Kiechle Marion, Neuenfeldt Miriam
Lehrstuhl für Gynäkologie und Geburtshilfe, Klinikum Rechts der Isar, Frauenklinik der Technischen Universität München (TUM), Ismaningerstrasse 22, 81675, Munich, Germany.
HRA Pharma Deutschland GmbH, Massenbergstrasse 9-13, 44787, Bochum, Germany.
Arch Gynecol Obstet. 2017 Mar;295(3):651-660. doi: 10.1007/s00404-016-4253-0. Epub 2016 Nov 28.
In March 2015, the oral emergency contraceptives levonorgestrel (LNG) and ulipristal acetate (UPA) were released from prescription-only status in Germany. The main research question is to analyse whether the OTC status of oral emergency contraceptives has an influence on the patterns of use.
All information is based on searches for public domain sources on emergency contraception. Searches were made for scientific publications, statistics, and surveys.
Due to additional active ingredient properties, UPA is superior to LNG in terms of ovulation-inhibiting effect. Since the OTC switch, demand for oral emergency contraceptives has risen by almost 50%, especially at weekends when sexual encounters and thus contraceptive failures are most frequent. However, the age distribution of the users has not changed as a result of the OTC switch. Doctors still play an important role in advising on emergency contraception after the removal of the prescription-only requirement. Pregnancies despite emergency contraception are terminated in more than half of the cases. In federal states with higher rates of use of the morning-after pill, fewer terminations of pregnancy were performed.
As a result of the OTC switch, more women and girls use the morning-after pill after unprotected intercourse and the time between unprotected intercourse and taking the oral emergency contraceptive decreases. This is of great advantage in terms of the mechanism of action. UPA is used more frequently than LNG. Only half of all people aged between 16 and 39 years in Germany are aware of the morning-after pill and 94% of women who had a pregnancy terminated in 2015 did not use any emergency contraception after the unprotected intercourse. In the population, there is still a great need for information and education on contraception and emergency contraception.
2015年3月，口服紧急避孕药左炔诺孕酮（LNG）和醋酸乌利司他（UPA）在德国从仅凭处方购买变为非处方药。主要研究问题是分析口服紧急避孕药的非处方药状态是否会对使用模式产生影响。
所有信息均基于对紧急避孕公共领域来源的搜索。搜索了科学出版物、统计数据和调查。
由于额外的活性成分特性，在抑制排卵效果方面，UPA优于LNG。自变为非处方药以来，口服紧急避孕药的需求增长了近50%，尤其是在周末，此时性接触以及避孕失败最为频繁。然而，非处方药转换并未改变使用者的年龄分布。在取消仅凭处方购买的要求后，医生在紧急避孕咨询方面仍发挥着重要作用。超过一半的情况下，即使采取了紧急避孕措施仍会怀孕。在服用紧急避孕药比例较高的联邦州，进行的妊娠终止手术较少。
非处方药转换的结果是，更多的妇女和女孩在无保护性交后使用紧急避孕药，无保护性交与服用口服紧急避孕药之间的时间缩短。就作用机制而言，这具有很大优势。UPA的使用频率高于LNG。在德国，16至39岁的人群中只有一半知道紧急避孕药，2015年终止妊娠的妇女中有94%在无保护性交后未使用任何紧急避孕措施。在人群中，对避孕和紧急避孕的信息及教育仍有很大需求。
