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Mifepristone A Promising Estrogen-Free Contraceptive

Daily low-dose mifepristone is a potentially safe oestrogen-free contraceptive pill, with the added health benefit of amenorrhoea, suggests a joint study in Scotland and China.

The drug suppressed ovulation and menstruation in most cycles among sexually-active women participating in this study, report researchers from the University of Edinburgh, Edinburgh, and the Shanghai Institute of Family Planning Technical Instruction, Shanghai. Moreover, there was asynchrony between ovarian activity and endometrial histology, which showed no signs of hyperplasia or atypia.

Dr D T Baird and colleagues collected endometrial biopsies from 90 women in Edinburgh and Shanghai before (late proliferative) and then again 60 and 120 days after the women had taken either 2 or 5 mg mifepristone per day for 120 days.

The study found that ovulation and menstruation were inhibited in more than 90% of cycles. Oestrogen production was similar to that observed during the follicular phase of the control cycle.

At 120 days, endometrial thickness increased significantly in women in Edinburgh but decreased in Shanghai. Endometrial histology indicated inactive proliferative or cystic changes with dense stroma.

There was a significant decrease in markers of proliferation, i.e. mitotic index and Ki67 staining.

No pregnancies occurred in a total of 200 women-months among 50 sexually active women who were using no other method of contraception.

Data from this preliminary study indicate ovulation and menstruation were suppressed in the majority of cycles, and there was asynchrony between ovarian activity and endometrial histology, with no signs of hyperplasia or atypia, the researchers note.
Hum Reprod 2003 Jan;18:1:61-68. "Effect of long-term treatment with low-dose mifepristone on the endometrium."

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