The history of family planning did not start with the development of the first condom or pill. The earliest documents explicitly referring to birth control methods are found in Mesopotamia and Ancient Egypt, for example the Kahun Gynecological Papyrus from about 1850 BCE. Hippocrates and numerous ancient essays on gynecology described certain plants with contraceptive properties which were used in Ancient Greece from the 7th century BCE. Some of these plants are known to be toxic and ancient Greek documents specify safe dosages. Recent studies have confirmed the birth control properties of many of these plants.
"And the villain still pursues her", a satirical Victorian era postcard
Types of Hormonal Fertility Control Products
Effective and safe methods became available in the 20th century. Today, a variety of effective fertility control methods are available. Hormonal-based medications can be delivered in a variety of dosage forms including tablets, creams, patches, micronized oral capsules, sublingual pills or suppositories. These formulations have been developed in response to patient needs. Preferred fertility control methods vary within and among countries and regions.
Hormonal fertility control products may act in more than one way to prevent pregnancy:
Although none of these methods is without side effects, hormonal fertility control products are the most effective method of preventing pregnancy and are associated with many health benefits which result from avoiding pregnancy and the termination of unwanted pregnancies.
The Pill – Oral Fertility Control (OC)
The Pill is one of the most researched drugs in the world. It is also one of the world's most prescribed medications - about 100 million women across the globe rely on it. The Pill is a contraceptive suitable for most healthy women, regardless of age, and can be used long-term. For women in their 20s who still have not finished their family planning, a short acting contraceptive is often preferred.
There are 2 types of oral contraceptives:
- The combined oral contraceptive (COC) contains estrogen and progestin.
- 21+7 - Day or 24+4 - Day
- Every day pill
- Progestin-Only-Pill (POP or Mini-pill) contains only progestin.
- Unlike combination OC's, progestin-only pills must be taken continuously without a hormone-free period
Today's OCs contain one fourth or less of the amount of estrogen and one tenth or less of the amount of progestin compared to the original OCs introduced in the 1960s. As the amount of estrogen and progestin in OCs has been decreased, the risk of certain adverse effects has also fallen dramatically. Low-dose products are defined as those containing less than 50 micrograms (mcg) of estrogen. The lowest estrogen dose currently available in an OC is 20 mcg.
Vaginal Ring Fertility Control
A flexible ring containing a low dose estrogen and progesterone which is Inserted into the vagina for three continuous weeks.
How the vaginal ring works:
The vaginal ring releases progestin alone or progestin with estrogen into the vaginal walls, and through vaginal mucosa to the bloodstream, preventing ovulation, thickening cervical mucus, and suppressing endometrial growth.
Transdermal Fertility Control
Patches, sprays, or gels, are applied weekly or daily transferring hormones through the skin.
How transdermal fertility works:
Transdermal patch is a patch which, when applied to the skin, releases synthetic estrogen and progestin through the skin to the bloodstream preventing ovulation, thickening the cervical mucus, and suppressing endometrial growth. Patches require replacement just once a week and they release the hormones at higher rates when compared to the oral combined OCs. Sprays or gels transfer fast-drying progestins onto the skin, are absorbed immediately and diffused into the bloodstream.
The spray-on approach is a new technique for transferring a preset dose of fast-drying hormones onto the skin. The spray is absorbed almost instantaneously, so there is no risk of washing it off. The hormones accumulate as a reservoir within the skin and then slowly diffuse into the bloodstream.
This device is implanted under the skin in the upper arm by creating a small incision and inserting the capsules in a fanlike shape. It usually takes 5-15 minutes to insert the implant and the capsules can sometimes be seen under the skin like a small vein. This type of fertility control implant works within 24 hours and last up to five years.
Injectable Fertility Control
Injected estrogen and progestin-based products like other fertility control agents, prevent ovulation, thicken the cervical mucus, and suppress endometrial growth. These longer acting products are gaining new attention from family planning clients and providers in developing countries. Recently the FDA has approved products such as norethindrone enanthate and depot-medroxyprogesterone acetate (progestin - only products for injection once per month to three months).
Intrauterine Device – IUD
The IUD requires an Insertion into the uterus by a healthcare professional. It continuously releases a progestin called levonorgestrel and it remains in the uterus for a period of 3 to 5 years. There are two broad categories of intrauterine devices: inert and copper-based devices, and hormonally-based devices that work by releasing a progestin.
The IUD provides an option for women who would otherwise consider sterilization and are less concerned about the need to employ the services of a healthcare professional.
- Ovulation Inhibition
- Thickening of cervical mucus
- Alteration and thinning of the endometrium