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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. 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. This is an important measure for population control.
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.
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.
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.
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.
1) Temporary methods- which includes,
1) Temporary methods- which includes,
a) Natural contraception (rhythm method, coitus interruptus, lactational amenorrhoea method etc.)
a) Natural contraception (rhythm method, coitus interruptus, lactational amenorrhoea method etc.)
b) Barrier Methods (Mechanical- male condom, female condom, diaphragm, cervical cap, Chemical-vaginal creams, jelly, foam tablets etc.)
b) Barrier Methods (Mechanical- male condom, female condom, diaphragm, cervical cap, Chemical-vaginal creams, jelly, foam tablets etc.)
c) Intrauterine contraceptive devices
c) Intrauterine contraceptive devices
d) Steroidal contraception (oral, parenteral, device, patch)
d) Steroidal contraception (oral, parenteral, device, patch)
2) Permanent Methods which includes,
2) Permanent Methods which includes,
a) Tubal occlusion
a) Tubal occlusion
b) Vasectomy
b) Vasectomy
Contraceptive options:
Contraceptive options:
I. Natural Family Planning
I. Natural Family Planning
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:
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:
1. Abstinence method:
1. Abstinence method:
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. [ref. Ashtanga hridaya]
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. [ref. Ashtanga hridaya]
2. Breathing exercise:
2. Breathing exercise:
Breathing exercise to be practiced during coitus in order to prevent conception is mentioned in “Bruhadaranyaka Upanishad”.
Breathing exercise to be practiced during coitus in order to prevent conception is mentioned in “Bruhadaranyaka Upanishad”.
3. Safe period or rhythm method:
3. Safe period or rhythm method:
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.
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.
In current practices, the safe period is applied by ‘rhythm method’, or ‘calendar method’.
In current practices, the safe period is applied by ‘rhythm method’, or ‘calendar method’.
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.
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.
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]
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]
4. Basal body temperature method
4. Basal body temperature method
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.
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.
5. Cervical mucus method
5. Cervical mucus method
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.
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.
6. Lactation amenorrhea method
6. Lactation amenorrhea method
Breastfeeding supresses ovulation. It is considered to an effective method of contraception only if the mother is exclusively breastfeeding the baby at regular intervals.
Breastfeeding supresses ovulation. It is considered to an effective method of contraception only if the mother is exclusively breastfeeding the baby at regular intervals.
7. Positions of sexual intercourse
7. Positions of sexual intercourse
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.
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.
8. Withdrawal method
8. Withdrawal method
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.
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.
Drawbacks of this method:
Drawbacks of this method:
*Needs great motivation and self-control in the male partner.
*The female partner may develop sexual neurosis as female satisfaction/ orgasm may not be achieved.
*The pre-ejaculate (fluid that is secreted for lubrication, in males,) may contain few sperms which may lead to unwanted pregnancy.
*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.
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.
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]
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]
Table 1: Oral contraceptives in Ayurveda
Table 1: Oral contraceptives in Ayurveda
Drugs Period of menstrual cycle Vehicle/After drink
Drugs Period of menstrual cycle Vehicle/After drink