How the ‘abortion pill’ could work as birth control - The Verge
Activists are trying to establish the contraceptive efficacy of mifepristone, a medication currently known as an "abortion pill," with crowdfunded research.
Imagine a totally new form of contraception. It’s a pill, but instead of taking it every day at the same time, you only take it once a week — or, potentially, even less frequently. If you’re not having regular sex, you can stop and start this pill as needed or just take it after you’ve had sex since it also works great as a “morning after” pill. It doesn’t contain the hormones estrogen or progesterone, so many of the side effects commonly associated with current birth control pills (including weight gain, mood swings, acne, and decreased libido) aren’t an issue. And if you wind up taking it long term, it thins your uterine lining, eliminating your period. More amazingly, it also has the potential to treat endometriosis and fibroids and maybe even prevent breast cancer.
Sound too good to be true? Here’s the best part: this hypothetical birth control pill already exists, has been extensively researched for both safety and efficacy, and, even better, is an FDA-approved medication. The catch? It’s mifepristone, better known as the “abortion pill” that Republicans around the country are currently trying to ban. At a moment when abortion access feels newly precarious, abortion advocates are hoping that a focus on mifepristone’s contraceptive properties will help tear down the artificial wall between “abortion” and “contraception” in the process — and help secure mifepristone access around the globe.
Mifepristone’s contraceptive properties aren’t actually news. Throughout the 1990s and 2000s, researchers like Kristina Gemzell Danielsson, a professor of obstetrics and gynecology at the Karolinska Institutet, examined the compound’s efficacy as both emergency contraception and a birth control pill. Though there was some debate over whether mifepristone worked best as a weekly or monthly contraceptive, the general consensus was that it showed great promise as a non-hormonal birth control pill. The same mechanism that it uses to halt fetal development — blocking the release of progesterone — can also be used to prevent ovulation and thin the uterine lining, making pregnancy impossible.
But about a decade ago, research interest in mifepristone seemed to dry up — largely, Gemzell Danielsson thinks, because of abortion stigma. Another compound, ulipristal acetate, held similar promise as an emergency contraceptive and fibroid treatment without the baggage of abortifacient branding. “It was sort of decided that [ulipristal acetate] should be developed more for contraception while mifepristone should be developed for abortion,” says Gemzell Danielsson, noting that ulipristal acetate went on to become a common emergency contraceptive (sold as Ella) and fibroids medication (under the brand name Esmya).
But ulipristal acetate has risks mifepristone doesn’t. Notably, there have been rare but serious instances of liver damage when taken regularly to treat fibroids. In contrast, mifepristone has largely been found to be safe, even when taken in large doses on a daily basis (Cushing’s syndrome patients routinely take 300-1200mg of mifepristone daily, vastly more than the 25-50mg a week required for contraception). Researchers have also found it’s a safer alternative to current endometriosis medications as well as a safe and effective fibroids treatment — and though it’s still early in the process, Gemzell Danielsson has been involved in studies that show promise for using mifepristone for breast cancer prevention.
Rating: 5