Abstract

PIP: Family planning, today a basis of the wellbeing of families and societies, developed slowly over the centuries until roughly the 1950s, when researchers in various parts of the world began to apply their knowledge of reproductive physiology to development of new contraceptive methods that would be as safe and effective as possible. The oral contraceptive, IUD, and tubal sterilization were developed or improved beginning in the 1950s and subsequently came into widespread use around the world. Among reversible contraceptive methods available at present are the barrier methods including the condom, diaphragm, cervical cap, various spermicidal tablets, creams, and jellies, and vaginal rings containing progestin. A variety of formulations of OCs containing estrogens and/or progestins are available. Some injectable formulations contain a mixture of ethinyl estradiol and progestin and provide contraceptive protection for 30 days. Others contain progestins only and are effective for 84 days after administration. Subdermal contraceptive implants containing levonorgestrel in 6 silastic capsules provide up to 5 1/2 years of contraceptive protection. The most common side effects, experienced by about 30% of users, are menstrual disturbances that occasionally require removal of the implants. 3 types of vaginal rings containing levonorgestrel, a combination of estrogen and progestin, or natural progesterone only have failure rates estimated at 4 per 100 woman-years. They are usually left in place for 3 weeks at a time followed by a 1 week interruption. Adhesive patches containing estrogen and progestin are designed to be applied weekly to the thorax for 3 weeks followed by a 1 week discontinuation. The method is expected to be on the market shortly. IUDs in some form have been in use since 1929, but their use increased with development of flexible plastic materials and at present a variety of forms are available, including copper devices. Couples who have achieved their desired family size may choose to employ a permanent method. Minilaparotomy consists of the opening of the abdominal wall through a small incision and ligation of the tubes. Laparotomy, the most comfortable, economical, and effective method of female sterilization, is used only in well-equipped hospitals because of the expensive equipment and skilled manpower required. Minilaparotomy and laparoscopic sterilization are conducted under local or general anesthesia as needed by each patient. Vasectomy, ligation of the deferent canals, prevents the sperm from being ejaculated. It does not require general anesthesia and is much simpler than any method of female sterilization.