Yuzpe regimen

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(i.e. without any estrogen component).[2] This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method.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

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

  1. ^ a b Kaunitz, Andrew M. "Emergency contraception". UpToDate.
  2. ^ "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.
  3. ^ 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.
  4. ^ Haspels AA (Aug 1994). "Emergency contraception: a review". Contraception. 50 (2): 101–8. doi:10.1016/0010-7824(94)90046-9. PMID 7956209.
  5. ^ 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.
  6. ^ [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.