Written by Dr.M.D.Mazumdar, MD

Contraception or birth control refers to the various procedures used to deliberately prevent the likelihood of pregnancy. It is used to limit family size and to plan future pregnancies.

Birth control methods have been practised since the ancient ages. Women have used vaginal suppositories during sexual intercourse to prevent pregnancy and herbs and roots of various plants to cause abortion. The earliest known condoms were animal intestines worn over the penis during coitus.

Nowadays, birth control is practised in some form or the other in almost all communities, regulated by cultural and religious attitudes to birth control.

Different methods of contraception have different characteristics as well as different advantages and disadvantages. A good idea of these various methods are necessary to be able to choose the right one.

Methods of Birth Control

Behavioural Methods

Behavioural methods depend on a good knowledge of the menstrual cycle as well as adequate self control by the couple.

• Coitus Interruptus: Coitus interruptus means 'interrupted sex". In this birth control method, the penis is withdrawn from the vagina just before ejaculation.

  The main advantage is that this method does not require the use of any drug, does not interfere with normal body functions, and the couple can plan for pregnancy at any time they want. The main disadvantage is that it is dependent almost wholly on the man's self-control. The failure rate is high at 15 - 18%.

• Rhythm method or Safe Period: This method requires a good knowledge of the female partner's menstrual cycle to identify the days on which sexual intercourse is possible without the risk of pregnancy. Read more ...

• Avoiding vaginal Intercourse: Anal sex, oral sex or sex without penetrating the vagina in which the sexual act occurs between the tightly held thighs of the woman has no risk of pregnancy.

Barrier Methods

In barrier methods of birth control, a barrier is placed between the penis and the vagina during intercourse so that the sperm cannot meet the ovum for fertilization.

• Male Condoms: Male condoms consist of a sheath, usually made of latex that covers the erect penis during penetration of the vagina. Read more...

• Female Condoms: The female condom is not used very often. Usually made of a substance called polyurethrane, it consists of a loose sheath with two rings on either side. The smaller ring is pushed deep into the vagina while the larger ring remains outside on the edge of the vagina.

  The condom can be inserted about 8 hours prior to sexual intercourse and can be kept in for about another 12 hours after intercourse. It can be used more than once during this period.

• Diaphragm: The vaginal diaphragm is a small saucer shaped rubber sheath with a metal coil in its rim which is fitted across the mouth of the uterus (cervix).

• Cervical Cap: The cervical cap is a small dome-shaped rubber device fitted on the cervix. It is uncomfortable to apply and is rarely used nowadays.

• Vaginal Sponge: The sponge is a small polyurethrane round device which needs to be placed inside the vagina before sexual intercourse. It releases spermicide wich makes sperm inactive. It should be left in place for 8 hours after use and can be used more than once during this time.

  The sponge also acts as a barrier contraceptive to some extent since it swells up to fit across the cervix once it is inside the vagina.

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Hormonal Methods

In this method, drugs are used to either prevent ovulation or to prevent implantation of the embryo after fertilization.

• Oral Contraceptive Pills: Birth control pills generally contain two hormones - estrogen and progesterone. They have two functions. The main one is to prevent ovulation. The second function is to disrupt the normal growth of the internal uterine lining (endometrium) so that the embryo cannot implant in it. Read more...

• Centchroman: Centchroman is a non-hormonal non steroidal contraceptive. Although it does not contain hormones, it acts on the hormones produced in the body, especially progesterone. The main function is to cause a slowing down in the growth rate of the internal uterine lining as well as to speed up the movement of the embryo so that implantation cannot occur. Read more...

• The Patch: The patch (e.g. Ortho Evra). This is a thin band-aid like patch containing estrogen and progesterone which should be applied over the skin. It releases the hormones slowly into the skin through which they are absorbed.

• Depo-provera: This birth control method consists of injecting a high dose of the hormone progesterone every three months. It acts mainly by preventing ovulation. The main disadvantage is that there may be irregular bleeding throughout the three months.

• Nuvaring: This is a thin silastic ring which should be inserted into the vagina once every month. It releases the hormones estrogen and progesterone and prevents ovulation during the menstrual cycle.

• Extended Cycle Oral Contraceptive Pill (COCP): Available commercially as Seasonale or Seasonique, this method consists of taking the pills containing estrogen and progesterone continuously for 3 months. So periods are prevented for these 3 months and occur only on the fourth month. As with other birth control methods using these hormones, it acts by preventing ovulation and causing changes in the internal uterine lining and cervical mucus to prevent implantation of a fertilized ovum.

• Vaginal Pessaries, Tablets, Creams or Foams : These contain spermicides which are toxic to the sperm and should be inserted into the vagina just before coitus. Their advantages are that they are easy to apply, do not interfere with coitus and act as lubricants. Disadvantage is that they are not very effective.

Intra-Uterine Contraceptive Devices (IUCD):

IUCDs or IUDs are contraceptive devices which are placed inside the uterus.

• Lippes Loop: This IUD mainly acts by preventing implantation of the fertilized ovum.

• Copper T: The Copper- T IUCDs work by not only preventing implantation but by also releasing copper which disrupts the growth of the endometrium and preventing fertilization.

• Mirena IUD: A form of hormonal IUD that releases small amounts of progesterone into the uterine cavity.

Read more about IUCDs here - IUCD

Surgical Methods:

These are more or less permanent methods of contraception.

• Tubal Ligation: Both the female tubes are tied off and usually cut during tubal ligation to prevent the sperm from reaching the ovum during intercourse.

• Vasectomy: In males, the two tubes which carry sperm from the testes to the penis are the vas deferens. Tying them off and cutting them is referred to as vasectomy.

• Essure: Essure is a method in which small micro-inserts are placed at the mouth of the fallopian tubes to cause scarring. This blocks the tubes and prevents sperm from reaching the ovum for fertilization.

Also Read-

• Normal Vaginal Discharge without Itching.
• Vaginal Itching without Discharge.
• Vaginal Discharge with Itching .
• Treatment of Vaginal Discharge without Itching.