Suppression of follicular rupture with meloxicam, a cyclooxygenase-2 inhibitor: potential for emergency contraception.
Level 2 - randomized trial
Individual randomized controlled crossover trial
PubMed 19933235 · doi:10.1093/humrep/dep392
What was done
Researchers assessed the effect of oral meloxicam (15 mg/day vs. 30 mg/day for five consecutive days) on ovulation when initiated during the late follicular phase once the leading follicle reached 18 mm. The study was a single-center, double-blind, randomized crossover trial in 27 surgically sterilized women aged 18–40 years with regular menstrual cycles. Volunteers completed two treatment cycles separated by a resting cycle, randomized to dose sequence. Measured outcomes included follicular rupture, serum LH, estradiol, progesterone levels, and adverse events.
What was found
Twenty-two volunteers completed both cycles. Dysfunctional ovulation occurred in 11/22 (50%) cycles treated with 15 mg/day and 20/22 (90.9%) cycles with 30 mg/day (P = 0.0068). All participants maintained normal luteal phase progesterone levels (mean maximal values +/- SEM: 42 +/- 4.1 nmol/l for 15 mg/day vs. 46.8 +/- 2.6 nmol/l for 30 mg/day). No serious adverse events occurred, and no differences between doses were observed for LH, estradiol, or menstrual cycle length.
Why it matters
Meloxicam at 30 mg daily effectively blocks follicular rupture even when administered late in the follicular phase, suggesting potential utility as a non-hormonal emergency contraceptive with a wider therapeutic window.
Limits
Small sample size (22 completed) in surgically sterilized women, meaning actual pregnancy prevention could not be evaluated. The study tested a multi-day regimen rather than single-dose emergency administration and lacked a placebo arm.
Cited by
- supports Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen around the time of ovulation can inhibit the acute inflammatory cascade and prevent the ovarian follicle from rupturing.