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  • Title: Contraception.
    Author: Herbert R.
    Journal: Nursing (Lond); 1983 Jun; 2(14):405, 408-14. PubMed ID: 6559284.
    Abstract:
    The first documented account of a birth control method is believed to be in Egypt in 1850 BC, but it has only been in the last 20 years or so that such a variety of reliable methods have become available. The contraceptive method that individual couples use is a matter of personal choice and may be influenced by religious, cultural, aesthetic, or medical reasons. A figure shows the anatomy of the male and female reproductive systems, and the physiology is briefly outlined. The main criteria for a successful contraceptive method is that it should reliably and safely prevent conception by preventing ovulation, fertilization, or implantation. Perhaps the most obvious contraceptive method would be to avoid sexual intercourse at the time when sperm would be likely to meet an ovum. The rhythm method is based on this principle but as most women do not have regular cycles it is difficult to predict the timing of ovulation accurately. The safe period or rhythm method is free from side effects, but it has a high failure rate--10-15% even with very careful and meticulous use. Several barrier contraceptive methods aim to prevent the sperm reaching the ovum (the cap, the diaphragm, and the condom); these methods should be used in conjunction with spermicides. The IUD acts in a different manner. This foreign body in the uterus does not stop fertilization occurring but prevents implantation of the fertilized ovum. Sterilization, either by ligation of the fallopian tubes or vasectomy, is a permanent but effective contraceptive method. Combined oral contraceptives (OCs) are the most popular forms of contraception and are taken by approximately 3.3 million women in the UK. It is almost 100% effective if taken regularly and is convenient as it is independent of the act of intercourse. The mini-pill or progestogen only pill has similar effects to the combined OCs on cervical mucus and the endometrium, but it does not necessarily prevent ovulation. It is considered to be about 98% effective. Depo Provera, an injectable hormonal contraceptive consisting of a progestogen that is almost 100% effective acts in a similar way to the progestogen only pill and also stops ovulation. The hormone is injected into a muscle and is released slowly over a 2-3 month period. Although the pill is a safe and convenient contraceptive method for most women, hormonal contraceptives do have generalized effects on the whole body. Some of these effects may be beneficial. There are some side effects and risks which range from the relatively minor to the more serious. Under some circumstances it is possible to take a special dose of a combined OC under medical supervision as a postcoital contraceptive. Insertion of an IUD up to 5 days after intercourse can also be effective postcoitally. Research into additional male and female forms of hormonal contraceptives is being conducted.
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