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Emergency contraception update: a Canadian perspective.

V W Y Leung1, J A Soon, M Levine

  • 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Clinical Pharmacology and Therapeutics
|November 29, 2007
PubMed
Summary
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Emergency contraception access improved as levonorgestrel (LNG) moved over-the-counter in Canada and the US. This shift aimed to overcome previous barriers, informing clinical practice on reproductive health outcomes.

Area of Science:

  • Reproductive Health
  • Pharmacology
  • Public Health Policy

Background:

  • Hormonal emergency contraception (EC) faced access barriers in Canada and the US.
  • Advocacy by professional and lay groups pushed for over-the-counter (OTC) availability of levonorgestrel (LNG).

Purpose of the Study:

  • To review the experience with EC access in Canada.
  • To inform clinical practice regarding LNG's mechanism, effectiveness, and impact on reproductive health outcomes following increased availability.

Main Methods:

  • Review of policy changes regarding EC access in Canada and the United States.
  • Synthesis of existing data on LNG's pharmacology, efficacy, and safety.
  • Analysis of the impact of increased OTC access on reproductive health outcomes.

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Main Results:

  • Canada progressively granted pharmacists EC prescriptive authority starting in 2000.
  • Health Canada authorized behind-the-counter LNG access in 2005, followed by US FDA approval for OTC access in 2006.
  • Increased availability of LNG is expected to influence reproductive health outcomes.

Conclusions:

  • Policy shifts in Canada and the US have expanded access to levonorgestrel for emergency contraception.
  • Further data is needed to fully elucidate the long-term effects of increased OTC availability on reproductive health.
  • This review provides insights for clinical practice concerning emergency contraception.