Contraceptive technology, 1980
Studies by A. Albert Yuzpe, MD, and Lee H. Schilling, MD, have shown Ovral to be an effective contraceptive after unprotected intercourse at any time in the menstrual cycle, not just in midcycle.
As a morning after pill, Ovral is taken in 2 doses: 2 tablets within 72 hours after coitus; 2 tablets 12 hours later, a total of 200 mcg ethinyl estradiol and 2 mg di-norgestrel. Risk of pregnancy from a single act of unprotected midcycle coitus averages 20-30% while the risk from unprotected intercourse at other times in the cycle averages 2-4%. Young, nulliparoous, women would be the prime target for the morning after pill. 98.5% of the women in Yuzpe’s study bled within 21 days. The 1.5% who do not bleed within the expected time will either be pregnant or have a delayed period. Ovral can be administered from a pack in the doctor’s office.
The major complaint about DES was nausea and vomiting. Only 24% of the women taking Ovral reported nausea. The episodes were mild and controlled with an antiemetic.
Both doctors and patients are wary of DES because of public concern about teratogenesis. Many doctors recommend termination of pregnancy if it was conceived while the woman was using DES. Ovral use does not usually indicate abortion.
The postcoital IUD insertion studies have included small numbers of patients, but the difficulties are that bleeding following insertion may suggest pregnancy, and the potential for pelvic infection is increased. Ovral should not be given to women who have contraindications to oral contraceptives, and benefits and risks should be weighed.