two islands are open.

From the 120 pharmacies across Malta and Gozo contacted by the journalist, an average of 64% sell the morning-after pill. However, the rate ranges from 50% on one Sunday in November to 75% on another.

Read the full report here and here.

The report also looked at the interaction with the pharmacy staff over the phone, and the questions a woman can be asked when procuring EC. The Chamber of Pharmacists insists that pharmacists should follow their guidelines, which tackle confidentiality and patient safety, among others. This guidelines are not available to the general public.

The news triggered reactions from a number of politicians and activists.

October 2020. ECEC’s mission is to expand access to and knowledge of emergency contraception (EC) in Europe, within a broader sexual and reproductive health and rights approach. Our work does not occur in a vacuum: ensuring access to EC is just one of the many measures necessary for people to be able to exercise sexual and reproductive rights, which are human rights.

ECEC wants to express its solidarity with the people of Poland, who are seeing their reproductive rights curtailed, and adhered to the joint civil society statement on international solidarity with women and peaceful protestors in Poland, prepared by the Centre for Reproductive Rights.

October 2020. On October 8^th the Italian Medicines Agency (AIFA) reclassified ulipistral acetate (UPA) EC pill EllaOne to “non-prescription but non-over-the-counter medicinal product” (Resolution no. 998). To date, women under 18  needed a medical prescritpion, prior to purchasing UPA ECPs at the pharmacy.

According to AIFA’s statment, this measure aims to further protect the physical and psychological health of adolescents, and to prevent unplanned pregnancies among youth. The Report to Parliament of the Minister of Health of June 2020 reported that, according to 2018 data, “the increased use of emergency contraception with levonorgestrel  and ulipistral acetate, had a positive effect on the reduction of pregnancy termination, which in Italy has continuously and progressively decreased since 1983”. Eliminating the prescription requirement for emergency contraception for minors aims, therefore, to contribute to reduce the conception rate under the age of 18 in the context of improving, in particular, the sexual health of adolescents and, more generally, of public health.”

You can read AIFA’s resolution here, and announcement of this reclassification here.

October 2020. In Ireland, a web-based App for EC counselling has been developed by www.MyClinic365.com. The App is based on The Faculty of Sexual and Reproductive Healthcare guideline on EC and is available in English to everyone: MyClinic365 EC Prescribing App

The MyClinic365.com team welcomes your feedback at info@myclinic365.com

This App is a good complement to the extensive guidances published by the Pharmaceutical Society of Ireland in 2015 and 2016 respectively (and subsequently updated), on the safe supply of non-prescription UPA and LNG EC pills, which are available to all on PSI website.