Yuzpe regimen
Encyclopedia
The Yuzpe Regimen is a method of emergency contraception
using a combination of estrogen
and progestogen hormones and started within 72 hours of sexual intercourse. It has been superseded by a progestogen-only hormonal regimen.
These hormones are administered as a number of combined oral contraceptive pills (COCPs). Each dose can vary from 2 to 5 pills depending on the brand of medication being used. Patients concurrently taking certain regular medications (e.g. rifamycin
and many anticonvulsant
drugs) that enhance the liver's break down of other drugs, must use an even higher hormone dose and may be better advised to use as an alternative the insertion of an IUD.
The standard regime is two tablets each with 50 µg ethinyl estradiol
and 250 µg levonorgestrel
, to be repeated 12 hours later.
The method is not guaranteed to prevent pregnancy and whilst the hormones may make the subsequent period come a few days early or late, a pregnancy test should be carried out if the period is more than 3 days late. The Yuzpe Regimen does not protect against sexually transmitted diseases.
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). This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method.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.
Should vomiting occur within 3 hours of taking a dose, then insufficient hormones may have been absorbed to provide the full contraceptive cover and an additional dose should be taken. Measures that may help to prevent nausea or vomiting include:
of approved medications is legal and commonplace in American medicine. Further, in February 1997, the FDA
declared emergency contraceptive use of certain birth control pills, following the Yuzpe regimen, as safe and effective.
Yuzpe regimen dedicated products (Preven in US and Schering-PC4 in UK) were discontinued following the introduction of progestogen-only ECPs (Plan B in US and Levonelle in UK).
Emergency contraception
Emergency contraception , or emergency postcoital contraception, refers to birth control measures that, if taken after sexual intercourse, may prevent pregnancy.Forms of EC include:...
using a combination of estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
and progestogen hormones and started within 72 hours of sexual intercourse. It has been superseded by a progestogen-only hormonal regimen.
History
The method was first developed by Canadian Professor A. Albert Yuzpe who published the first studies demonstrating the method's safety and efficacy in 1974.Description
This regimen allows a woman who has had unprotected sex to avoid pregnancy by taking 12 hours apart two sufficient doses of estrogen and progestogen hormones. The sooner this is started, the more effective it is and the effectiveness more than 72 hours after sexual intercourse is greatly reduced.These hormones are administered as a number of combined oral contraceptive pills (COCPs). Each dose can vary from 2 to 5 pills depending on the brand of medication being used. Patients concurrently taking certain regular medications (e.g. rifamycin
Rifamycin
The rifamycins are a group of antibiotics that are synthesized either naturally by the bacterium Amycolatopsis mediterranei or artificially. They are a subclass of the larger family Ansamycin...
and many anticonvulsant
Anticonvulsant
The anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers, and in the treatment of neuropathic pain. The goal of an...
drugs) that enhance the liver's break down of other drugs, must use an even higher hormone dose and may be better advised to use as an alternative the insertion of an IUD.
The standard regime is two tablets each with 50 µg ethinyl estradiol
Ethinylestradiol
Ethynylestradiol , also ethynyl estradiol , is a derivative of estradiol. Ethynyl estradiol is an orally bio-active estrogen used in almost all modern formulations of combined oral contraceptive pills...
and 250 µg levonorgestrel
Levonorgestrel
Levonorgestrel is a second generation synthetic progestogen used as an active ingredient in some hormonal contraceptives.-Chemistry:...
, to be repeated 12 hours later.
The method is not guaranteed to prevent pregnancy and whilst the hormones may make the subsequent period come a few days early or late, a pregnancy test should be carried out if the period is more than 3 days late. The Yuzpe Regimen does not protect against sexually transmitted diseases.
Subsequently, the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) undertook an investigation into the use of progestogen-only tablets as an Emergency Hormonal Contraceptive (i.e. without any estrogen component). This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method. A single dose of 100 mg mifepristone
Mifepristone
Mifepristone is a synthetic steroid compound used as a pharmaceutical. It is a progesterone receptor antagonist used as an abortifacient in the first months of pregnancy, and in smaller doses as an emergency contraceptive. During early trials, it was known as RU-38486 or simply RU-486, its...
is also more effective than the Yuzpe regime.
Side effects
Some temporary, but usually minor, reactions include:- Nausea and/or vomiting
- Breast tenderness
- Irregular Bleeding
- Headache or Dizziness
Should vomiting occur within 3 hours of taking a dose, then insufficient hormones may have been absorbed to provide the full contraceptive cover and an additional dose should be taken. Measures that may help to prevent nausea or vomiting include:
- Take the pills with food.
- Take Dramamine or Bonine an hour before taking the pills, if you are especially sensitive to or bothered by nausea—however, this step is not necessary.
- Schedule your doses so that you take the second dose before bed.
Formulations
Many common combined oral contraceptive pills could be used for the Yuzpe regimen, although their manufacturers did not label the pills for this use. Such off-label useOff-label use
Off-label use is the practice of prescribing pharmaceuticals for an unapproved indication or in an unapproved age group, unapproved dose or unapproved form of administration...
of approved medications is legal and commonplace in American medicine. Further, in February 1997, the FDA
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
declared emergency contraceptive use of certain birth control pills, following the Yuzpe regimen, as safe and effective.
Yuzpe regimen dedicated products (Preven in US and Schering-PC4 in UK) were discontinued following the introduction of progestogen-only ECPs (Plan B in US and Levonelle in UK).
External links
- General information on the Yuzpe Regimen was provided by plannedparenthood.org.
- A biography of A. Albert Yuzpe — Genesis Fertility Centre.