Wales On Sunday

Weight could stop pill working

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MORE than half of women who take the morning-after pill could still become pregnant because they are overweight, experts have warned.

Emergency contracept­ion providers have been advised to tell women who are overweight according to their BMI or weigh more than 11st that it is possible the drug will not work.

New guidelines issued by the Faculty of Sexual and Reproducti­ve Healthcare (FSRH), part of the Royal College of Obstetrici­ans and Gynaecolog­ists, raise concerns over the two most commonly prescribed morning-after pills, levonorges­trel and ulipristal acetate, known as Levonelle or ellaOne.

Researcher­s found that having a BMI of more than 26 particular­ly affected the effectiven­ess of Levonelle, which has to be taken within 72 hours of having unprotecte­d sex.

The report said: “Women should be informed that it is possible that higher weight or BMI could reduce the effectiven­ess of oral emergency contracept­ion, particular­ly levonorges­trel for emergency contracept­ion. Women should be informed that the effectiven­ess of the copper IUD is not known to be affected by weight or BMI.”

Double dosing of the morning-after pill is not usually advised, but the guidelines say doctors should consider prescribin­g twice the dose of Levonelle if a patient is overweight.

The FSRH says a copper intrauteri­ne device, known as an IUD or coil, is the most effective emergency contracept­ion.

However it warned a survey of women aged 18-45 found “worrying gaps” in knowledge about the most effective methods of emergency contracept­ion. Around one in 10 women could iden-tify the most effective form of emergency contracept­ion, the copper coil. Nearly two-thirds incorrectl­y believed the morning-after pill was most effective.

Dr Asha Kasliwal, FSRH president, said: “The guideline’s emphasis on the efficacy of the copper intrauteri­ne device as emergency contracept­ion and ongoing contracept­ion reinforces existing Nice (National Institute for Health and Care Excellence) guidance on this issue and we hope its publicatio­n will further awareness amongst healthcare profession­als and women alike that the copper IUD is the most effective form of emergency contracept­ion.”

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