Postcoital contraception underrecognized and underutilized

Diethylstilbestrol as a “morning after” contraceptive

1992 Study Abstract

Postcoital contraception can play an important role in the prevention of unwanted adolescent pregnancy in the US.

Diethylstilbestrol (DES), 25 mg twice daily for 5 days within 24 to a maximum of 72 hours after unprotected sexual intercourse, received US Food and Drug Administration (FDA) approval for pregnancy prevention in 1973.

In 1978, however, the manufacturer, Eli Lilly, included in its packaging instructions that DES should not be used for postcoital contraception given the development of clear-cell adenocarcinoma of the vagina or cervix in the daughters of women who took DES to prevent spontaneous abortion.

The FDA had not withdrawn its approval of DES for this purpose. Other drugs that have been effectively used for postcoital contraception include 0.5 mg of norgestrel and 0.05 mg of ethinyl estradiol (2 tablets within 72 hours of unprotected intercourse and another 2 tablets 12 hours later) and conjugated estrogens.

This approach to pregnancy prevention sidesteps many of the medical and moral complexities associated with use of the abortifacient RU-486. In fact, the Catholic bishops of Great Britain have approved the use of postcoital contraception in women who are victims of sexual assault.

Sources

  • Postcoital contraception underrecognized and underutilized, Female Patient, NCBI PubMed PMID: 12287765, 1992 Jun.
  • Featured image bunchfamily.
DES DIETHYLSTILBESTROL RESOURCES

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