The “morning-after pill”

The use of diethylstilbestrol (DES) as a postcoital contraceptive agent is discussed

1971 Study Abstract

A course of post-coital estrogens, in adequate dosage, is a highly effective and safe (though misnamed) form of post-coital contraception that deserves to be more widely known and prescribed. Both unwanted pregnancies and the demand for abortion could be reduced by its widespread use in emergency situations.

Several natural and synthetic estrogens have been used in various dosages; a popular regimen is 5 milligrams of stilbestrol, 5 times per day for 5 days, preferably accompanied by an anti-emetic, since nausea and occasional vomiting may occur.

Some authorities advise starting the course of estrogens within 48 hours of unprotected intercourse and others set a reliable outside limit of 72 hours, turning a Friday night indiscretion into a Monday morning routine appointment rather than a weekend emergency.

For a series of 30 cases started on the above dosage within 72 hours of coitus without contraception or with condom failure, I am able to report no pregnancies. These patients proved particularly responsive to counselling, almost all keeping subsequent appointments for a more satisfactory method of birth control.

Similar success was reported verbally at the recent American College Health Association conference1 by a gynecologist from Yale.

An interim report from the University of Utrecht indicated no failures in 72 women using post-coital estrogens, and a comprehensive review of the literature on the subject, with an analysis of 1000 cases, is to be presented by the same author at the forthcoming Fertility-Sterility Conference in Tokyo in October.

Professor Haspels’ excellent paper should do much to clear up the confusion that exists in many minds between this highly reliable method of post-coital contraception and the virtually useless attempts that are sometimes made to terminate a pregnancy by administering estrogens after a missed menstrual period.

This subject is, of course, unrelated to the use of prostaglandins, which is an entirely different story.

Sources

  • The “morning-after pill”, Canadian Medical Association journal, NCBI PubMed PMC1931140, 1971 Aug 7.
DES DIETHYLSTILBESTROL RESOURCES

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