STRATEGIES USED TO ENHANCE ACCEPTABILITY OF EMERGENCY CONTRACEPTION EC

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STRATEGIES USED TO ENHANCE ACCEPTABILITY OF
EMERGENCY CONTRACEPTION (EC)

• Medard M. Lech MD, PhD, FPCOG, DPH
• School of Public Health
• National Postgrad. Center of Medical Education
• Warsaw, Poland.
• BUDAPEST 13th September 2003

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Abortion rates (for 1000 live births) in
selected Europen countries

• Czech Republic - 410 (Year 1999)
• Hungary - 782 (Year 1997)
• Lithuania - 518 (Year 1999)
• Poland - ?
• Russia - 1860 (Year 1997)
• Source www.who.int

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Hormonal Emergency Contraception (EC)

• The easy way of distribution,
• Simple method of dosage,
• Low cost,
• High effectiveness.

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REASONS for the use of EC are obvious. MYTHS -
Social/Medical restrains from EC use are more
than dubious Low effectiveness,
huge unwanted effects, act as the
early abortion pills,
complications in farther pregnancies
sterility/infertility etc
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EC BARRIERS

• Lack of awareness,
• Difficult access (in most of the European
  countries)
• Not complete understanding of the mode of action,
• Ethics/religious opposition.

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Why not? Awareness

• Taboo (!)
• Ambivalent attitude of policy makers,
• Lack of sexual education,
• Failure of sexual education,
• Poor social marketing of EC

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Why not? Difficult access

• Patients have to know the EC methods,
• Patients have to find urgently the prescriber,
• Patients have to obtain easily the EC product.
• 
  / time
  constraints

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Why not? MODE OF ACTION ?

• Effects on the migration and function of
• spermatozoa,
• Effects on the ovulatory process,
• D o u b t f u l l effects on the endometrium
• / Croxattio H.B.
  Emergency Contraception pills how do they work?
• 
  IPPF Med.. Bull, 200236(6)1-2.

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Products registered for EC are available all
over Europe

• LNG 0.75
• Postinor
• Postinor Duo
• Levonelle
• Rigesoft
• Norlevo
• EC products approved as an OTC only in France,
  Sweden, Norway, UK, Portugal, Belgium, Denmark,
  Switzerland and Finland, (Romania?)

• LNG 0.25EE 0.05
• Tetragynon
• Fertilan

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Strategies used to enhance EC use
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ESC next step ??

• The ESC Seminar (?)/Special Session(?)
• From Biology to Emergency Contraception