The journal Contraception published a literature review that found progestin-only pills (POPs) may be more effective than anticipated. Carmela Zuniga (MA), an associate research scientist at Ibis Reproductive Health, Cambridge, Massachusetts and her colleagues conducted the review. The Cochrane database, PubMed Central, and PubMed Central were used by the researchers to search for relevant studies. This search was completed until March 20, 2022. The final analysis included 54 studies.
Four researchers were assigned to independently extract the data, and 2 to analyze it with R and Excel. Zuniga was a co-author of the study and spoke to Contemporary OBGYN(r) about the results. According to Zuniga, the research shows that POPs might be more effective than previously believed.
If 100 people use POP for one year, it is estimated that seven pregnancies will occur. According to Zuniga, the expected number of pregnancies is closer to 2, based on our research. Zuniga clarified that this is a typical POP estimate and includes those who use the pill correctly. People who take the pill in an incorrect way or use it in inconsistent ways.
Contemporary obgyn’s (r) Zuniga told them that the important thing about this review is that it focused not only on POP formulations but also included information from randomized trials. This review has provided information on efficacy, rates and effectiveness across a range of POP formulations and study types.
Because we considered randomized studies and studies that only analyzed one type of POP rather than studies that compared different POP formulations, each study was subject to bias assessment, and we conducted our analysis accordingly. He stated that the focus was on studies that had been deemed to have a low- or moderate risk of bias. He also said that study authors had found that unintended pregnancy rates during typical POP use were lower than they expected. If all studies are included and if studies with high risks of bias are excluded.
Zuniga stated that most of the literature about POP efficacy is based on older POP formulations. The information comes from studies published between 20 and 50 years ago. Researchers now have better methods for collecting data and reporting results. Future studies that evaluate the effectiveness or efficacy of POP should use Pearl Index rates with confidence intervals. Report life-table rates with. Zuniga stated that further research is required to determine if and how patients’ characteristics influence effectiveness rates for various POP formulations.
She told Contemporary OBGYN(r) that decades of research have shown that POPs can be used as a safe and effective contraceptive method. However, only 4% of US birth control pill users use them. Although the reasons for low use rates are not known, it is possible that providers may be hesitant to prescribe POPs. There is also the belief that POPs lose their effectiveness if they are not taken within a 24-hour period. This includes a 3-hour window. This belief is supported by very few clinical studies and several studies. However, it turns out that some formulations, such as desogestrel, norgestrel and drospirenone, may not apply to this timing.
He stated that the current guidelines and recommendations for POPs must be updated to reflect new findings. There are many POP formulations available, but only two are currently available in the US: Drospirenone and Norethindrone. FDA is currently reviewing a request for an over-the-counter POP product that contains norgestrel. Zuniga stated that more POP products are now available in the US. This allows providers to help patients understand the differences among POPs as well as the differences between POPs and combined estrogen/progestin oral contraceptives.