frequently asked questions

The late period pill is for people whose period is up to 3 weeks (21 days) late. It involves taking 3 doses of misoprostol.

The late period pill is not for people who want to know if they are pregnant. As part of the study, you will first provide a urine sample for a pregnancy test but neither you nor the clinic staff will know the results of the test.

Three doses of misoprostol will be given for you to take on your own. The second dose will be taken 3 hours after the first dose. The third and final dose will be taken 3 hours after the second dose.

After taking the medication, you should have bleeding and cramping, heavier than your usual period. This can last 2 to 3 days.

Four weeks after taking the medication, you will answer questions on the online follow-up survey. Then, you will need to come back to the health center to provide a second urine sample. The results of this test will help study staff know whether the late period pill worked or if follow-up care is needed.

The late period pill is for people who suspect they are pregnant because their period is late, but have not confirmed pregnancy.

A medication abortion (or abortion pills) is for people who have confirmed they are pregnant (using a test, ultrasound or exam conducted by a doctor or nurse) and want to end their pregnancy. However, the same pills are used for both.

A late period pill will end a pregnancy if you are pregnant.

Emergency contraception (or Plan B) is a large dose of contraceptive (or birth control) medication that is given to a person up to 72 hours (3 days) after having sex (well before a person thinks they have a late period). It is used to prevent pregnancy.

A late period pill is for people who suspect they may be pregnant because their period is up to 3 weeks (or 21 days) late. It involves taking medication that causes the uterus to push out its contents, including any potential pregnancy. It is used to end a possible pregnancy if there is one.

Misoprostol is used for a variety of purposes, including preventing ulcers in the stomach during treatment with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs and aspirin are used to treat pain, fever, arthritis, and inflammatory conditions. It is also used in combination with another medication (mifepristone) to end a pregnancy. It can also be on its own to end early pregnancies.

No, misoprostol is frequently used among people who are not pregnant to prevent stomach ulcers

There is substantial research on the use of misoprostol for a variety of indications, including for people who have confirmed they are pregnant and want to end their pregnancy. This research shows that misoprostol-alone for abortion is highly effective – with an efficacy rate of 93-100%. That means that the pills may not work for up to 7% of participants. People who are not pregnant also safely take misoprostol for conditions like stomach ulcers.

You will answer a series of questions about your period on the study website about your personal beliefs, background, pregnancy history and to see whether you qualify for the study. Based on your responses, you will be told whether you qualify to participate.

If you qualify and want to participate, you will then complete the consent process remotely.

If you complete the consent process, you will then enroll in the study and provide contact information. You will be asked for your contact information and contact information for a friend or family member in case we can't reach you.

Next, you will be asked to call the study team to review the consent information and to schedule a visit to the health center.

At the health center you will:

• Provide a urine sample to the health center staff that will be tested later for pregnancy status. These results will not be shared with you.

• Receive 3 doses of the the late period pill (misoprostol) and receive instructions to take with you.

• Receive at at-home pregnancy test kit to use at your virtual visit 2-4 weeks later.

After you leave the clinic (at home or elsewhere), you will:

• Place the pills in your mouth between your cheek and gum, leaving the tablets there for 30 minutes and then swallowing the remainder of the tablets.

• Within 3 and then 6 hours of taking the first dose at the clinic visit, you will take the 2 remaining doses of late period - each dose, 3 hours apart.

Within 2-4 weeks, you will:

• Attend a virtual (Zoom) follow-up visit. This visit is required so we can ensure that the late period pill worked.

• At this visit, you will use the at-home pregnancy test kit provided to you and share the results of the pregnancy test with the research team member to confirm that the late period pill worked. In a rare case that the pregnancy test is positive, a health center staff will help you to get follow-up care.

Receive a link to an online follow-up survey by text or e-mail.

Complete the online survey to answer questions about symptoms related to the use of the medication [bleeding, cramping, pain after taking the pills] and your experience in the study.

Item Yes, your privacy is very important. Your email address or text number will be used to contact you to check in to see if you have questions, to remind you of the required follow-up contact and interview, and to send you the online follow-up survey to complete. Your personal information will not be shared with any people outside the research study.

The study uses an encrypted, HIPAA-compliant data collection system. The information that you provide to the health center staff will be stored securely, just as it would be for other services at the clinic. No identifiable personal information will be shared with any external parties.description

Participating in the Late Period Pill Study has several potential advantages:

If you are worried that you may be pregnant because your period is late, you will have an option to bring your period back. You will be able to ensure you are not pregnant.

The study will cover the cost of the late period pill and pregnancy tests.

You may be able to obtain treatment sooner than if you had to schedule an appointment at a clinic for abortion care.

But participating in the Late Period Pill Study may also have disadvantages for some people:

• You will not find out if you are pregnant.

• You will need to attend a follow-up visit remotely (i.e., over Zoom) after taking the medication and this may be inconvenient for some people.

Yes, the late period pill study welcomes people of all genders. We believe our study is strengthened with greater diversity among participants.

You will not be charged for the medications in this study.

If a study doctor or nurse says you need to get additional tests or follow-up care, your insurance (if you have insurance) will pay for these services and any out-of-pocket costs will be covered by the study so there will be no direct costs to you.

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No, there is no control group in the study because misoprostol has already been proven to be effective at inducing uterine bleeding. All participants will receive the same study medication, misoprostol.

To qualify for the Late Period Pill Study, you will need to meet the following criteria. These include:

• Be 18 years or older

• Speak English

• Have a period that is late up to 21 days (up to 3 weeks)

• Be certain that your period is late by 21 days or less.

• Have had regular periods in the last 4-6 months.

• Do not want to be pregnant.

• Understand that if you are pregnant, the pills will end your pregnancy.

• Plan to have an abortion if the late period pill does not work, and understand that there is the potential for birth defects if any ongoing pregnancy.

• Do not want to verify pregnancy status.

• Do not have any risk factors for ectopic pregnancy (any ectopic pregnancy in the past, recent vaginal bleeding or spotting, recent pelvic pain on one side, or past permanent contraception or tubal surgery).

• Do not have an IUD.

• Do not currently use a contraceptive implant or injectable.

• Do not have a known allergy to misoprostol.

• Agree to participate in the follow-up visit 4 weeks later.

Based on the information you provide, the study team will let you know if you qualify to participate in the Late Period Pill Study.

Dr. Ushma Upadhyay of the University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH) is conducing this study. ANSIRH is a group of researchers in the Department of Obstetrics, Gynecology, and Reproductive Sciences. Our mission is to conduct innovative and rigorous research on complex issues related to people’s sexual and reproductive lives.Item description