Yuzpe regimen

The Yuzpe regimen is a method of emergency contraception that uses a combination of ethinyl estradiol and levonorgestrel, specifically 1 mg of norgestrel (or 500 mg of levonorgestrel) and 100 mcg of ethinyl estradiol ASAP and again in 12 hrs. It is less effective and less commonly used than a larger dose of levonorgestrel alone, a dose of ulipristal acetate, or insertion of a copper intrauterine device. It is designed to be used within 72 hours of unprotected sexual intercourse because it works by inhibiting ovulation.[1]

Typically, the Yuzpe regimen uses several doses of combined oral contraceptive pills. It may be preferred in locations where other forms of emergency contraception are unavailable or accessing emergency contraception carries a societal stigma. In these places, people often self-administer combined oral contraceptives as emergency contraception.[1]

Subsequently, the World Health Organization (WHO) undertook an investigation into the use of progestogen-only tablets as an Emergency Hormonal Contraceptive (i.e. without any estrogen component).[2] This showed greater efficacy with reduced side effects and has therefore superseded the Yuzpe method. A single dose of 100 mg mifepristone is also more effective than the Yuzpe regime.[3]

History

The method was first developed by Canadian Professor of Obstetrics and Gynecology A. Albert Yuzpe as a method of reducing potential unwanted pregnancies, including pregnancy from rape.[4][5] He published the first studies demonstrating the method's safety and efficacy in 1974.[6]

References
  1. Kaunitz, Andrew M. "Emergency contraception". UpToDate.
  2. "Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation". Lancet. 352 (9126): 428–33. 8 August 1998. doi:10.1016/S0140-6736(98)05145-9. PMID 9708750. S2CID 25085328.
  3. Ashok PW, Stalder C, Wagaarachchi PT, Flett GM, Melvin L, Templeton A (May 2002). "A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception". BJOG. 109 (5): 553–60. doi:10.1111/j.1471-0528.2002.01371.x. PMID 12066946.
  4. Haspels AA (Aug 1994). "Emergency contraception: a review". Contraception. 50 (2): 101–8. doi:10.1016/0010-7824(94)90046-9. PMID 7956209.
  5. Yuzpe AA, Smith RP, Rademaker AW (1982). "A multicenter clinical investigation employing ethinyl estradiol combined with dl-norgestrel as postcoital contraceptive agent". Fertil Steril. 37 (4): 508–513. doi:10.1016/S0015-0282(16)46157-1. PMID 7040117.
  6. Yuzpe AA, Thurlow HJ, Ramzy I, Leyshon JI (August 1974). "Post coital contraception—A pilot study". J Reprod Med. 13 (2): 53–8. PMID 4844513.
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