Mechanism of Action:

Ella operates primarily by influencing progesterone, the hormone pivotal for ovulation and the sustenance of pregnancy. Here’s a detailed breakdown of its function:

Prevention or Delay of Ovulation: The active component, Ulipristal acetate, attaches to the progesterone receptor, effectively inhibiting the action of progesterone within the body. This process obstructs or postpones the release of an egg from the ovary, a crucial step for fertilization. In the absence of egg release, sperm cannot achieve fertilization.

Modification of Cervical Mucus: Additionally, it may modify the cervical mucus, rendering it denser and more challenging for sperm to navigate through to reach the egg.

Alteration of the Endometrium: There is some indication that Ella may also modify the uterine lining (the endometrium), potentially making it less hospitable to a fertilized egg, thereby hindering implantation. However, this is regarded as a secondary mechanism.

Timing and Usage:

Timing: Ella is most effective when administered within 120 hours (5 days) following unprotected intercourse or contraceptive failure, with optimal efficacy occurring the sooner it is taken. Its effectiveness diminishes with time.

Single Dose: The formulation consists of a single oral dose of 30 mg.

No Impact on Existing Pregnancy: It is important to note that Ella does not terminate an existing pregnancy nor does it harm a fertilized egg that has already implanted in the uterus. Its sole purpose is to prevent pregnancy following unprotected intercourse.

Efficacy:

Ella boasts an impressive efficacy rate of up to 85% when administered within 24 hours following unprotected intercourse. However, its effectiveness diminishes with time; the longer one waits to take the pill, the less effective it becomes. Notably, after a span of 72 hours (3 days), the effectiveness experiences a significant decline.

Body Weight: For women with a BMI exceeding 30, Ella may exhibit reduced effectiveness. Nevertheless, it remains the premier choice for emergency contraception for those with higher body weights, surpassing alternatives such as Plan B.

Side Effects:

While Ella is predominantly safe, it is not without potential side effects. Common and generally mild reactions may include:

– Headaches

– Nausea and vomiting (should vomiting occur within three hours of ingestion, an additional dose may be necessary)

– Abdominal discomfort

– Fatigue

– Alterations in menstrual cycles (such as early, delayed, or heavier periods)

– Dizziness or lightheadedness

– Breast tenderness

– Mild mood fluctuations

Most of these side effects are transient and typically resolve shortly after the pill is taken.

Drug Interactions:

Certain medications may compromise the effectiveness of Ella. These include:

– Enzyme inducers: Drugs that enhance liver enzyme activity, such as those prescribed for epilepsy (e.g., phenytoin, carbamazepine), tuberculosis (e.g., rifampicin), and HIV (e.g., ritonavir), can diminish Ella’s efficacy.

– Antifungals and antibiotics: Some medications, including St. John’s Wort, may interact adversely with Ella, thus it is prudent to consult a healthcare provider or pharmacist prior to combining treatments.

Contraindications:

Ella is generally safe for the majority of women, yet it may not be appropriate for everyone. Consider the following:

– Pregnancy: Ella should not be utilized if pregnancy is already confirmed. While it does not pose harm to the fetus or induce miscarriage, it is ineffective for terminating an existing pregnancy.

– Severe liver conditions: Individuals with liver issues should seek medical advice before using Ella.

– Breastfeeding: Ella is deemed safe for nursing mothers; however, it is recommended to wait at least 36 hours post-ingestion before resuming breastfeeding.

Body Weight:

For women with a BMI over 30, Ella may show diminished effectiveness. Nonetheless, it remains the superior option for emergency contraception for those with higher body weights, outshining alternatives like Plan B.

Side Effects:

While Ella is largely safe, it is not devoid of potential side effects. Common and generally mild reactions may encompass:

– Headaches

– Nausea and vomiting (if vomiting occurs within three hours of ingestion, an additional dose may be required)

– Abdominal discomfort

– Fatigue

– Changes in menstrual cycles (including early, delayed, or heavier periods)

– Dizziness or lightheadedness

– Breast tenderness

– Mild mood fluctuations

Most of these side effects are temporary and typically resolve shortly after the pill is consumed.