Six years after deregulation of emergency contraception in Switzerland: Has free access induced changes in the profile of clients attending an emergency pharmacy in Zürich?

ABSTRACT

Objectives Emergency contraception (EC) has been freely accessible in Swiss pharmacies since November 2002. Today some groups are still concerned that free access might result in less use of efficient contraceptive methods, overuse and more risky sexual behaviour.

Methods Profiles of EC users one and six years after deregulation were analysed with regard to age, contraceptive methods used, reasons for EC use, and last contact with a gynaecologist. Data were collected from a centrally located pharmacy. Written official assessment forms concerning 1500 women (750 in 2004 and 750 in 2009) were analysed.

Results Free access to EC use had no impact on regular contraceptive behaviour. The percentage of pill and condom users was very high (85%). The percentage of EC-users without any contraception (17–18%) was the same over the years. In 2009, condom rupture was reported more frequently (p < 0.001). In addition significantly more women had used EC previously in their history.

Conclusion Free access to EC has not resulted in less use of efficient contraceptive methods. In the context of falling abortion rates our results are reassuring. This also applies to adolescents, who mainly used EC as a back-up method and seldom in the context of unprotected intercourse.

KEYWORDS:

• Emergency contraception
• Norlevo^®
• Levonorgestrel
• Contraception
• Adolescents
• Community pharmacy
• Switzerland

ACKNOWLEDGEMENTS

We thank Ingrid Barrage from the Bahnhof-pharmacy in Zürich for providing the data and anonymising the assessment forms and cand. med. Ursina Bruderer for entering the data.

Declaration of interest: G.M. has received occasional lecture, clinical trial and consultancy fees from Organon and Bayer Schering Pharma. The authors alone are responsible for the content and the writing of the paper.