The practice of contraception is as old as human existence. For centuries, humans have relied on their imagination to avoid pregnancy. Ancient writings noted on the Kahun papyrus dating to 1850 BCE refer to contraceptive techniques using a vaginal pessary of crocodile dung and fermented dough, which most likely created a hostile environment for sperm. The Kahun papyrus also refers to vaginal plugs of gum, honey, and acacia. During the early second century in Rome, Soranus of Ephesus created a highly acidic concoction of fruits, nuts, and wool that was placed at the cervical os to create a spermicidal barrier.
Today, the voluntary control of fertility is of paramount importance to modern society. From a global perspective, countries currently face the crisis of rapid population growth that has begun to threaten human survival. At the present rate, the population of the world will double in 40 years; in several of the more socioeconomically disadvantaged countries, populations will double in less than 20 years.
On a smaller scale, effective control of reproduction can be essential to a woman’s ability to achieve her individual goals and to contribute to her sense of well-being. A patient’s choice of contraceptive method involves factors such as efficacy, safety, noncontraceptive benefits, cost, and personal considerations. This article addresses the predominant modes of contraception used in the United States, along with the safety, efficacy, advantages, disadvantages, and noncontraceptive benefits of each.
For excellent patient education resources, visit eMedicine’s Men’s Health Center and Pregnancy and Reproduction Center. Also, see eMedicine’s patient education articles Birth Control Overview, Birth Control Barrier Methods, How to Use a Condom, Vasectomy, Tubal Sterilization, Understanding Birth Control Medications (Contraceptives), Birth Control Hormonal Methods, Birth Control Intrauterine Devices (IUDs), and Emergency Contraception.