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17 Dec 2013

The nation’s peak family planning organisation has backed continued use of the emergency contraceptive pill as “better than nothing”, following uncertainty about its efficacy for heavier women.

Sexual Health and Family Planning Australia (SH&FPA) has recommended that women continue to use the morning after pill despite claims it does not work in women who weigh more than 80 kilograms.

As reported in the 2 December edition of Australian Medicine (to view, visit: https://ama.com.au/ausmed/morning-after-pill-be-taken-lightly), the Australian medicines watchdog is reviewing use of the morning after pill Norlevo after French-based manufacturer HRA Pharma announced it was planning to issue advice that the medication may not be effective in women who weigh more than 75 kilograms, and is ineffective in women who weigh more than 80 kilograms.

The company acted after assessing the findings of a 2011 University of Edinburgh study of women using emergency contraception.

The SH&FPA said it held consultations with the Therapeutic Goods Administration (TGA) and the International Consortium for Emergency Contraception (ICEC) following HRA Pharma’s announcement, and had so far found no grounds to recommend women stop using the morning after pill.

“At the time of writing is reduced to the extent that it should not be offered to these women,” the peak body said. “As such, in the absence of an alternative, the emergency contraceptive pill readily available in Australia, which is extremely safe, may still offer some benefit in preventing an unintended pregnancy, and is better than nothing.”

The organisation said that, as an overall strategy to reduce the need for emergency contraception, it recommended the use of long acting reversible contraceptives, such as implants and intrauterine devices (IUDs).

It said that, addition to the morning after pill, another emergency contraceptive was the copper IUD, which can be inserted up to five days after unprotected sex, and was the most effective form of emergency contraception.

The organisation said it would continue to consult with the TGA and the ICEC to determine if any changes needed to be made to emergency contraception pill practice.

“Until we have more conclusive evidence, the emergency contraceptive pill and the copper IUD are two suitable options for any woman seeking emergency contraception,” it said.

The importance of effective contraception has been underlined by figures, reported in the Adelaide Advertiser, showing more than 70,000 women have abortions every year, with estimates that up to 60 per cent of them were using contraceptives at the time of their unintended pregnancy.

The SH&FPA said long acting reversible contraceptives were 20 times more effective at preventing unintended pregnancies than other forms of contraception, but less than 10 per cent of Australian women used such devices.

But the range of such contraceptives available to women may soon increase after the TGA approved the long acting IUD Jaydess, which releases the hormone Levonorgestrel into the uterus for up to three years.

The Adelaide Advertiser reported it could become available through the Pharmaceutical Benefits Scheme in early 2015.

Adrian Rollins

 


Published: 17 Dec 2013