For women who have infrequent sex and do not want to be on long-term birth control, there are very few options for on-demand contraception.
However, a recent study has shown that a new combination birth control pill that a woman takes prior to sex can prevent pregnancy for up to five days. Researchers found that the combined medication disrupted the participants ovulation at each stage of their fertile window more than any other treatment.
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While the study was small and more research is needed to make the medication a reality, researchers say this new birth control option for women shows some promise.
"Many people still have unmet contraceptive needs," said Dr. Erica Cahill, an obstetrician-gynecologist at Stanford University and one of the study authors told U.S. News & World Report.
"This is especially true for people looking for a method that they only have to use when sexually active that is more effective and less intrusive than condoms, diaphragms, withdrawal or spermicide, the only available pericoital [used at the time of sex] or on-demand methods at this moment," Cahill added.
The experimental birth control pill combines ulipristal acetate – currently used as a "morning-after" pill – with the non-steroidal anti-inflammatory drug meloxicam to disrupt ovulation.
A woman is at greatest risk of conception during her luteal surge before ovulation. Once a developing egg follicle reaches a certain size, luteinizing hormone levels surge, which then triggers ovulation about 24 to 36 hours later.
Ulipristal acetate disrupts ovulation at the beginning of the luteal surge, while meloxicam can disrupt ovulation even after the luteal surge starts, the researchers explained.
Nine women ages 18 to 35 were included in the study. The participants were monitored through two menstrual cycles, receiving a combined dose of 30 mg of ulipristal acetate and 30 mg of meloxicam during the second cycle around the time of their luteal surge, which is usually the midpoint of their menstrual cycle.
By measuring hormone levels and checking follicle growth on ultrasound scans, the researchers were able to determine if ovulation had occurred or if it had been disrupted by the combined pill. They reported that ovulation was fully disrupted in six women, while eight of the women experienced some signs of ovulatory dysfunction.
The researchers also noted that treatment cycles lasted for almost three days longer, which could be important for tracking fertility.
Many women are interested in birth control methods that don't involve having to go to a clinic for injections or implant placement, as well as options that don't contain the hormone estrogen. Currently, the only on-demand contraceptions are condoms, spermicides and Phexxi, a hormone-free birth control gel that was approved by the Federal Drug Administration in May 2020.
Traditional birth control pills must be taken daily. There are also emergency contraceptive pills that can be taken after sex to prevent pregnancy.
According to the U.S. Centers for Disease Control and Prevention, there are both reversible and permanent methods of birth control.
Reversible methods include intrauterine devices that are placed inside the uterus, implants, injections and patches that contain the hormone progestin. Additionally, women can opt to wear a hormonal vaginal contraceptive ring that is placed inside the vagina.
There are also what are referred to as "barrier methods," which include the diaphragm, sponge, condom and spermicides.
Some women prefer using the the pull out method or fertility awareness-based methods that are based on the understanding of their monthly fertility pattern. Permanent methods of birth control refer to tubal litigation for women and vasectomy for men.
Dr. Stephanie Teal, chair of obstetrics and gynecology at University Hospitals Cleveland Medical Center, told MedPage Today that there could be a potential demand for this new contraceptive pill because different patients have a range of preferred methods regarding how to prevent pregnancy.
"Many more women in their teens, 20s, and early 30s are saying 'I don't want to be on the pill everyday,' or 'I want to have more control in knowing where I am at in my cycle, and then managing my contraception,'" said Teal.