Contraceptive

Contraceptive - Family planning

Alternatives to Vaginal Intercourse

Abortion

Already Soranus, a physician from Ephesos, practicing in the old Rome, found out more than 1800 years ago, that it is better to prevent the conception, than to abort when pregnant.
Unfortunately this old simple advice is not always obeyed today, although it is to day very simple to prevent a pregnancy, but only about 2 % of all women do it.

At the beginning of all methods to prevent pregnancy men's used withdrawal, also called Coitus interruptus , ejaculation outside the vagina (Book Genesis, Cap. 38, V. 9). But the interrupt is neither helpful for lovemaking, nor offers a effective method to prevent an unwanted pregnancy.

How can the effectiveness of a contraceptive method be measured?
The PEARL pregnancy rate is the standard method for comparison of effectiveness. This measures the number of pregnancies that occur for each contraceptive method if used by 100 women for one year.

If, out of 100 women don't using birth control methods over the period of one year, 85 women becomes pregnant the PEARL -Index is 85; on this value all methods must be based.

With the oldest and also today still most frequently applied method of the Coitus interruptus 18 - 35 woman will become pregnant during the first year; in other words: Each 5th women still are going pregnant, the method is definitely unsuitable. Up to date methods offers a 99.x safety against unwanted pregnancies, a PERAL -Index less than 1.0.

The oldest preserved description by introduction of different substances in the vagina to prevent pregnancies, originates from Egyptian Papyri Kahun around 1959 before Christ. Still today, for example, slices of lemon are applied in some regions of the world or also rice's mucus with common salt; it is astonishing how effective it is partly. Chemical contraceptives either kills sperm or make them inactive. Spermicides are present in the form of tablets, uvulas, creams, foams, jellies, ointments, films or sprays and must be applied into the vagina approx. 5 - 10 minutes before intercourse or within 30 minutes of ejaculation. PEARL pregnancy rate between 6 and 36.

Flushings of the vagina, also with addition of chemicals, which were used in former times frequently and are still occasionally applied also today, do not offer protection against an unplanned pregnancy, which would be not discussible (PEARL -Index 31). "Bidets" for it you can find in older hotels still occasionally.

The condom has found long spreading; the Englishmen name it "Parisian" and the Frenchmen "Londoner". "Italian" would be more correct, because this oldest barrier method was described at first time by the Italian gynecologist and anatomist Fallopio 1564, indeed not to prevent pregnancies, but to offer protection against sexually transmitted infections (STD's).
A similarly great importance attained the diaphragm (first of all in the USA) that a little bit more than 100 years ago (1882) were introduced by Mensinga. The idea came from the Berlin gynecologist Wilde, which invented the cervical cap just 50 years previously which has not asserted itself in Germany, however.

Great importance against it has still the periodic total abstinence, probably not least also because the Roman Catholic Church approves it also today still as world-wide only religion as exclusive birth control method at all under certain conditions.
The calendar method (indicated by Ogino and Knaus 70 years ago) presume a cycle with always the same length (normally 28 days). But only few woman have a regular menstruation always at the same time, because the cycle can already react to the smallest exterior influences (for example traveling).
Substantially safer - in addition, very many more difficult - are temperature methods, which are based on the increase of the basal temperature after the ovulation, an effect of the hormone progesterone, which was discovered in 1932.

The intrauterine device (IUD) is the world's most widely used method of reversible birth control for women and already indicated 1909 by Richter , but actually introduced only by Graefenberg. The coil has a PEARL -Index less than 0.5. However the principle of this contraceptive is very old. The Bedouins put stones in the uterus of camels to prevent pregnancies of the animals during cross the desert.

With the introduction of contraceptives contains hormones Pincus succeeded 1958 a crucial break-through: The Pill . The ingenious to it is that one achieves both a most effective ( PEARL -Index 0.5) method of the suppression of the ovulation, and at the same time a bleeding receives, which is similar to a menstruation and is therefore from inestimable psychological value for a women.

Dr. Miller authored journal article about contraceptive.