Is this the end of the pill as we know it? Fertility experts create an ‘on-demand’ method of contraception that women take just before they have sex
- Researchers identify an ‘on-demand’ treatment that can be taken right before sex
- Morning after pill and arthritis drug combination disrupts ovulation
- They said medications are the “best candidate” for on-demand oral birth control
Taking birth control pills every day may soon become a thing of the past for women who use birth control.
Researchers from Stanford University in California have discovered what they claim is an “promising” on-demand treatment – meaning it can be taken right before sex.
A combination of the morning-after pill and an arthritis medication has been found to “disrupt ovulation at peak fertility.”
They said the cocktail — which was given in two pills — was the “best candidate” for oral birth control taken just before sex.
The treatment works by disrupting ovulation, which is the point in the menstrual cycle when a woman is most likely to get pregnant, which is also how birth control pills work.
The researchers wanted to see if a combination of drugs present during corpus luteum increase – three days before ovulation – could be taken to act as an on-demand birth control pill at this moment of “peak fertility”. As it stands, the pill must be taken daily to work, with condoms and diaphragms being the only contraceptive method available on demand.
The researchers said patients and doctors are “very interested” in developing on-demand contraceptives.
Current birth control pills can cause side effects including mood swings, nausea, headaches and slightly increase the risk of blood clots and cervical cancer.
As it stands, the pill must be taken daily or three weeks a month to work, with condoms and diaphragms being the only contraceptive method available on demand.
Nine women aged 18 to 35 years were given a one-time dose of 30 mg ulipristal acetate and 30 mg meloxicam during luteal augmentation – the days before ovulation when it is difficult to disrupt.
What contraceptive methods are currently available?
Contraceptives are intended to prevent pregnancy. A woman can get pregnant if a man’s sperm reaches one of her eggs.
Contraception attempts to prevent this from happening by keeping the egg and sperm separate, by stopping egg production or by stopping the sperm and egg from attaching together to the uterine lining.
Contraception is free for most people in the UK. Available options include:
- caps or diaphragms
- combined contraceptive pill
- contraceptive implant
- contraceptive injection
- contraceptive patch
- female condom
- IUD (intrauterine device or coil)
- An intrauterine device (IUS) (intrauterine device or hormonal IUD)
- Natural Family Planning (Fertility Awareness)
- Progestogen-only pills
- vaginal ring
Ulipristal acetate — sold as ellaOne — stops or delays the release of an egg.
As it is currently used, it must be taken within five days of sex to prevent pregnancy and is not currently intended to be used as a regular form of contraception.
Meloxicam is sold under brand names including Mobic, and is an anti-inflammatory drug used to treat long-term conditions including rheumatoid arthritis.
Whereas the morning after pill disrupts ovulation before the luteal surge, meloxicam has previously been observed to interfere with ovulation even after the luteal surge has begun.
The study looked at nine participants, who were monitored for two menstrual cycles, about two months apart, to determine their normal ovulation patterns and when their corpus luteum increase occurred.
In the third course, they were given a drug cocktail. To determine if ovulation occurred or was disrupted, they performed ultrasound scans and blood tests to measure key hormones.
The drug was considered an effective method of contraception if it impeded ovulation.
The results, published in the BMJ Journal of Sexual and Reproductive Health, showed that ovulation was disrupted in six women, while eight women met some of the criteria for incomplete ovulation.
During the cycle the women took the drugs, their menstrual cycles increased by three days, from 29 to 32, and their progesterone levels were lower. One participant reported irregular bleeding.
The researchers said the results were “promising” and suggested that the drug combination could disrupt ovulation “when the risks of pregnancy are higher.”
They added that this makes it “a promising candidate for evaluation as an oral contraceptive (at the time of sex)”.
However, they note that more studies are needed on the performance of the drug combination and the side effects it causes.
The findings also suggest that taking meloxicam along with ulipristal acetate may increase the effectiveness of the morning after pill, they said.