Contraception

Contraception methods is an umbrella term that encompasses several birth control techniques that are used to prevent fertilization. Contraception includes barrier methods like condoms as well as oral contraceptives and injectable contraceptives. It is different from contragestion in that this involves post coital birth control, including intrauterine devices and morning after pills. Contraception is a very ancient practice, with a Kahun papyrus (old Egyptian text) mentioning several then current contraceptive methods including vaginal plugs and pessaries. Moreover, Soranus of Ephesus came up with a spermicidal barrier made with a combination of acidic fruits, nuts and wool back in the early 2nd Century.

While a very individual choice, contraception methods can have worldwide effects, especially in terms of overpopulation, as it is estimated that the population of the world will double in 40 years. This poses a threat to human survival and to the balance of the planet’s resources. On a more personal level, effective contraception can allow a woman to accomplish her goals and improve her overall sense of well-being. Contraception methods are divided by Clitoris.com into several categories, each with different levels of efficacy, safety and cost.

Periodical abstinence is comprised of coitus interruptus and natural family planning. Coitus interruptus means to withdraw the entire length of the penis from the vagina before ejaculation occurs. The lack of contact between spermatozoa and ovum would ideally prevent fertilization, however the likelihood of pregnancy is high is the method is applied incorrectly or inconsistently. On the plus side, it is immediately available, doesn’t require any devices or chemicals, and it is free of cost. Natural planning revolves around couples trying to avoid the woman’s fertile period, which can be determined by means of calendar, cervical mucus or symptothermal methods. The benefits are basically the same as with coitus interruptus. The disadvantages are that the woman needs to have regular and predictable cycles, discipline is required to maintain full abstinence during the fertile period, and the rate of failure is somewhat high, approximately 25%.

Mechanical barrier include both male and female condom. The male condom is a thin sheath usually made with latex, although other materials are available. Besides contraception, it also provides effective protection from sexually transmitted diseases. Low price is another reason for its popularity. Failure is mostly associated with improper use, for instance failure to put it on correctly and use of oil based lubricants with latex condoms. The female condom is composed of two flexible rings, one at the closed end as an insertion mechanism and inner anchor placed inside the vaginal canal, and other that forms the external edge and stays outside of the canal. The female condom has a diameter of 7.8 cm and a length of 17 cm and prevents pregnancy by blocking the passage of semen into the vagina. The inside is coated with a silicone based lubricant, but it doesn’t contain spermicide; it can be placed up to 8 hours prior to intercourse, but it might be difficult to insert and the interior ring may be uncomfortable. Currently it is used by less than 1% of women in the U.S.  Other barriers are the diaphragm and the cervical cap.

Oral contraception methods exist in the U.S. Market since 1962, and today there are more than 30 formulations available that prevent ovulation. Women have to follow an administration schedule to maximize effectiveness. In case they miss a dose, they should make up for it as soon as possible and then take one tablet twice a day until the missed pill is covered. Perfect use yields a 0.1% failure rate. The disadvantages include side effects such as nausea, breast tenderness, breakthrough bleeding, amenorrhea and headaches.