Female contraception originates, as far as we know, with the Egyptians., and shows that our ancestors were at least as keen on preventing unwanted births as we are today. Some of the earliest recorded methods of preventing conception were the use of acacia leaves, honey and lint that was soaked and placed in the vagina to block sperm. A document from 1850 BC describes various contraceptive pessaries, including acacia gum, which recent research has confirmed to have spermatocidal qualities and is still used in contraceptive jellies.
The oldest method of contraception, however, is abstinence, or the withdrawal method, known as “coitus interruptus”, which is referenced in The Book of Genesis when Onan “spills his seed” (ejaculates) on the ground so as to not father a child with his deceased brother’s wife Tamar.
Other early birth control methods from around the world included:
- condoms (external and internal) made of animal bladders, linen, silk, or plants
- vaginal douches or sponges soaked in oil, vinegar, lemon juice, or cedar oil — substances believed to slow or weaken sperm
- oral contraceptives, including Queen Anne’s lace seeds, lead and other toxic metals, pomegranate seeds, silphium, unripe papaya, and blue cohosh
Some birth control methods used today, like condoms and diaphragms, were developed and used widely (though somewhat secretly) before the 1900s. Latex condoms, however, weren’t introduced until the 1920s.
Margaret Sanger, who founded the first American birth control clinic in 1916, propelled the research that led to the creation of the oral contraceptive pill, one of the most popular modern contraceptives. The success of oral contraceptives eventually led to the development of other modern hormonal birth control methods.
As contraceptives evolved, the PEARL index was established in 1966 as a method of assessing the effectiveness of birth control methods in clinical trials It is also sometimes used to compare birth control methods, a lower Pearl index representing a lower chance of getting unintentionally pregnant.
The Most Widely Used Modern Methods of Female Contraception
The most popular and widely used method globally is probably the male condom, but in terms of how women can control their own fertility on their own, these are today’s options:
- Oral contraceptives (progesterone only or a combination of oestrogen and progesterone) known as “The Pill”.
- 2 or 3 monthly progesterone injections.
- NuvaRing -a once a month intravaginal ring.
- Evra patches- applied once per week.
- Implanon -a subcutaneous progesterone implant lasting 3 years.
- IUD -intra uterine devices, e.g. Copper T or Mirena/Kyleena that last for 5 years.
- Female condoms (not widely used).
- Sterilisation/tubal ligation.
- The morning after pill- this is an emergency solution for women who have had unprotected sex (consensual or non-consensual) to prevent pregnancy. It contains 1.5 milligrams of levonorgestrel, and works by stopping the release of an egg from your ovary. It may prevent sperm from fertilizing the egg. It is not intended as a primary birth control method.
No contraceptive is always 100% effective, and it is important to recognise this.
Whatever your birth control method of choice, it is crucial to inform and educate patients about their choices and to warn them about drug interaction with certain meds, e.g., antibiotics that might interact with efficacy of contraceptives.