Difference between revisions of "Contraceptive"

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|title=Contraceptive
 
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|keywords=Contraceptive, Contraceptive meaning, carakasamhitaonline, charak samhita, caraka samhita, ayurved, Contraceptive in ayurveda,Contraceptive Classification, Natural contraception,Barrier Methods, Intrauterine contraceptive devices,Steroidal contraception, Tubal occlusion, Vasectomy,contraceptive herbs
 
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|description=Contraception means the prevention of pregnancy by interfering with the normal process of ovulation, fertilization, or implantation
 
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|image_alt=charak samhita
 
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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.
 
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The literature suggests that contraception has been available from ancient times. The major texts of Ayurveda like Charak Samhita, Sushruta Samhita and Ashtanga Hridaya describe natural methods of contraception. The ancient Indian epics like Garuda purana (1000 BC), Bruhadaranyaka Upanishad (700 BC), Atharva veda (1000–900 BCE), Ayurveda texts like Rasa ratna  samuchhaya  (1400 A.D.), Bhavaprakasha  (1600 A.D.), Yogaratnakara (1600 A.D.), and Bhaishajya Ratnavali  (1900 A.D.) describe additional contraceptive options in the form of oral and local contraceptives practiced at the respective times.
 
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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: ==
 
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An ideal contraceptive method should be widely acceptable, inexpensive, simple to use, safe and effective. It should require minimal motivation, maintenance and supervision.
 
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== Classification: ==
 
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The methods of contraception can be broadly divided into two.
 
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'''1) Temporary methods- which includes,'''
 
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a) Natural contraception (rhythm method, coitus interruptus, lactational amenorrhoea method etc.)
 
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b) Barrier Methods (Mechanical- male condom, female condom, diaphragm, cervical cap, Chemical-vaginal creams, jelly, foam tablets etc.)
 
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c) Intrauterine contraceptive devices
 
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d) Steroidal contraception (oral, parenteral, device, patch)
 
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'''2) Permanent Methods which includes,
 
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'''
 
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a) Tubal occlusion
 
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b) Vasectomy
 
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==Contraceptive options: ==
 
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===I. Natural Family Planning===
 
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These are convenient methods but carry a failure rate of up to 25%.  With this, pregnancy can be prevented by using one or more of the following:
 
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'''1. Abstinence method:'''
 
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Ayurveda literature emphasises the regulated sexual life or abstinence as the best method of contraception. It is one of the three major pillars for sustenance of life. [A.Hr. Sutra Sthana 7/52]
 
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'''2. Breathing exercise:'''
 
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Breathing exercise to be practiced during coitus in order to prevent conception is mentioned in “Bruhadaranyaka Upanishad”.<ref>Bruhadaranyaka Upanishad, IV, Brahmana, Sutra 10.</ref>
 
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'''3. Safe period or rhythm method:''' 
 
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The description regarding fertile period and “safe period” is available in Ayurveda classics. The first 12 or 16 days of menstrual cycle are considered as fertile period (ritukala) and once this time period is over, the reproductive tract (yoni) gets constricted and do not promote the entry of sperm (shukra) into the uterus. [Su. Sa. Sharira Sthana 3/9] After ovulation, during progesterone dominant phase of menstrual cycle, cervical mucus becomes hostile to the sperms and prevent their entry into the uterus. So, this period can be considered as the safe period for coitus to avoid unwanted pregnancy.
 
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In current practices, the safe period is applied by ‘rhythm method’, or ‘calendar method’.
 
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A Menstrual calendar is maintained by writing down the first day of bleeding as Day One of the menstrual cycle.  Normal cycle can range from 25 to 35 days.  Ovulation generally occurs midcycle.  The calendar must be maintained for extended period of time to ascertain average cycle length.
 
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However, this do not assure 100% contraception because in a woman with excellent reproductive health, even the whole month may be considered as fertile period. [A. S. Sharira Sthana 1/46]
 
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'''4. Basal body temperature method'''
 
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Physiologically, the body temperature increases during ovulation. This method requires checking body temperature upon waking up every morning.  During ovulation, the temperature should rise during ovulation. Intercourse should be avoided in this period to achieve contraception.
 
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'''5. Cervical mucus method
 
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'''
 
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The cervical mucus/vaginal discharge changes in quantity, quality and consistency throughout menstrual cycle.  During the first few days of the cycle there is minimal discharge which increases to the largest amount during ovulation.  At that time the discharge thickens and can be stretched between fingers, known as Spinbbarkeit test.  Intercourse should be avoided during that period.
 
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'''6. Lactation amenorrhea method'''
 
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Breastfeeding supresses ovulation.  It is considered to an effective method of contraception only if the mother is exclusively breastfeeding the baby at regular intervals.
 
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'''7. Positions of sexual intercourse'''
 
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Left lateral, right lateral and elbow-knee positions are not recommended for a fruitful coitus and conception. So, these positions may not result conception in the ideal way. [Cha. Sa. [[Sharira Sthana]] 8/6] More research studies are needed to assure the contraception in these methods.
 
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'''8. Withdrawal method'''
 
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In this, the couple proceeds with intercourse in the usual way until the moment of ejaculation, when the male withdraws and ejaculates outside the vagina or the external genitalia.
 
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Drawbacks of this method:
 
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*Needs great motivation and self-control in the male partner.
 
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*The female partner may develop sexual neurosis as female satisfaction/ orgasm may not be achieved.
 
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*The pre-ejaculate (fluid that is secreted for lubrication, in males,) may contain few sperms which may lead to unwanted pregnancy.
 
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*One or both partners may not feel completely satisfied by the sexual experience.
 
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==II. Oral contraceptives==
 
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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>
 
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These recipes suppress or delay ovulation. Once the functioning of reproductive hormones (raja) is suppressed or altered, it prevents the conception.  Food and beverages that are excessively hot in potency cause disturbances in the reproductive physiology especially in the growth and development of follicles/ovum (andopachaya). [ Ka. Sa. Kalpa Sthana 7/32]
 
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'''Table 1: Oral contraceptives in Ayurveda'''
 
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{| class= "wikitable" |}
 
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|-
 
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!Drugs!!Period of menstrual cycle!!Vehicle/After drink (anupana/prakshepa) !! Dose / Duration
 
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|-
 
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|Powder of Piper longum Linn(pippali), Embelia ribes(vidanga), borax(tankana)<ref>Bhavamishra. Bhavaprakasha ,chikitsaprakarana, yoniroga ahikara, verse 33,In:Hindi translation by Pandit Shri Brahma Shankara Mishra, Volume II ,Reprint edition. Varanasi: Chaukhamba Sanskrit bhawan;2018.pp.-765</ref>|| First 12-16 days (ritu kala)|| Milk||12- 16 days
 
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|-
 
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|Flowers of Hibiscus rosasinensis (japa)<ref>Bhavamishra. Bhavaprakasha ,chikitsa prakarana, yoniroga adhikara, verse 34,In:Hindi translation by Pandit Shri Brahma Shankara Mishra, Volume II ,Reprint edition. Varanasi: Chaukhamba Sanskrit bhawan;2018.pp.-765</ref>||First 12-16 days(ritu kala)|| fermented rice water (Kanji) and Old jiggery(48g)||3 days
 
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|-
 
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|Root of Amaranthus spinosus (tanduliyaka)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 52 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:813</ref> ||after the stoppage of menstrual bleeding ||Rice water|| 3 days
 
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|-
 
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|Leaves of Abes webbiana (talisa) and red orche (gairika)<ref>  Yogaratnakara, Yoniroga Chikitsa, verse 54 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:813</ref>||4th day of menstruation||Not specified ||12 g, 1 day
 
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|-
 
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|Extract of Berberis aristata (rasanjana), Iris germanica Linn. (shweta vacha),and Terminalia chebula (haritaki)<ref>Chakrapani, Chakradatta, yoni vyapad chikitsa, verse 23 In: chakradtta, Hindi translation by Dr.Indradev Tripathi,Reprint edition, Vranasi: Chaukhambha  Sanskrit Bhavan,2018,pg no:382.</ref>|| Not specified||Cold water||Not specified(probably for the whole month)
 
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|Paste of leaves of Cesampelus pareira (patha)<ref>Govinda Das,Bhaisajyaratnavali , Streeroga Adhikara, verse 153 , Hindi translation by Pandit. Shri Lalchandraji, reprint edtion,Delhi:Motilal banarasidas, 2002, pg no:707.</ref> ||After the stoppage of menstrual bleeding||Not specified||Not specified
 
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|3 years old jaggery<ref>Ramsagara triphathi, Anangaranga, https://collections.nlm.nih.gov/ext/dw/0327725/PDF/0327725.pdf, page no:57</ref> || Not specified|| Not specified|| Continuously for 15 days
 
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|Decoction of Plumbago zeylanica (chitraka)<ref name= anangaranga>Ramsagara triphathi,Anangaranga,https://collections.nlm.nih.gov/ext/dw/0327725/PDF/0327725.pdf, page no:58</ref>|| From the 4th day of menstrual cycle/after the stoppage of bleeding ||Rice water|| 3 days
 
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|-
 
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|Decoction of Nauclea cadamba/ Nauclea parvifolia (kallambha) and the feet of jungle flies.<ref name=anangaranga/>|| From the 4th day of menstrual cycle/after the stoppage of bleeding||Not specified ||3 days
 
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|19.5 g of marking nut/semicarpus anacardium or seeds of Terminalia bellerica (bibhitaki) boiled in rice water.<ref name=anangaranga/> ||From the 4th day of menstrual cycle/after the stoppage of bleeding)||Not specified||7 days
 
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|Ashes of stem of  Euphorbia neriifolia (sehunda)<ref name=kuchimara>Kuchimaratanra, text with English translation by Goli Penchalaprasada, Varnasi: Chawkhamba Krishnadas Academy, 2007.</ref>||21 days||Not specified ||1 tola(12 gm)
 
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|Curcuma longa (haridra) rhizome having knots <ref name=kuchimara/>||3 days during menstruation, and continued for 3 more days||Not specified||1 rhizome/day, (total 6 days)
 
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|Powder of Carum carvi (krishna jeeraka), Hedchim spicatum (kachura), Mesua ferrea (nagakesara), Terminalia chebula (haritaki), Ngella sativa (kalonji), Myrica nagi (kayaphala)<ref name=kuchimara/>|| 7 days||Not specified||In the size of Ziziphus fruit
 
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|Powder of seeds of Brassica campestris a (sarshap), Amaranthus spinosus (tandula), sugar candy (sharkara)- pound with rice water.<ref name=kuchimara/> ||Not specified ||Milk||Not specified
 
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|}
 
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In current medical practices, two synthetic female hormones, oestrogen and progesterone are used to prevent pregnancy by inhibiting ovulation.These are also known as ‘birth control pills’. Some injectable steroid contraceptives like progesterone only contraceptive injections including DMPA or Depo-Provera and Nexplanon are also in practice.
 
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Adverse effects:
 
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*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.
 
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==III. Barrier methods==
 
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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.
 
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'''Table 2: Local contraceptives in Ayurveda'''
 
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{| class="wikitable" |}
 
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|-
 
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!Drugs!!Mode of administration
 
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|-
 
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|Powdered seeds of Butea monosperma(palasha) along with honey.<ref>Shodhala, Gadanigraha, pradara chikitsa, verse 60, In: Gadanigraha, part 3,  Hindi translation by Indradeva Tripathi, 3rd edition,Varanasi: Chaukhambha Sanskrit Bhawan,1999, page no:456 </ref> ||Applied as vaginal paste during fertile period(ritukala)
 
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|Piece of rock salt + oil<ref>Yogaratnakara, Yoniroga Chikitsa, verse 51 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:813</ref> || Vaginal insertion before coitus.
 
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|Wood of Azadiracta indica(nimba)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 53 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:813</ref>|| Vaginal fumigation before coitus/ during fertile period.
 
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|Powdered root of Datura metel(dhattutra)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 53 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011</ref>||Vaginal filling before coitus.
 
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|Root of Datura metel(dhattutra) collected on 14th day(dark night) of lunar month<ref>Shodhala, Gadanigraha, pradara chikitsa, verse 60, In: Gadanigraha, part 3,  Hindi translation by Indradeva Tripathi, 3rd edition,Varanasi: Chaukhambha Sanskrit Bhawan,1999, page no:456 </ref>||Tie in waste before coitus.
 
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|}
 
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In current practices, male condoms and vaginal diaphragms are used in barrier methods.
 
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==IV. Intra uterine contraceptive devices==
 
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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.
 
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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.
 
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==V. Surgical procedures for sterility==
 
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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.
 
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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.
 
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==VI. Emergency contraception==
 
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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.
 
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This method should be reserved for emergency situations and should not be used as an ongoing method of contraception on regular basis because it has a high failure rate and can cause irregular menstrual bleeding.
 
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'''Abortifacients:'''
 
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Some drugs having the abortifacient action are used for inducing bleeding per vagina in case of accidental conception.
 
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The table 3 lists the drugs for oral administration and table 4 shows locally used drugs in vagina to induce bleeding.
 
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'''Table 3: Oral drugs for inducing bleeding per vagina/ abortion'''
 
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{| class="wikitable" |}
 
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|-
 
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!Drug !! Vehicle(anupana)
 
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|-
 
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|Scraped lime powder from the walls of temple(devalaya churna) – 12 g <ref>Yogaratnakara, Yoniroga Chikitsa, verse 61 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:814</ref>||water
 
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|Root of Plumbago zeylanica(chitraka) and leaf juice of Vitex negundo Linn(nirgundi)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 59 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:814</ref> || honey
 
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|Seeds of carrot(Daucus carota)+Roots of Cajanus cajan Linn(tuwari)+lead oxide(sindura)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 57-58 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:814</ref>||water
 
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|Faeces of mare mixed with fermented rice water(kanji) and filtered+rock salt+ Apium graveolens Linn(ajamoda)+oil of Brassica nigra(asuri)+Aconitum ferox(visha)<ref>Yogaratnakara, Yoniroga Chikitsa, verse 62 In: Yogaratnakara with Vidyaprabha Hindi commentary, Dr. Indradev Tripathi, Dr. Daya Shankar Tripathi editors,3rd ed, Varanasi:Chawkhamba Krishnadas Academy, 2011 Pg no:814</ref>||not specified
 
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|-
 
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|Paste of fried leaves of Celastrus panniculata(jyotishmati) and flowers of Hibiscus rosasinensis(japa)<ref>Govinda Das,Bhaisajyaratnavali , Streeroga Adhikara, verse 151 , Hindi translation by Pandit. Shri Lalchandraji, reprint edtion,Delhi:Motilal banarasidas, 2002, pg no:707</ref> || water
 
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|Paste of Cedrus deodora(devadaru) and Cynodon dactylon(durva) aling with paste rice grain.<ref>Ramsagara triphathi, Anangaranga, https://collections.nlm.nih.gov/ext/dw/0327725/PDF/0327725.pdf</ref>||water
 
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|}
 
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'''Table 4: Local drugs for inducing menstrual flow/ abortion'''
 
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{|class="wikitable" |}
 
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|-
 
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!Drug!!Mode of administration
 
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|The stem of leaf of Ricinus communis (eranda patra danda)<ref name=Tewari>Tewari PV, Chaturvedi C. Method of population control in ayurvedic classics. Anc Sci Life. 1981;1(2):72-79.</ref> || Vaginal insertion
 
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|-
 
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|Root of Boerhavia diffusa (punarnava)<ref name=Tewari/> || Vaginal insertion
 
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|-
 
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|Root of Clitorea ternata (Shweta aparajita)<ref name=Tewari/> || Vaginal insertion
 
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|-
 
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|Aerial roots of Cardiospermum helicacabum Linn(Sharngeshta/Kakadani)<ref name=Tewari/> ||Vaginal insertion
 
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|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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|}
 
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==Current researches==
 
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The following table no. 5 reviews pharmacological research studies on single drugs mentioned in contraceptive formulations in Ayurveda.
 
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'''Table 5: Researches on contraceptive herbs'''
 
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{| class="wikitable" |}
 
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|-
 
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!Drug!!Observations
 
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|-
 
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|Embelia ribes(vidanga) ||Root powder in 100g/kg in rats exhibited 100% inhibition of pregnancy in albino rats.<ref>Garg SK, Garg GP, Screening of Indian Plants for antifertility activity,Indian Journal of Experimental Biology, 16(10), 1978. Pg 1077-79.</ref>
 
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Embelin 50-100mg/kg in rats from day 1 to day 7 of pregnancy showed 85.71% anti-implantation activity, significant anti-estrogenic and progestational properties.<ref>Prakash AO, Antifertility investigaions, Embelin- an oral contraceptive of plant origin, Planta Med 41(3), 1981, pg 259—66.</ref>
 
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|-
 
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|Abies webbiana(Talisa) || Benzene and alcoholic extracts of leaf produced 51% anti- implantation activity.<ref>Anonymous, Pharmacological investigations of certain medicinal plants & compound formulations used Ayurveda and Sidha , CCRAS New Delhi, 1996, 474.</ref>
 
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|-
 
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|Azadiracta indica (nimba)||Bark extract had shown in vitro spermicidal activity.<ref>Vnita Bhargava, Prakash AO, Spermicidal activity in vitro of bark extract of Azadiracta indica in rats,Ancient Science of Life 20(1/2)</ref>
 
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|-
 
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|Daucus carota(grinjana)||Extracts of the seeds showed petroleum, ether, benzene, alcohol & water showed 85%, 95%, 92%,50% anti-implantation activity respectively.<ref>Uduppa KN & Singh RH,Antifertility property of the alcoholic extract of carrot seed, J Res Indian Med Yoga Homeo 14(1),1979, pg 128-30.</ref>
 
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|-
 
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|Hibiscus rosasinensis(Japa)||Alcoholic extract of flower showed 50-60% inhibition of pregnancy at 200mg/kg dose.Benzene extract produced 100% antifertility effect in 250mg/kg.<ref>Kholkute SD,Uduppa KN, Antifertility properties of Hibiscus rosasinensis, J Res Indian Med,9(4), 1974, pg 99.</ref>
 
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|-
 
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|Plumbago rosea / Plumbago zeylanica(chitraka)||Root powder in a dose of 100mg/100g from Day 1 to Day 7 of pregnancy in albino rats showed 100% antifertility activity.<ref>Anonymous, Pharmacological investigations of certain medicinal plants & compound formulations used Ayurveda and Sidha , CCRAS New Delhi, 1996, 84.</ref>
 
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|-
 
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|Terminalia arjuna(arjuna)||Anti-zygotic, anti-implantation, abortifacient activities.<ref>Lal B, Uduppa KN, A preliminary study of anti- fertility effect of an indigenous drug- arjuna(Terminala arjuna), JRAS,14(1),1991, Pg 165-169.</ref>
 
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|-
 
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|Mesua ferrea(Nagaksara)|| Flowers exhibited anti-implantation activity in female rats.<ref>Seshadri c & Pillai SR, Antifertility activity of a compound Ayurvedic preparation, J Sci Res Pl Med 2 (1 &2),1981.pg 1-3.</ref>
 
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|}
 
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The Central Council for Research in Ayurvedic Sciences (CCRAS), working under the Ministry of AYUSH carried out the screening of many herbal and herbo-mineral drugs for the contraceptive activity under the Research Scheme for screening of contraceptive agents.
 
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*A compound drug called AYUSH AC-V, which is a combination of Abes webbiana(talisa patra) and red orche (gairika), showed 100% anti-implantation effect on multigravida  rats.<ref>Revan Siddappa et al; Evaluation of contraceptive effect of a traditional medicine on albino rats, Aryavaidyan Vol.XXIII, No.1, Aug-Oct 2009, Pp 9-12</ref>
 
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*Another coded drug called AYUSH AC-IV, Embelia ribes (vidanga), Laccardia lacca (laksha), Areca catechu (puga) and Saraca asoka (ashoka) in equal parts, 1gm/day in two divided doses in 281 women for 15 days (D4-D18). There was no pregnancy reported even after 10th cycle.<ref>Gowri N, Srinivasn K, Venkataraghavan S. Clinical study of ac-4-an ayurvedic compound preparation as an oral contraceptive. Anc Sci Life. 1982;2(2):79-83.</ref>
 
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*The various clinical trials conducted by CCRAS, the combination of Piper longum Linn(pippali), Embelia ribes(vidanga), borax(tankana) known as “pippalyadi yoga” was tested in 722 women in tablet form 1g/day. It effectively prevented pregnancy in 98.42%.<ref>https://eparlib.nic.in/bitstream/123456789/574253/1/9271.pdf</ref>
 
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*Oil of Azadiracta indica A Juss (nimba), 1 ml intra vaginally before each coitus, tested in 225 women with proven fertility showed 98.7% result in prevention of pregnancy and in a dose of 3 ml (intra vaginally before each coitus) showed 100% result in prevention of pregnancy during the study period of 12 cycles.
 
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*“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>
 
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==References==
 

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