Mechanism of Action of Ulipristal Acetate for Emergency Contraception: A Systematic Review

Frontiers in Pharmacology
Elena RosatoCarlo Bastianelli

Abstract

Ulipristal acetate (UPA) is now recommended as first choice hormonal emergency contraception (EC), due to its higher efficacy and similar safety compared to Levonorgestrel - EC. Even though all trials demonstrated that the first mechanism of action is inhibition of ovulation, some authors still postulate that a post fertilization effect is also possible, raising the alert on medication and fostering the ethical debate. A Medline database search was performed in order to find recent articles related to UPA's effects on ovulation, on fallopian tube and on endometrium. We also analyzed the effects on sperm function and pregnancy. All studies conclude that UPA is effective in inhibition of ovulation even when administered shortly before LH peak. The effects on fallopian tube are unclear: according to some authors UPA inhibits ciliar beat through an agonistic effect on progesterone receptors, according to others it antagonizes the progesterone-induced ciliar beat decrease. Concerning the action on endometrium and on embryo implantation most of the studies concluded that low dose UPA used for EC has no significant effect on the decrease of endometrial thickness and on embryo's attachment, but these results are still matter of debate....Continue Reading

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Citations

Sep 30, 2016·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Carlo BastianelliGiuseppe Benagiano
Jan 19, 2019·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Bruno Mozzanega, Giovanni Battista Nardelli
Mar 3, 2019·Molecular Human Reproduction·Matías D Gómez-ElíasDébora J Cohen
Sep 19, 2020·International Journal of Environmental Research and Public Health·Bernhard LangerVanessa Wenig
Dec 3, 2020·Proceedings of the National Academy of Sciences of the United States of America·Olga KimJaeyeon Kim
May 1, 2021·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Elisavet KaltsouniInger Sundström-Poromaa
Dec 10, 2021·Journal of Pharmacy Practice·Rebecca H StoneHenry N Young

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Methods Mentioned

BETA
contraception
biopsy

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