Birth control, sometimes synonymous with contraception, is a regimen of one or more actions, devices, or medications followed in order to deliberately

prevent or reduce the likelihood of pregnancy or childbirth. Contraception may refer specifically to mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a spermatozoon. The history of birth control began with the discovery of the connection between coitus and pregnancy. The oldest forms of birth control included coitus interruptus, pessaries, and the ingestion of herbs that were believed to be contraceptive or abortifacient. The earliest record of birth control use is instructions on creating a contraceptive pessary from Ancient Egypt. Different methods of birth control have varying characteristics. Condoms, for e ample, are the only method that provides significant protection from se ually transmitted diseases. Cultural and religious attitudes on birth control vary significantly. Methods See also: Comparison of birth control methods [edit] Physical methods [edit] Barrier methods

Condom !rolled"up# $arrier methods place a physical impediment to the movement of sperm into the female reproductive tract. The most popular barrier method is the male condom, a late or polyurethane sheath placed over the penis. The condom is also available in a female version, which is made of polyurethane. The female condom has a fle ible ring at each end % one secures behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina. Cervical barriers are devices that are contained completely within the vagina. The contraceptive sponge has a depression to hold it in place over the cervi . The cervical cap is the smallest cervical barrier. &t stays in place by suction to the cervi or to the vaginal walls. The 'ea(s shield is a larger cervical barrier, also held in place by suction. The diaphragm fits into place behind the woman(s pubic bone and has a firm but fle ible ring, which helps it press against the vaginal walls. The )&'C) diaphragm is a new diaphragm design which is still in clinical testing and is not yet available. [edit] Hormonal methods

*rtho Tri"cyclen, a brand of oral contraceptive, in a dial dispenser. There are variety of delivery methods for hormonal contraception. Combinations of synthetic oestrogens and progestins !synthetic progestogens# are commonly used. These include the combined oral contraceptive pill !+The ,ill+#, the ,atch, and the contraceptive vaginal ring !+-uva.ing+#. -ot currently available for sale in the /nited )tates is 'unelle, a monthly in0ection. *ther methods contain only a progestin !a synthetic progestogen#. These include the progestin only pill !the ,*, or (minipill(#, the in0ectables Depo ,rovera !a depot formulation of medro yprogesterone acetate given as an intramuscular in0ection every three months# and -oristerat !-orethindrone acetate given as an intramuscular in0ection every 1 weeks#, and contraceptive implants. The progestin"only pill must be taken at more precisely remembered times each day than combined pills. The first contraceptive implant, the original 2"capsule -orplant, was removed from the market in the /nited )tates in 3444, though a newer single"rod implant called &mplanon was approved for sale in the /nited )tates on 5uly 36, 7882. The various progestin"only methods may cause irregular bleeding during use. [edit] Ormeloxifene (Centchroman) *rmelo ifene !Centchroman# is a selective oestrogen receptor modulator, or )E.9. &t causes ovulation to occur asynchronously with the formation of the uterine lining, preventing implantation of a zygote. &t has been widely available as a birth control method in &ndia since the early 3448s, marketed under the trade name )aheli. Centchroman is legally available only in &ndia. [edit] Intrauterine methods

An intrauterine device. These are contraceptive devices which are placed inside the uterus. They are usually shaped like a +T+ % the arms of the T hold the device in place. There are two main types of intrauterine contraceptives: those that contain copper !which has a spermicidal effect#, and those that release a progestogen !in the /) the term progestin is used#.

The terminology used for these devices differs in the /nited ;ingdom and the /nited )tates. &n the /), all devices which are placed in the uterus to prevent pregnancy are referred to as intra"uterine devices !&/Ds# or intra"uterine contraceptive devices !&/CDs#. &n the /;, only copper"containing devices are called &/Ds !or &/CDs#, and hormonal intrauterine contraceptives are referred to with the term &ntra"/terine )ystem !&/)#. This may be because there are seven types of copper &/Ds available in the /;, compared to only one in the /). [edit] Emer ency contraception See also: Emergency contraceptive availability by country )ome combined pills and ,*,s may be taken in high doses to prevent pregnancy after a birth control failure !such as a condom breaking# or after unprotected se . <ormonal emergency contraception is also known as the +morning after pill,+ although it is licensed for use up to three days after intercourse. Copper intrauterine devices may also be used as emergency contraception. =or this use, they must be inserted within five days of the birth control failure or unprotected intercourse. $ecause emergency contraception may prevent a fertilized egg from developing, some people consider it a form of abortion. [edit] Induced a!ortion Abortion can be done with surgical methods, usually suction"aspiration abortion !in the first trimester# or dilation and evacuation !in the second trimester#. 9edical abortion uses drugs to end a pregnancy and is approved for pregnancies where the length of gestation has not e ceeded 1 weeks. )ome herbs are believed to cause abortion !abortifacients#. The efficacy of these plants as such has never been studied in humans. )ome animal studies have found them to be effective on other species. >37?>@? The use of herbs to induce abortion is not recommended due to the risk of serious side effects. Abortion is sub0ect to ethical debate. [edit] "terili#ation )urgical sterilization is available in the form of tubal ligation for women and vasectomy for men. &n women, the process may be referred to as +tying the tubes,+ but the fallopian tubes may be tied, cut, clamped, or blocked. This serves to prevent sperm from 0oining the unfertilized egg. The non"surgical sterilization procedure, Essure, is an e ample of a procedure that blocks the tubes. )terilization should be considered permanent. [edit] Beha$ioral methods [edit] %ertility a&areness )ymptoms"based methods of fertility awareness involve a woman(s observation and charting of her body(s fertility signs, to determine the fertile and infertile phases of her cycle. 9ost methods track one or more of the three primary fertility signs:>3A? changes in basal body temperature, in cervical mucus, and in cervical position. &f a woman tracks both basal body temperature and another primary sign, the method is referred to as symptothermal. )ome fertility monitoring devices use urinalysis to follow the levels of estrogen and luteinizing hormone throughout a woman(s menstrual cycle. *ther bodily cues such as mittelschmerz are considered secondary indicators. Calendar"based methods such as the .hythm method and )tandard Days 9ethod are dissimilar from symptoms"based fertility awareness methods, in that they do not involve the observation or recording of bodily cues of fertility. &nstead, statistical methods estimate the likelihood of fertility based on the length of past menstrual cycles. )tatistical methods are less accurate than fertility awareness methods, and are considered by many fertility awareness teachers to have been obsolete for at least 78 years.

Charting of the menstrual cycle may be done by the woman on paper or with the assistance of software. The calendar" based methods may use a device such as Cycle$eads. )ymptoms"based methods may be assisted by fertility monitoring devices that accept and interpret temperature readings, information from home urinalysis tests, or both. To avoid pregnancy with fertility awareness, unprotected se is restricted to the least fertile period. During the most fertile period, barrier methods may be availed, or she may abstain from intercourse. The term natural family planning !-=,# is sometimes used to refer to any use of =A methods. <owever, this term specifically refers to the practices which are permitted by the .oman Catholic Church % breastfeeding infertility, and periodic abstinence during fertile times. =A methods may be used by -=, users to identify these fertile times. [edit] Coitus interruptus Coitus interruptus !literally +interrupted se +#, also known as the withdrawal method, is the practice of ending se ual intercourse !+pulling out+# before e0aculation. The main risk of coitus interruptus is that the man may not make the maneuver in time. Although concern has been raised about the risk of pregnancy from sperm in pre"e0aculate, several small studies>3?>7? have failed to find any viable sperm in the fluid. [edit] '$oidin $a inal intercourse The risk of pregnancy from non"vaginal se , such as outercourse !se without penetration#, anal se , or oral se is virtually zero. !A very small risk comes from the possibility of semen leaking onto the vulva !with anal se # or coming into contact with an ob0ect, such as a hand, that later contacts the vulva.# <owever, with this method, care must be taken to prevent the progression to intercourse. [edit] '!stinence )e ual abstinence is the practice of refraining from all se ual activity. [edit] (actational 9ost breastfeeding women have a period of infertility after the birth of their child. The lactational amenorrhea method, or 'A9, gives guidelines for determining the length of a woman(s period of breastfeeding infertility. [edit] Methods in de$elopment [edit] %or females

,raneem is a polyherbal vaginal tablet being studied as a spermicide, and a microbicide active against <&B.>3C? $ufferDel is a spermicidal gel being studied as a microbicide active against <&B. >3@? Duet is a disposable diaphragm in development that will be pre"filled with $ufferDel. >32? &t is designed to deliver microbicide to both the cervi and vagina. /nlike currently available diaphragms, the Duet will be manufactured in only one size and will not reEuire a prescription, fitting, or a visit to a doctor. >3@? The )&'C) diaphragm is a silicone barrier which is still in clinical testing. &t has a finger cup molded on one end for easy removal. 'ike the Duet, the )&'C) is novel in that it will only be available in one size. A vaginal ring is being developed that releases both estrogen and progesterone, and is effective for over 37 months.>36? Two types of progestogen"only vaginal rings are being developed. ,rogestogen"only products may be particularly useful for women who are breastfeeding. >36? The rings may be used for four months at a time.>31? A progesterone"only contraceptive is being developed that would be sprayed onto the skin once a day. >34? Fuinacrine sterilization and the Adiana procedure are two permanent methods of birth control being developed.>78?

[edit] %or males Main article: Male contraceptive

*ther than condoms and withdrawal, there are currently no available methods of reversible contraception which males can use or control. )everal methods are in research and development:

As of 7886, a chemical called Ad0udin is currently in ,hase && human trials as a male oral contraceptive.>73? .&)/D !.eversible &nhibition of )perm /nder Duidance#, is an e perimental in0ection into the vas deferens that coats the walls of the vas with a spermicidal substance. The method can potentially be reversed by washing out the vas deferens with a second in0ection. E periments in vas"occlusive contraception involve an implant placed in the vasa deferentia. E periments in heat"based contraception involve heating a man(s testicles to a high temperature for a short period of time.

[edit] Misconceptions 9odern misconceptions and urban legends have given rise to a great deal of false claims:

The suggestion that douching with any substance immediately following intercourse works as a contraceptive is untrue. Ghile it may seem like a sensible idea to try to wash the e0aculate out of the vagina, it is not likely to be effective. Due to the nature of the fluids and the structure of the female reproductive tract H if anything, douching spreads semen further towards the uterus. )ome slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be a reliably effective method. &t is a myth that a female cannot become pregnant as a result of the first time she engages in se ual intercourse. Ghile women are usually less fertile for the first few days of menstruation, >77? it is a myth that a woman absolutely cannot get pregnant if she has se during her period. <aving se in a hot tub does not prevent pregnancy, but may contribute to vaginal infections. Although some se positions may encourage pregnancy, no se ual positions prevent pregnancy. <aving se while standing up or with a woman on top will not keep the sperm from entering the uterus. The force of e0aculation, the contractions of the uterus caused by prostaglandins>citation needed? in the semen, as well as ability of sperm to swim overrides gravity. /rinating after se does not prevent pregnancy and is not a form of birth control, although it is often advised anyway to help prevent urinary tract infections.>7A? Toothpaste cannot be used as an effective contraceptive >7C? I a b !*ctober 344A# +.esearchers find no sperm in pre"e0aculate fluid+. Contraceptive Technology Update 3C !38#: 3@C"3@2. ,9&D 3771248@. I a b Jukerman, J.K Geiss D.$. *rvieto .. !April 788A#. +)hort Communication: Does ,ree0aculatory ,enile )ecretion *riginating from Cowper(s Dland Contain )permL+. Journal of Assisted Reproduction and enetics 78 !C#: 3@6"3@4. ,9&D 37627C3@. /niversity ,ress 3444, &)$-"38: 826C768722, Chapters @"6 ) A <istory of $irth Control 9ethods. !lanned !arenthood !5une 7887#. .etrieved on 7882"84"87., which cites: Thomas, ,atricia. !3411#. Contraceptives, 9edical Gorld -ews, 74!@# !3C 9arch#, C1 ) !=ebruary 7888# +Evolution and .evolution: The ,ast, ,resent, and =uture of Contraception+. Contraception "nline #$aylor College of Medicine% 38 !2#. ) .iddle, 5ohn 9. !3447#. Contraception and Abortion from the Ancient &orld to the Renaissance' Cambridge, 9A: <arvard /niversity ,ress. ) Geschler, Toni !7887#. Ta(ing Charge of )our *ertility, .evised Edition, -ew Mork: <arperCollins, p.@7. &)$- 8"82"84A62C"@. ) 5oshi ), ;atti /, Dodbole ), $harucha ;, $ ;, ;ulkarni ), .isbud A, 9ehendale ) !788@#. +,hase & safety study of ,raneem polyherbal vaginal tablet use among <&B"uninfected women in ,une, &ndia.+. Trans R Soc Trop Med +yg 44 !38#: 624"6C. ,9&D 3281C@C6. I a b $ufferDel. .e,rotect &nc. !7882"38"7C#. .etrieved on >>7886"8@"34??.

) Diaphragms. Cervical $arrier Advancement Society !7888#. .etrieved on 7882"38"31. I a b !April 788@# +-ew Contraceptive Choices+. !opulation Reports, -.*" !ro/ect, Center for Communication !rograms 9 !34#. The 5ohns <opkins )chool of ,ublic <ealth. .etrieved on 7882"86"3C. Chapter 7: Baginal .ings .ubenstein, &rwin, and )usan 9. Gick. +Cell.+ Gorld $ook *nline .eference Center. 7881. 37 5an. 7881 Nhttp:OOwww.worldbookonline.comOwbOArticleLidPar3877C8Q ) De )ouza C,, *smani )A !7886#. +9itosis, not 0ust open or closed+. Eu(aryotic Cell 2 !4#: 3@73H6. ,9&D 36228A2A. ) 9aton, AntheaK <opkins, 5ean 5ohnson, )usan 'a<art, David, Fuon Garner, David, Gright, 5ill D !3446#. Cells: $uilding $loc(s of 0ife. -ew 5ersey: ,rentice <all, 68"6C. &)$- 8"3AC7AC62"2. I a b 'illy 9, Duronio . !788@#. +-ew insights into cell cycle control from the Drosophila endocycle.+. "ncogene 7C !36#: 762@"6@. ,9&D 3@1A1@3A. I a b $low 5, Tanaka T !788@#. +The chromosome cycle: coordinating replication and segregation. )econd in the cycles review series.+. EM$" Rep 2 !33#: 3871"AC. ,9&D 3272CC76. ) Jhou 5, Mao 5, 5oshi < !7887#. +Attachment and tension in the spindle assembly checkpoint.+. J Cell Sci 33@ !,t 31#: A@C6"@@. ,9&D 373124C3. ) -anninga - !7883#. +Cytokinesis in prokaryotes and eukaryotes: common principles and different solutions.+. Microbiol Mol $iol Rev 2@ !7#: A34"AA. ,9&D 33A1338C. ) .aven, ,eter <.K .ay =. Evert, )usan E. Eichhorn !788@#. $iology of !lants, 1th Edition. -ew Mork: G.<. =reeman and Company ,ublishers, @1"26. &)$- 8"6326"3886"7. ) 'loyd C, Chan 5. !7882#. +-ot so divided: the common basis of plant and animal cell division.+. .at Rev Mol Cell $iol' 6 !7#: 3C6"@7. ,9&D 32C4AC78. b c d e ,rinciples of Denetics, =ourth Edition, 5ohn Giley and )ons, &nc., 7882. ) $&' 38C " 'ecture 3@