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|title=Contraceptives

|title = Contraceptives

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|description=Contraception means the prevention of pregnancy by interfering with the normal process of ovulation, fertilization, or implantation

|description=Contraception means the prevention of pregnancy by interfering with the normal process of ovulation, fertilization, or implantation

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Contraception means the prevention of pregnancy by interfering with the normal process of ovulation, fertilization, or implantation. The intentional prevention of conception is achieved by the use of various devices, sexual practices, chemicals, drugs or surgical procedures.<ref>Jain R, Muralidhar S. Contraceptive methods: needs, options and utilization. J Obstet Gynaecol India. 2011;61(6):626-634. doi:10.1007/s13224-011-0107-7</ref> This is an important measure for population control.  

Contraception means the prevention of pregnancy by interfering with the normal process of ovulation, fertilization, or implantation. The intentional prevention of conception is achieved by the use of various devices, sexual practices, chemicals, drugs or surgical procedures.<ref>Jain R, Muralidhar S. Contraceptive methods: needs, options and utilization. J Obstet Gynaecol India. 2011;61(6):626-634. doi:10.1007/s13224-011-0107-7</ref> This is an important measure for population control.  

In today’s medical practice, many forms of contraception are available.  Benefits of contraception include decrease in unwanted pregnancies thereby reducing maternal deaths by as much as 40%.  Contraception also helps in increasing time interval between pregnancies, which increases perinatal and infant survival. Contraception is available to both females and males.  It can be reversible or permanent.  Choice often depends on availability, prior experience, knowledge and comorbidities. This article focuses on contraceptive options described in Ayurveda and current practices.   

In today’s medical practice, many forms of contraception are available.  Benefits of contraception include decrease in unwanted pregnancies thereby reducing maternal deaths by as much as 40%.  Contraception also helps in increasing time interval between pregnancies, which increases perinatal and infant survival. Contraception is available to both females and males.  It can be reversible or permanent.  Choice often depends on availability, prior experience, knowledge and comorbidities. This article focuses on contraceptive options described in Ayurveda and current practices.   

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== Ideal contraceptive: ==

== Ideal contraceptive: ==

An ideal contraceptive method should be widely acceptable, inexpensive, simple to use, safe and effective. It should require minimal motivation, maintenance and supervision.  

An ideal contraceptive method should be widely acceptable, inexpensive, simple to use, safe and effective. It should require minimal motivation, maintenance and supervision.  

 

== Classification: ==

== Classification: ==

 

The methods of contraception can be broadly divided into two.

The methods of contraception can be broadly divided into two.

b) Vasectomy

b) Vasectomy

 

==Contraceptive options: ==

==Contraceptive options: ==

 

===I. Natural Family Planning===

===I. Natural Family Planning===

*One or both partners may not feel completely satisfied by the sexual experience.

*One or both partners may not feel completely satisfied by the sexual experience.

 

==II. Oral contraceptives==

==II. Oral contraceptives==

 

The “Atharva veda” describes certain drugs to make a person impotent which is administered by chanting some verses as a punishment to the person committing social sins.<ref>Atharvaveda VI-138/1, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  

The “Atharva veda” describes certain drugs to make a person impotent which is administered by chanting some verses as a punishment to the person committing social sins.<ref>Atharvaveda VI-138/1, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  

Adverse effects:

Adverse effects:

*Menstrual irregularity, amenorrhoea, delayed return of fertility, weight gain decrease in bone mineral density, alterations in lipid profile, other symptom like head ache, breast tenderness,moodiness, nausea, hair loss, less sex drive etc.

*Menstrual irregularity, amenorrhoea, delayed return of fertility, weight gain decrease in bone mineral density, alterations in lipid profile, other symptom like head ache, breast tenderness,moodiness, nausea, hair loss, less sex drive etc.

 

==III. Barrier methods==

==III. Barrier methods==

 

Some methods to make the reproductive tract rough and dry, in order to prevent conception are mentioned in Atharva veda.<ref>Atharvaveda VI-37/3, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This may cause alterations in the normal pH, or nature of cervical mucus to prevent the entry of sperms, or altering the receptivity of endometrium to prevent the implantation of zygote.<ref>Tewari PV, Chaturvedi C. Method of population control in ayurvedic classics. Anc Sci Life. 1981;1(2):72-79.</ref> This may be considered as vaginal barrier method.

Some methods to make the reproductive tract rough and dry, in order to prevent conception are mentioned in Atharva veda.<ref>Atharvaveda VI-37/3, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This may cause alterations in the normal pH, or nature of cervical mucus to prevent the entry of sperms, or altering the receptivity of endometrium to prevent the implantation of zygote.<ref>Tewari PV, Chaturvedi C. Method of population control in ayurvedic classics. Anc Sci Life. 1981;1(2):72-79.</ref> This may be considered as vaginal barrier method.

In current practices, male condoms and vaginal diaphragms are used in barrier methods.

In current practices, male condoms and vaginal diaphragms are used in barrier methods.

 

==IV. Intra uterine contraceptive devices==

==IV. Intra uterine contraceptive devices==

In females, causing obstruction to vessels of the reproductive tract (yoni) using a special type of stone is mentioned for inducing sterility.<ref>Atharvaveda VI-37/2, part 2, Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This may be considered as a primitive form of intra uterine contraceptive devices. Now a days, Intra Uterine Device (IUD) is inserted into uterine cavity and left for contraception. These are made from polypropylene impregnated with barium sulphate.  

In females, causing obstruction to vessels of the reproductive tract (yoni) using a special type of stone is mentioned for inducing sterility.<ref>Atharvaveda VI-37/2, part 2, Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This may be considered as a primitive form of intra uterine contraceptive devices. Now a days, Intra Uterine Device (IUD) is inserted into uterine cavity and left for contraception. These are made from polypropylene impregnated with barium sulphate.  

The commonly used devices are Copper T 200 (Cu T-200), Copper T (Gravigard), Multi load copper – 250 (ML Cu – 250 ) and Multi load Copper –375 (ML Cu- 375). These are used for 3 to 5 years of contraception.

The commonly used devices are Copper T 200 (Cu T-200), Copper T (Gravigard), Multi load copper – 250 (ML Cu – 250 ) and Multi load Copper –375 (ML Cu- 375). These are used for 3 to 5 years of contraception.

 

==V. Surgical procedures for sterility==

==V. Surgical procedures for sterility==

Infliction of crush injury to the two chords situated near the scrotum or the scrotum itself is also mentioned in Atharva veda.<ref>Atharvaveda VI-138/4-5, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This shows the references of vasectomy and castration respectively.  

Infliction of crush injury to the two chords situated near the scrotum or the scrotum itself is also mentioned in Atharva veda.<ref>Atharvaveda VI-138/4-5, part 2,Vishveshwaranad vedic institute, Hoshiapur, edition 1, 1961.</ref>  This shows the references of vasectomy and castration respectively.  

In current practices, sterilization in males is achieved through vasectomy. In females, various procedures like laparotomy, culdotomy, laparoscopy are opted for sterilization.  These methods are irreversible and opted for permanent contraception.

In current practices, sterilization in males is achieved through vasectomy. In females, various procedures like laparotomy, culdotomy, laparoscopy are opted for sterilization.  These methods are irreversible and opted for permanent contraception.

 

==VI. Emergency contraception==

==VI. Emergency contraception==

This method can be used in the form of oral tablets or IUD.  It is indicated in cases of unprotected intercourse, condom failure, noncompliance with other methods and rape.

This method can be used in the form of oral tablets or IUD.  It is indicated in cases of unprotected intercourse, condom failure, noncompliance with other methods and rape.

|Combination of Lagineria vulgaris (iksvaku), Baliospermum montanum (danti), Piper longum (pippali), Jaggery, Randia dumetorum (madanaphala), Fermented liquid (kinva), Glycyrrhiza glabra (yashti madhu) and Latex of Euphorbia nerifolia (snuhi kshira)<ref>Govinda Das,Bhaisajyaratnavali , Streeroga Adhikara, verse 150 , Hindi translation by Pandit. Shri Lalchandraji, reprint edtion,Delhi:Motilal banarasidas, 2002, pg no:706.</ref> || Vaginal suppository

|Combination of Lagineria vulgaris (iksvaku), Baliospermum montanum (danti), Piper longum (pippali), Jaggery, Randia dumetorum (madanaphala), Fermented liquid (kinva), Glycyrrhiza glabra (yashti madhu) and Latex of Euphorbia nerifolia (snuhi kshira)<ref>Govinda Das,Bhaisajyaratnavali , Streeroga Adhikara, verse 150 , Hindi translation by Pandit. Shri Lalchandraji, reprint edtion,Delhi:Motilal banarasidas, 2002, pg no:706.</ref> || Vaginal suppository

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==Current researches==

==Current researches==

 

The following table no. 5 reviews pharmacological research studies on single drugs mentioned in contraceptive formulations in Ayurveda.

The following table no. 5 reviews pharmacological research studies on single drugs mentioned in contraceptive formulations in Ayurveda.

*“Praneem”, a purified extract from the dried seeds of Azadirachta indica (Neem), extract from the pericarp of fruits of Sapindus species and quinine hydrochloride, showed contraceptive efficacy in rabbits and monkeys after intra vaginal application. Precoital application of the cream provided complete protection against pregnancy in rabbits in the 1st 30 minutes after application. The conception rate was acceptable at 60 minutes (7%), but thereafter it climbed to unacceptable levels (28.6% at 90 minutes and 75% at 12 hours).<ref>Garg S, Taluja V, Upadhyay SN, Talwar GP , Studies on the contraceptive efficacy of Praneem polyherbal cream, Contraception, 1993 Dec;48(6):591-6</ref>

*“Praneem”, a purified extract from the dried seeds of Azadirachta indica (Neem), extract from the pericarp of fruits of Sapindus species and quinine hydrochloride, showed contraceptive efficacy in rabbits and monkeys after intra vaginal application. Precoital application of the cream provided complete protection against pregnancy in rabbits in the 1st 30 minutes after application. The conception rate was acceptable at 60 minutes (7%), but thereafter it climbed to unacceptable levels (28.6% at 90 minutes and 75% at 12 hours).<ref>Garg S, Taluja V, Upadhyay SN, Talwar GP , Studies on the contraceptive efficacy of Praneem polyherbal cream, Contraception, 1993 Dec;48(6):591-6</ref>

 

==References==

==References==