Health
New Research Finds Potential Alternative to Abortion Pill Mifepristone
A new study suggests a possible alternative to the abortion pill mifepristone, a drug that continues to be a target of lawsuits and legislation from abortion opponents.
But the potential substitute could further complicate the politics of reproductive health because it is also the key ingredient in a contraceptive morning-after pill.
The new study, published Thursday in the journal NEJM Evidence, involved a drug called ulipristal acetate, the active ingredient in the prescription contraceptive Ella, one of two types of morning-after pills approved in the United States. (The other, Plan B One-Step, which does not require a prescription, contains a different drug and does not work in a way that would terminate a pregnancy, according to scientific evidence.)
In the study, 133 women who were up to nine weeks’ pregnant took twice the dose of the ulipristal acetate contained in Ella, followed by misoprostol, the second drug used in the typical medication abortion regimen. All but four of the women completed the termination of their pregnancies without further intervention, a 97 percent completion rate that is similar to the regimen using mifepristone. (The others finished the process with additional medication or a procedure.)
There were no serious complications, and the study concluded that using ulipristal acetate for abortion was safe.
Dr. Beverly Winikoff, the lead author of the study and the president of Gynuity Health Projects, a reproductive health research organization, said that after the Supreme Court overturned the national right to abortion in 2022, she began wondering about a possible role for ulipristal acetate, which has a similar chemical structure to mifepristone.
“I was thinking, there’s maybe something else we can do,” she said. “Another option. And this one is already on the market.”
The political implications of the study are complex because of their potential to blur the line between the public perception of emergency contraception and abortion. For years, abortion opponents have opposed morning-after pills by saying they can cause abortions, and reproductive health experts have countered by pointing to scientific evidence that the pills do not terminate pregnancies but instead act to prevent pregnancy after sex.
Some reproductive health experts are concerned that research showing that a morning-after pill ingredient can be used for abortion could stoke attempts to crack down on emergency contraception and sow confusion that could bolster the larger anti-abortion strategy.
Kristi Hamrick, a spokeswoman for Students for Life of America, said her organization would “absolutely” consider litigation over Ella.
“The pro-life movement should be vindicated,” Ms. Hamrick said. “We’ve been arguing for years that Ella acts as an abortifacient.”
Mary Ziegler, a law professor and abortion expert at the University of California, Davis, said the study could present challenges for both sides of the abortion debate.
“It’s going to put wind in the sails of abortion opponents who have been saying things like contraceptives can be abortifacients,” she said, adding, “This study being released will be difficult, I think, for abortion rights supporters to manage.”
But Ms. Ziegler said the study’s findings could also be “politically risky” for abortion opponents because public support for contraception is high and many voters in conservative states endorsed ballot measures protecting abortion rights. “I think it’s one of those things that’s going to tempt social conservatives to push probably faster than politics would currently permit in the direction of regulating contraception,” she said. “And I think that could backfire.”
Reproductive health experts said the new study did not refute the science showing that morning-after pills don’t induce abortions, because it involved a different dose of the drug.
Abortion opponents said they were not surprised by the study’s findings.
“After years of denying ulipristal acetate’s potential to end the life of an embryo, abortion advocates are now starting to use it as a substitute for the abortion drug mifepristone,” Dr. Donna Harrison, director of research for the American Association of Pro-Life Obstetricians and Gynecologists, said in a statement. “The reason for this is simple. Ulipristal and mifepristone function in the same way.”
Ella was already a target for some conservatives. Project 2025, a right-wing policy blueprint that has been strongly tied to the new Trump administration, said that Ella should be removed from required insurance coverage of contraception under the Affordable Care Act because it is “a potential abortifacient.”
Mifepristone, the first pill in the standard two-drug medication abortion regimen, is the only drug specifically approved for abortion in the United States. Typically used through 12 weeks’ gestation, mifepristone stops the development of a pregnancy by blocking the hormone progesterone. The second drug, misoprostol, is taken 24 to 48 hours later and causes contractions similar to a miscarriage.
Ulipristal acetate is in the same class of medications as mifepristone and also blocks the activity of progesterone, a hormone that prepares the uterus to receive and hold an embryo, said Dr. Daniel Grossman, a reproductive health physician and researcher at the University of California, San Francisco, who was not involved in the new study.
In the study, a 60 milligram dose of ulipristal acetate (double the 30 milligrams in Ella) was substituted for mifepristone and followed by misoprostol, which has various medical uses and has not been targeted as much by abortion opponents. (Misoprostol can also facilitate an abortion on its own, but is considered more effective in a combination regimen.)
Reproductive health experts said they welcomed the search for alternatives to mifepristone because abortion opponents have been waging efforts to sharply restrict the medication across the country, most notably with a federal lawsuit against the Food and Drug Administration. The Supreme Court rejected that lawsuit last year, ruling that the initial plaintiffs lacked standing to sue, but the suit has since been revived with three states as plaintiffs.
Dr. Grossman, who wrote an editorial about the study, said the prospect of a substitute for mifepristone was “certainly a promising finding.” But, he added, “if because of this new evidence that at higher doses, ulipristal acetate could cause an abortion, that were to lead to ulipristal acetate being taken off the market for emergency contraception, that would be really, really bad.”
The company that manufactures Ella, Perrigo, issued a statement saying that Ella “was not tested in this study.” It added, “Ella is an F.D.A.-approved emergency contraception pill that acts before pregnancy can occur,” she continued. “There continues to be no evidence to show that, on its own, Ella causes an abortion.”
The study was conducted in Mexico City and was co-led by researchers there.
Several experts said that because it was a relatively small first study with no comparison group of patients, more research was needed before ulipristal acetate should be used for abortion. “We can’t change clinical practice based on this study,” said Kelly Cleland, a researcher who is the executive director of the American Society for Emergency Contraception.
Scientists have long understood that hormone-based drugs may be able to play different functions at different doses along the spectrum of a woman’s reproductive health cycle.
In Europe, researchers including Dr. Rebecca Gomperts, a Dutch physician and founder of telemedicine organizations that provide abortion pills globally, are studying low doses of mifepristone as a weekly birth control pill. Dr. Gomperts said she considered the new ulipristal acetate study sufficient to prescribe the drug off-label for medication abortion.
“The more uses we have for these medications, the harder it will be for people to take them away,” said Dr. Paul Blumenthal, an emeritus professor of obstetrics and gynecology at Stanford University who was in an advisory group for the study.
Plan B is a much more widely used morning-after pill in the United States, but Ella is considered more effective for some women, including people who are overweight. Plan B is intended to be taken within three days after unprotected sex, while Ella can be taken within five days.
Both pills prevent pregnancy by blocking ovulation, the release of eggs from the ovaries that occurs before eggs can be fertilized, scientific studies have shown.
The claim by some abortion opponents that morning-after pills are abortion drugs is based on a theory that they might also prevent a fertilized egg from implanting in the womb. Most scientific research has not found that to be the case.
For years, despite scientific evidence to the contrary detailed in an investigation by The New York Times, the F.D.A.-approved label and packaging for Plan B One-Step said that while the pill worked by blocking ovulation, there was a possibility it might prevent implantation. In 2022, the agency changed the language to make it clear that Plan B acts only before fertilization, “will not work if you’re already pregnant, and will not affect an existing pregnancy.”
The F.D.A. label for Ella says that its “likely primary mechanism of action” is to stop or delay ovulation. The label adds that the medication may also affect implantation. Studies in recent years, however, suggest that Ella does not operate by blocking a fertilized egg from implanting in the womb.
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Research continues to uncover new details on how fasting may help extend life.
A new study published in the journal Nature Communications investigated how intermittent fasting can boost longevity in small worms often used in aging research.
Researchers from the University of Texas Southwestern Medical Center in Dallas compared worms that were fed normally to those that underwent a 24-hour fast in early adulthood and were then fed again, according to a press release.
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The scientists measured a variety of factors, including stored fat, gene activity related to fat metabolism and lifespan.
The results showed that the life-boosting benefit did not depend on the fasting itself but on the body’s behavior after eating again.
Experts say sustainability is key when choosing a long-term weight-loss strategy. (iStock)
Study lead Peter Douglas, associate professor of molecular biology and a member of the Hamon Center for Regenerative Science and Medicine at UT Southwestern, suggested that these discoveries “shift the focus toward a neglected side of the metabolic coin – the re-feeding phase.”
“Our data suggest that the health-promoting effects of intermittent fasting are not merely a product of the fast itself, but are dependent on how the metabolic machinery recalibrates during the subsequent transition back to a fed state,” he said.
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“Our findings bridge a gap between lipid metabolism and aging research,” he added. “By targeting aging, the single greatest risk factor for human disease, we move beyond treating isolated conditions toward a preventive model of medicine that enhances quality of life for all individuals.”
Lauri Wright, director of nutrition programs at the University of South Florida’s College of Public Health, called this a “high-quality” study that adds an “important nuance to how we think about fasting and longevity.”
Intermittent fasting typically involves limiting meals to an eight-hour daily window or fasting every other day. (iStock)
The benefits of the refeeding phase after fasting were “especially interesting,” Wright, who was not involved in the study, told Fox News Digital.
“The researchers showed that longevity was linked to the body’s ability to turn off fat breakdown after fasting, allowing cells to restore energy balance,” she reiterated.
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“From a scientific standpoint, that’s a meaningful shift because it suggests fasting is not just about burning fat, but about metabolic flexibility.”
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Fasting may support longevity through triggering metabolic switching, enhancing cellular repair and stress resistance and improving markers like insulin sensitivity, research shows.
Limitations and cautions
Although this study provides “important insight” on the power of refeeding, Wright noted that the findings should be approached with caution, as the study was done on worms and cannot always be translated to humans.
“Additionally, it explains how a process might work in a controlled lab condition rather than real-world eating behaviors,” she added as a limitation. “Finally, the study is short-term and doesn’t give us the long-term translation on lifespan outcomes.”
The review found intermittent fasting was barely more effective than doing nothing, according to the study authors. (iStock)
Wright cautioned that fasting is “not a magic solution for longevity, and how you eat overall matters more than when you eat.”
“I advise, first and foremost, to focus on diet quality, including a variety of fruits and vegetables, healthy fats and minimally processed foods,” she said.
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For those who are considering fasting, it’s better to stick with a moderate plan — like a 12- to 14-hour overnight fast — rather than going to extremes, Wright said. After fasting, she recommends focusing on well-balanced meals.
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Several groups of people should be cautioned against fasting, according to Wright, including those with diabetes who are on insulin or hypoglycemic medications, those who are pregnant or breastfeeding, anyone with a history of eating disorders and older adults at risk of malnutrition.
Anyone considering intermittent fasting should consult with a doctor before starting.
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More than three million people travel to undergo cosmetic surgery each year, statistics show — but the potential savings come at a cost.
Most people opting to pursue this so-called “medical tourism” are chasing budget-friendly price tags.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks, according to board-certified plastic surgeon Dr. Sheila Nazarian of California.
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The doctor recently joined Lisa Brady on the “The FOX News Rundown” podcast to discuss the rising trend of medical tourism. One of the biggest risks, she said, is the lack of safety regulations in popular destinations like Mexico and Turkey.
As demand spikes in these medical tourism “mills,” there have been reports of non-medically trained staff performing procedures like hair transplants.
Most people opting to pursue “medical tourism” are chasing budget-friendly price tags. (iStock)
“I’ve heard that they [international clinics] are even recruiting people who maybe were taxi drivers and then putting them through their own training program … to become hair transplant technicians,” Nazarian said. “That’s how high the demand has become.”
In the U.S., medical school graduates are granted a “physician and surgeon” license, which means doctors — including pediatricians or OB-GYNs — can legally perform cosmetic surgeries, even if they didn’t receive specialized training for those procedures during residency, Nazarian noted.
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Instead of pinching pennies, the doctor recommended paying whatever amount is necessary to ensure quality treatment.
“People think of it as, you know, going to the mall. … It’s surgery, and surgery has risks,” she said. “You need to be with someone who not only can perform a beautiful surgery, but who can handle possible complications well.”
“You need to ask them: ‘What was your residency training in? And if you wanted to, would you be allowed to do this procedure in a hospital?’”
Aftercare is another critical factor in the success and safety of a cosmetic procedure, as the doctor emphasized that 20% of a surgical result depends on post-operative care.
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This can be difficult or even impossible to manage when a doctor is in a different time zone, she cautioned, or if the clinic disappears shortly after the procedure.
Nazarian also noted the importance of addressing the psychological component of plastic surgery, noting that no procedure will fix underlying unhappiness. The doctor said she uses screening questionnaires to ensure that patients are truly seeking self-improvement rather than a “cure” for deeper issues.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks. (iStock)
“If you’re not already generally very content with your life, a knife in my hand is not going to bring you there,” Nazarian said.
“The analogy I always give is you don’t want a paisley couch — you want a neutral couch and you can put paisley pillows on it,” she said, noting that a procedure should “make you look normal, God-given, athletic. And then you can change your clothes when the trends come and go.”
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Samuel Golpanian, M.D., a double board-certified plastic surgeon in Beverly Hills, said he has also seen an increasing number of patients undergoing cosmetic procedures abroad, sometimes with “devastating consequences.”
“The key is being extremely careful before embarking on this journey.”
“I’ve seen a wide range of complications, including infections, poor wound healing, significant scarring and tissue necrosis (skin death),” he told Fox News Digital. “These complications often lead to prolonged pain, ongoing medical problems, and significant additional costs to repair the damage.”
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Golpanian said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues.
One surgeon said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues. (iStock)
“I’ve also seen damage to underlying structures, asymmetry and results that are extremely difficult — sometimes impossible — to correct.”
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“That said, I’ve also seen some good outcomes, so it’s not all bad,” he noted. “The key is being extremely careful before embarking on this journey.”
Quick tips for safe ‘medical tourism’
Fully vet the surgeon. “Most surgeons will provide information about their education and training, but it’s important not to accept these claims at face value,” Golpanian said. “Verify them directly by contacting the institutions where they trained.”
Ask for references from prior patients. Ideally, it’s best to get references from U.S.-based patients who can speak candidly about both their experience and their results, the surgeonsaid.
Think beyond the cost. Golpanian emphasized the adage “you get what you pay for.” “Cost should take a back seat to experience, training, judgment and proven results,” he advised.
Be cautious about relying on before-and-after photos. These can be selective or even enhanced, Golpanian warned.
Keep aftercare in focus. “Make sure the practice emphasizes comprehensive follow-up care and has a clear, realistic post-operative plan in place.”
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