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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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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
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
Hormonal Emergency Contraception (EC) • The easy way of distribution, • Simple method of dosage, • Low cost, • High effectiveness.
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
EC BARRIERS • Lack of awareness, • Difficult access (in most of the European countries) • Not complete understanding of the mode of action, • Ethics/religious opposition.
Why not? Awareness Taboo (!) Ambivalent attitude of policy makers, Lack of sexual education, Failure of sexual education, Poor social marketing of EC
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
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, 2002;36(6):1-2.
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 0.25+EE 0.05 Tetragynon Fertilan Products registered for EC are available all over Europe
ESC next step ?? The ESC Seminar (?)/Special Session(?) „From Biology to Emergency Contraception”