With the rapid growth of the population in the world as well as the increased sense in general awareness for HIV/AIDS, has forced to think on birth control methods. The current world’s population is estimated to be around 6.4 billion with annual growth of 76 million and hence, it is estimated to reach 9 billion by year 2050. In next two decades, world’s two highly populous countries, China & India are expected to reach the population of 1.5 billion each i.e more than one third of the total world population of that time. It is alarming situation for the world to control this “population explosion”. Therefore, United Nations are urging countries specially highly populated countries to control their population.
As per the survey report for birth control methods if applied in 169 countries, 137 million women willing to delay their contraceptives, 64 million women are using less effective birth control measures. If these women are helped with adequate birth control treatment (like pills, condoms), 23 million of unplanned births, 22 million induced abortions and 1.4 million infants could be avoided as estimated by United Nations Population Fund.
Besides population, HIV/AIDS is also very important factor forcing the need for birth control. An estimated, world has 38 million people have either AIDS or infected with HIV (human immunodeficiency virus). In seven African countries, one out of 5 adults is infected with HIV. Birth control methods are, therefore, become imperative to control further spread of HIV/AIDS, particularly in these countries. The population in these countries is projected at 35% lower by 2025 free from HIV/AIDS. It will further reduce the total life expectancy by an average of 29 years in these countries.
History of Birth Control
200 AD, Greek gynecologist Soranus said that women become fertile during ovulation. He suggested some birth control tips for women to avoid unwanted pregnancy like smearing olive oil, pomegranate pulp, ginger, or tobacco juice around vagina to kill sperm, drinking water used by blacksmith to cool hot metals and jumping 7 times backward after the sexual intercourse. Many birth control methods like ayurvedic treatments used centuries ago (aside from sexual abstinence). However, there are some historical records of Egyptian women are found who were using some herbal or acid substances like crocodile dung or lubricants like honey or household olive oil as vaginal suppository, which they may have found effective at killing sperm.
However, commercial use of birth control method started in 1960 in the form of birth control pill. It was in 1950, when Planned Parenthood Federation of America invited biologist Dr. Gregory Pincus to develop oral contraceptive pill that would be harmless, universally acceptable and safe for husband and wife. After under going many tests with more than 6,000 women in Puerto Rico and Haiti , it was 1960 when the first commercially produced birth control pill called Enovid-10 was introduced to women in USA . This first oral contraceptive was made with two hormones Estrogen (100 to 175 microgram) and Progestin (10 mg). They were proved to be 99% effective if taken as directed. With estimation, more than 18 million women in US are relying on birth control pills
Types of birth control pills
Unlike the decades old oral contraceptive pills (which had higher number of hormones), today’s birth control pills are in low-dose forms with health benefits. So, women can take birth control pills with much fewer health risks.
Generally there are three types of birth control pills available
1. Progestin only pills (POP)
It is also known as “mini-pill” containing no estrogen. It is recommended for breastfeeding women because estrogen reduced milk production. This POP pill works by thickening the cervical mucus and thus preventing sperm to enter uterus
2. Combination birth control pills
The widely known birth control pills are having combination of two hormones progestin and estrogen. These types of oral contraceptive pills come with the pack of 21 “active pills” and 7 “placebos” , which do not contain any hormones. These are, in fact, known as “reminder pills”
These combination pills are further sub-divided into three types of pills due to the level of two hormones progestin and estrogen.
i) Monophasic birth control pills
Here, every active pill contains the equal number of progestin and estrogen. The other seven pills are placebo having no hormones. Menstruation starts when these placebo pills are taken
ii) Multiphasic birth control pills
They are also known as biphasic or trphasic oral contraceptive pills due to different levels of hormones in active pills. These pills are required to be taken at specific time in its entire pills schedule. Multiphasic birth control pills help offsetting the risks of oral contraceptives.
iii) Continuous birth control pills
it is also known as 365 days pills to be taken continuously throughout the year without the year. This is the new entry of oral contraceptive pills in the birth control market. Food and Drug Administration (FDA) has approved Lybrel, which is the only continuous birth control pill approved so far and available for general women use. Women do not get menstrual period while they are under the treatment of Lybrel, however, they might find some breakthrough bleeding or spotting, particularly at the initial stage.
3) Emergency birth control pills
Also known as “morning after pills”, these are designed for immediate pregnancy protection after the unprotected sex. It is highly recommended to take emergency pills within 48 hours and maximum 72 hours to be effective in avoiding pregnancy. These are different than usual oral contraceptive pills where you plan your birth control much in advance. Emergency pills are also taken when the women are sexually assaulted. FDA has approved Plan B as the safest emergency pills. Due to OTC (over the counter) approval by FDA for women above 18 years, Plan B can now be ordered behind pharmacy counter.
