DES has received wide attention
Approaches to postcoital interception are discussed.
High dose estrogen only regimens have an overall failure rate of .7%. The mechanism of action is speculated to include luteolysis and disordered endometrial development. Although several preparations have comparable potency if administered within 72 hours, diethylstilbestrol (DES) has received wide attention. As with other estrogen regimens, the main deficiency of DES relates to the need to consume high doses of estrogen, with its attendant potential risks and side effects.
Combination regimens, under which women are treated with 2 doses of 2 tablets each containing 1 mg dl-norgestrel and 100 mcg ethinyl estradiol (EE), are being investigated. Experience with 1300 treatment cycles indicated a failure rate of 1.6%. Advantages include a reduction in the duration of therapy, 12 hours versus 5 days; fewer tablets consumed, and a 125-fold reduction in consumed estrogen. Research is continuing on lower doses and nonoral administration. Progesterone receptor antagonists may be ideally suited for luteolytic interception and are being investigated. Administration of 50 mg of R2323 on days 15 to 17 over 2000 treatment cycles has shown a failure rate of 5%. Agonistic analog of gonadotropin-releasing hormone is being studied as a potential luteolytic interceptor. In a recent study, single or double subcutaneous administration between days 5-8 after the luteinizing hormone peak resulted in luteolysis in 96% of the treatment cycles.
- The morning after: novel hormonal approaches to postcoital interception, Fertility and sterility, NCBI PubMed, PMID: 6402385, 1983 Mar.
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