Birth control, sometimes synonymous with contraception, is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of pregnancy or childbirth. Contraception may refer specifically to mechanisms which are intended to reduce the likelihood of the fertilization of an ovum by a spermatozoon. Birth control is commonly used as part of family planning.The history of birth control began with the discovery of the connection between coitus and pregnancy. The oldest forms of birth control included coitus interruptus, pessaries, and the ingestion of herbs that were believed to be contraceptive or abortifacient. The earliest record of birth control use is an Ancient Egyptian set of instructions on creating a contraceptive pessary.Different methods of birth control have varying characteristics. Condoms, for example, are the only methods that provide significant protection from sexually transmitted diseases. Cultural and religious attitudes on birth control vary significantly.History And the villain still pursues her. Humorous Victorian era postcard.And the villain still pursues her. Humorous Victorian era postcard.Probably the oldest methods of contraception aside from sexual abstinence are coitus interruptus, lactational, certain barrier methods, and herbal methods emmenagogues and abortifacients.Coitus interruptus withdrawal of the penis from the vagina prior to ejaculation probably predates any other form of birth control. Once the relationship between the emission of semen into the vagina and pregnancy was known or suspected, some men began to use this technique. This is not a particularly reliable method of contraception, as few men have the selfcontrol to correctly practice the method at every single act of sexual intercourse. Although it is commonly believed that preejaculate fluid can cause pregnancy, modern research has shown that preejaculate fluid does not contain viable sperm.There are historic records of Egyptian women using a pessary a vaginal suppository made of various acidic substances and lubricated with honey or oil, which may have been somewhat effective at killing sperm. However, it is important to note that the sperm cell was not discovered until Anton van Leeuwenhoek invented the microscope in the late th century, so barrier methods employed prior to that time could not know of the details of conception. Asian women may have used oiled paper as a cervical cap, and Europeans may have used beeswax for this purpose. The condom appeared sometime in the th century, initially made of a length of animal intestine. It was not particularly popular, nor as effective as modern latex condoms, but was employed both as a means of contraception and in the hopes of avoiding syphilis, which was greatly feared and devastating prior to the discovery of antibiotic drugs.
Various abortifacients have been used throughout human history. Some of them were effective, some were not those that were most effective also had major side effects. One abortifacient reported to have low levels of side effects — silphium — was harvested to extinction around the st century. The ingestion of certain poisons by the female can disrupt the reproductive system women have drunk solutions containing mercury, arsenic, or other toxic substances for this purpose. The Greek gynaecologist Soranus in the nd century suggested that women drink water that blacksmiths had used to cool metal. The herbs tansy and pennyroyal are wellknown in folklore as abortive agents, but these also work by poisoning the woman. Levels of the active chemicals in these herbs that will induce a miscarriage are high enough to perilously damage the liver, kidneys, and other organs. However, in those times where risk of maternal death from postpartum complications was high, the risks and side effects of toxic medicines may have seemed less onerous. Some herbalists claim that black cohosh tea will also be effective in certain cases as an abortifacient.Aside from abortifacients, herbal contraceptives in folklore have also included a few preventative measures. Hibiscus rosasinensis, known in Ayurveda as a contraceptive, may have antiestrogenic properties. Papaya seeds, rumored to be a male contraceptive, have recently been studied for their azoospermic effect on monkeys.The fact that various effective methods of birth control were known in the ancient world sharply contrasts with a seeming ignorance of these methods in wide segments of the population of early modern Christian Europe. This ignorance continued far into the th century, and was paralleled by eminently high birth rates in European countries during the th and th centuries. Some historians have attributed this to a series of coercive measures enacted by the emerging modern state, in an effort to repopulate Europe after the population catastrophe of the Black Death, starting in . According to this view, the witch hunts were the first measure the modern state took in an attempt to eliminate knowledge about birth control within the population, and monopolize it in the hands of stateemployed male medical specialists gynecologists. Prior to the witch hunts, male specialists were unheard of, because birth control was naturally a female domain.
Presenters at a family planning conference told a tale of Arab traders inserting small stones into the uteruses of their camels in order to prevent pregnancy, a concept very similar to the modern IUD. Although the story has been repeated as truth, it has no basis in history and was meant only for entertainment purposes. The first interuterine devices which occupied both the vagina and the uterus were first marketed around . The first modern intrauterine device contained entirely in the uterus was described in a German publication in . The Gräfenberg ring, the first IUD that was used by a significant number of women, was introduced in .The Rhythm Method with a rather high method failure rate of ten percent per year was developed in the early th century, as researchers discovered that a woman only ovulates once per menstrual cycle. Not until the s, when scientists better understood the functioning of the menstrual cycle and the hormones that controlled it, were methods of hormonal contraception and modern methods of fertility awareness also called natural family planning developed.Margaret Sanger was an American birth control activist and the founder of the American Birth Control League which eventually became Planned Parenthood. She was instrumental in opening the way to access birth control.In the FDA approved the first form of hormonal birth control, the combined oral contraceptive pill.edit Methods See also Comparison of birth control methodsedit Physical methodsPhysical methods may work in a variety of ways, among them physically preventing sperm from entering the female reproductive tract hormonally preventing ovulation from occuring making the womans reproductive tract inhospitable to sperm or surgically altering the male or female reproductive tract to induce sterility. Some methods use more than one mechanism. Physical methods vary in simplicity, convenience and efficacy.
edit Barrier methodsondom rolledup.Condom rolledup.Barrier methods place a physical impediment to the movement of sperm into the female reproductive tract.The most popular barrier method is the male condom, a latex or polyurethane sheath placed over the penis. The condom is also available in a female version, which is made of polyurethane. The female condom has a flexible ring at each end — one secures behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina.Cervical barriers are devices that are contained completely within the vagina. The contraceptive sponge has a depression to hold it in place over the cervix. The cervical cap is the smallest cervical barrier. Depending on the type of cap, it stays in place by suction to the cervix or to the vaginal walls. The diaphragm fits into place behind the womans pubic bone and has a firm but flexible ring, which helps it press against the vaginal walls.Spermicide may be placed in the vagina before intercourse and creates a chemical barrier. Spermicide may be used alone, or in combination with a physical barrier.edit Hormonal methodsOrtho Tricyclen, a brand of oral contraceptive, in a dial dispenser.Ortho Tricyclen, a brand of oral contraceptive, in a dial dispenser.There are variety of delivery methods for hormonal contraception.Combinations of synthetic oestrogens and progestins synthetic progestogens are commonly used. These include the combined oral contraceptive pill The Pill, the Patch, and the contraceptive vaginal ring NuvaRing. Not currently available for sale in the United States is Lunelle, a monthly injection.Other methods contain only a progestin a synthetic progestogen. These include the progesterone only pill the POP or minipill, the injectables Depo Provera a depot formulation of medroxyprogesterone acetate given as an intramuscular injection every three months and Noristerat Norethindrone acetate given as an intramuscular injection every weeks, and contraceptive implants. The progestinonly pill must be taken at more precisely remembered times each day than combined pills. The first contraceptive implant, the original capsule Norplant, was removed from the market in the United States in , though a newer singlerod implant called Implanon was approved for sale in the United States on July , . The various progestinonly methods may cause irregular bleeding during use.
Ormeloxifene Centchroman is a selective oestrogen receptor modulator, or SERM. It causes ovulation to occur asynchronously with the formation of the uterine lining, preventing implantation of a zygote. It has been widely available as a birth control method in India since the early s, marketed under the trade name Saheli. Centchroman is legally available only in India.edit Intrauterine methodsAn intrauterine device.An intrauterine device.These are contraceptive devices which are placed inside the uterus. They are usually shaped like a T — the arms of the T hold the device in place. There are two main types of intrauterine contraceptives those that contain copper which has a spermicidal effect, and those that release a progestogen in the US the term progestin is used.The terminology used for these devices differs in the United Kingdom and the United States. In the US, all devices which are placed in the uterus to prevent pregnancy are referred to as intrauterine devices IUDs or intrauterine contraceptive devices IUCDs. In the UK, only coppercontaining devices are called IUDs or IUCDs, and hormonal intrauterine contraceptives are referred to with the term IntraUterine System IUS. This may be because there are seven types of copper IUDs available in the UK, compared to only one in the US.edit Emergency contraception See also Emergency contraceptive availability by countrySome combined pills and POPs may be taken in high doses to prevent pregnancy after a birth control failure such as a condom breaking or after unprotected sex. Hormonal emergency contraception is also known as the morning after pill, although it is licensed for use up to three days after intercourse.Copper intrauterine devices may also be used as emergency contraception. For this use, they must be inserted within five days of the birth control failure or unprotected intercourse.Emergency contraception appears to work by suppressing ovulation. However, because it might prevent a fertilized egg from implanting, some people consider it a form of abortion. The details of the possible methods of action are still being studied.edit Induced abortionAbortion can be done with surgical methods, usually suctionaspiration abortion in the first trimester or dilation and evacuation in the second trimester. Medical abortion uses drugs to end a pregnancy and is approved for pregnancies where the length of gestation has not exceeded weeks.Some herbs are believed to cause abortion abortifacients. The efficacy of these plants as such has never been studied in humans. Some animal studies have found them to be effective on other species. The use of herbs to induce abortion is not recommended due to the risk of serious side effects.
Abortion is subject to ethical debate.edit SterilizationSurgical sterilization is available in the form of tubal ligation for women and vasectomy for men. In women, the process may be referred to as tying the tubes, but the fallopian tubes may be tied, cut, clamped, or blocked. This serves to prevent sperm from joining the unfertilized egg. The nonsurgical sterilization procedure, Essure, is an example of a procedure that blocks the tubes. Sterilization should be considered permanent.edit Behavioral methodsBehavioral methods involve regulating the timing or methods of intercourse to prevent the introduction of sperm into the female reproductive tract, either altogether or when an egg may be present.edit Fertility awarenessSymptomsbased methods of fertility awareness involve a womans observation and charting of her bodys fertility signs, to determine the fertile and infertile phases of her cycle. Most methods track one or more of the three primary fertility signs changes in basal body temperature, in cervical mucus, and in cervical position. If a woman tracks both basal body temperature and another primary sign, the method is referred to as symptothermal. Some fertility monitoring devices use urinalysis to follow the levels of estrogen and luteinizing hormone throughout a womans menstrual cycle. Other bodily cues such as mittelschmerz are considered secondary indicators.Calendarbased methods such as the Rhythm method and Standard Days Method are dissimilar from symptomsbased fertility awareness methods, in that they do not involve the observation or recording of bodily cues of fertility. Instead, statistical methods estimate the likelihood of fertility based on the length of past menstrual cycles. Statistical methods are less accurate than fertility awareness methods, and are considered by many fertility awareness teachers to have been obsolete for at least years. Charting of the menstrual cycle may be done by the woman on paper or with the assistance of software. The calendarbased methods may use a device such as CycleBeads. Symptomsbased methods may be assisted by fertility monitoring devices that accept and interpret temperature readings, information from home urinalysis tests, or both. To avoid pregnancy with fertility awareness, unprotected sex is restricted to the least fertile period. During the most fertile period, barrier methods may be availed, or she may abstain from intercourse.The term natural family planning NFP is sometimes used to refer to any use of FA methods. However, this term specifically refers to the practices which are permitted by the Roman Catholic Church — breastfeeding infertility, and periodic abstinence during fertile times. FA methods may be used by NFP users to identify these fertile times.
Coitus interruptus literally interrupted sex, also known as the withdrawal method, is the practice of ending sexual intercourse pulling out before ejaculation. The main risk of coitus interruptus is that the man may not perform the maneuver correctly, or may not perform the maneuver in a timely manner. Although concern has been raised about the risk of pregnancy from sperm in preejaculate, several small studies have failed to find any viable sperm in the fluid.edit Avoiding vaginal intercourseThe risk of pregnancy from nonvaginal sex, such as outercourse sex without penetration, anal sex, or oral sex is virtually zero. A very small risk comes from the possibility of semen leaking onto the vulva with anal sex or coming into contact with an object, such as a hand, that later contacts the vulva.edit AbstinenceSexual abstinence is the practice of refraining from all sexual activity.edit LactationalMost breastfeeding women have a period of infertility after the birth of their child. The lactational amenorrhea method, or LAM, gives guidelines for determining the length of a womans period of breastfeeding infertility.edit Methods in developmentedit For females Praneem is a polyherbal vaginal tablet being studied as a spermicide, and a microbicide active against HIV. BufferGel is a spermicidal gel being studied as a microbicide active against HIV.Duet is a disposable diaphragm in development that will be prefilled with BufferGel. It is designed to deliver microbicide to both the cervix and vagina. Unlike currently available diaphragms, the Duet will be manufactured in only one size and will not require a prescription, fitting, or a visit to a doctor.The SILCS diaphragm is a silicone barrier which is still in clinical testing. It has a finger cup molded on one end for easy removal. Like the Duet, the SILCS is novel in that it will only be vailable in one size. A vaginal ring is being developed that releases both estrogen and progesterone, and is ffective for over months. Two types of progestogenonly vaginal rings are being developed. Progestogenonly products may be particularly useful for women who are breastfeeding. The rings may be used for four onths at a time.A progesteroneonly contraceptive is being developed that would be sprayed onto the skin once a day. Quinacrine sterilization and the Adiana procedure are two permanent methods of birth control being developed.edit For males Main article Male contraceptiveOther than condoms and withdrawal, there are currently no available methods of reversible contraception which males can use or control. Several methods are in research and development As of , a chemical called Adjudin is currently in Phase II human trials as a male oral ontraceptive. RISUG Reversible Inhibition of Sperm Under Guidance, is an experimental injection into the vas deferens that coats the walls of the vas with a spermicidal substance. The method can potentially be reversed by washing out the vas deferens with a second injection.
Experiments in vasocclusive contraception involve an implant placed in the vasa deferentia. Experiments in heatbased contraception involve heating a mans testicles to a high temperature for a short period of time.edit MisconceptionsModern misconceptions and urban legends have given rise to a great deal of false claims The suggestion that douching with any substance immediately following intercourse works as a contraceptive is untrue. While it may seem like a sensible idea to try to wash the ejaculate out of the vagina, it is not likely to be effective. Due to the nature of the fluids and the structure of the female reproductive tract – if anything, douching spreads semen further towards the uterus. Some slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be a reliably effective method. It is a myth that a female cannot become pregnant as a result of the first time she engages in sexual intercourse. While women are usually less fertile for the first few days of menstruation, it is a myth that a woman absolutely cannot get pregnant if she has sex during her period.Having sex in a hot tub does not prevent pregnancy, but may contribute to vaginal infectionsAlthough some sex positions may encourage pregnancy, no sexual positions prevent pregnancy. Having sex while standing up or with a woman on top will not keep the sperm from entering the uterus. The force of ejaculation, the contractions of the uterus caused by prostaglandinscitation needed in the semen, as well as ability of sperm to swim overrides gravity.Urinating after sex does not prevent pregnancy and is not a form of birth control, although it is often advised anyway to help prevent urinary tract infections. Toothpaste cannot be used as an effective contraceptivedit Effectiveness See also the table at Comparison of birth control thodsEffectiveness is measured by how many women become pregnant using a particular birth control method in the first year of use. Thus, if women use a method that has a percent firstyear failure rate, then sometime during the first year of use, of the women should become pregnant.The most effective methods in typical use are those that do not depend upon regular user action. Surgical sterilization, DepoProvera, implants, and intrauterine devices IUDs all have firstyear failure rates of less than one percent for perfect use. Sterilization, implants, and IUDs also have typical failure rates under one percent. The typical failure rate of DepoProvera is disagreed upon, with figures ranging from less than one percent up to three percent.
Other methods may be highly effective if used consistently and correctly, but can have typical use firstyear failure rates that are considerably higher due to incorrect or ineffective usage by the user. Hormonal contraceptive pills, patches or rings, fertility awareness methods, and the lactational amenorrhea method LAM, if used strictly, have firstyear or for LAM, firstmonth failure rates of less than %. In one survey, typical use firstyear failure rates of hormonal contraceptive pills and by extrapolation, patches or rings were as high as five percent per year. Fertility awareness methods as a whole have typical use firstyear failure rates as high as percent per year however, as stated above, perfect use of these methods reduces the firstyear failure rate to less than %.Condoms and cervical barriers such as the diaphragm have similar typical use firstyear failure rates and percent, respectively, but perfect usage of the condom is more effective three percent firstyear failure vs six percent and condoms have the additional feature of helping to prevent the spread of sexually transmitted diseases such as the HIV virus. The withdrawal method, if used consistently and correctly, has a firstyear failure rate of four percent. Due to the difficulty of consistently using withdrawal correctly, it has a typical use firstyear failure rate of percent, and is not recommended by some medical professionals.edit Protection against sexually transmitted infections See also safe sexNot all methods of birth control offer protection against sexually transmitted infections. Abstinence from all forms of sexual behavior will protect against the sexual transmission of these infections. The male latex condom offers some protection against some of these diseases with correct and consistent use, as does the female condom, although the latter has only been approved for vaginal sex. The female condom may offer greater protection against sexually transmitted infections that pass through skin to skin contact, as the outer ring covers more exposed skin than the male condom, and can be used during anal sex to guard against sexually transmitted infections. However, the female condom can be difficult to use. Frequently a woman can improperly insert it, even if she believes she is using it correctly.citation neededThe remaining methods of birth control do not offer significant protection against the sexual transmission of these diseases.However, socalled sexually transmitted infections may also be transmitted nonsexually, and therefore, abstinence from sexual behavior does not guarantee percent protection against sexually transmitted infections. For example, HIV may be transmitted through contaminated needles which may be used in intravenous drug use, tattooing, body piercing, or injections. Healthcare workers have acquired HIV through occupational exposure to accidental injuries with needles.edit Religious and cultural attitudesedit Religious views on birth control Main article Religious views on birth controlReligions vary widely in their views of the ethics of birth control. In Christianity, the Roman Catholic Church accepts only Natural Family Planning, while Protestants maintain a wide range of views from allowing none to very lenient. Views in Judaism range from the stricter Orthodox sect to the more relaxed Reform sect. In Islam, contraceptives are allowed if they do not threaten health or lead to sterility, although their use is discouraged. Hindus may use both natural and artificial contraceptives. A common Buddhist view of birth control is that preventing conception is ethically acceptable, while intervening after conception has occurred or may have occurred is not.
edit Birth control educationMany teenagers, most commonly in developed countries, receive some form of sex education in school. What information should be provided in such programs is hotly contested, especially in the United States and Great Britain. Possible topics include reproductive anatomy, human sexual behavior, information on sexually transmitted diseases STDs, social aspects of sexual interaction,negotiating skills intended to help teens follow through with a decision to remain abstinent or to use birth control during sex, and information on birth control methods.One type of sex education program used mainly in the United States is called abstinenceonly education, and it promotes sexual abstinence until marriage. The programs do not encourage birth control, often provide inaccurate information about contraceptives and sexuality, stress failure rates of condoms and other contraceptives, and teach strategies for avoiding sexually intimate situations. Advocates of abstinenceonly education believe that the programs will result in decreased rates of teenage pregnancy and STD infection. In a nonrandom, Internet survey of , women who found and completed a minute multiplechoice online questionnaire listed in one of several popular search engines, women who received sex education from schools providing primarily abstinence information, or contraception and abstinence information equally, reported fewer unplanned pregnancies than those who received primarily contraceptive information, who in turn reported fewer unplanned pregnancies than those who received no information. However, randomized controlled trials demonstrate that abstinenceonly sex education programs increase the rates of pregnancy and STDs in the teenage population. Professional medical organizations, including the AMA, AAP, ACOG, APHA, and Society for Adolescent Medicine, support comprehensive sex education providing abstinence and contraceptive information and oppose the sole use of abstinenceonly sex educationChristianityMain article Christian views on contraceptionAmong Christian denominations today there are a large variety of positions towards contraception. The Roman Catholic Church has disallowed artificial birth control for as far back as one can historically trace. Contraception was also officially disallowed by Protestants until when the Anglican Communion changed its policy. Soon after, most Protestant groups came to accept the use of modern contraceptives as a matter of Biblically allowable freedom of conscience.
Main article Christian views on contraception#Roman Catholic ChurchThe Roman Catholic Church is morally opposed to contraception and orgasmic acts outside of the context of marital intercourse, believing that all sexual acts must be open to procreation. The only form of birth control permitted is abstinence. Modern scientific methods of periodic abstinence such as Natural Family Planning NFP were counted as a form of abstinence by Pope Paul VI in his encyclical Humanae Vitae. The following is the condemnation of contraception Therefore We base Our words on the first principles of a human and Christian doctrine of marriage when We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children. Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary. Similarly excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent rocreation—whether as an end or as a means.A number of other documents provide more insight into the Churchs position on contraception. The commission appointed to study the question in the years leading up to Humanae Vitae issued two reports, a majority report explaining why the Church could change its teaching on contraception, and a minority report which explains the reasons for upholding the traditional Christian view on contraception. In , the Vatican released a document entitled Vademecum for Confessors which states the Church has always taught the intrinsic evil of contraception. Furthermore, many Church Fathers condemned the use of contraception. Other Catholics have voiced significant disagreement with the Churchs stance on contraception. The Canadian Conference of Catholic Bishops issued probably the most heavily dissenting document, the Winnipeg Statement. In it, the bishops argued that many Catholics found it very difficult, if not sometimes impossible, to obey Humanae Vitae. Additionally, they reasserted the Catholic principle of primacy of conscience. Theologians such as Charles Curran have also criticized the stance of Humanae Vitae on artificial birth control. According to the American Enterprise Institute, % of Catholics say they believe the church should allow Catholics to use birth control.
edit Protestantism Main article Christian views on contraception#Protestant Christianity Author and FamilyLife Today radio host Dennis Rainey suggests four categories as useful in understanding current Protestant attitudes concerning birth control. These are the children in abundance group, such as Quiverfull adherents who view all birth control as wrong the children in managed abundance group, which accept only Natural Family Planning the children in moderation group which accepts prudent use of a wide range of contraceptives and, the no children group which sees itself as within their Biblical rights to define their lives around nonnatal concerns.Meanwhile, Protestant movements such as Focus on the Family view contraception use outside of marriage as encouragement to promiscuity. Sex is a powerful drive, and for most of human history it was firmly linked to marriage and childbearing. Only relatively recently has the act of sex commonly been divorced from marriage and procreation. Modern contraceptive inventions have given many an exaggerated sense of safety and prompted more people than ever before to movesexual expression outside the marriage boundary.edit IslamThe Quran does not make any explicit statements about the morality of contraception, but contains statements encouraging procreation. Various interpretations have been set forth over time, and at the time of this writing, discussions on the web can be found easily that take various positions. Early Sunni Muslim literature discusses various contraceptive methods, and a study sponsored by the Sunni Egyptian government concluded that not only was azl coitus interruptus acceptable from a moral standpoint, but any similar method that did not produce sterility was also acceptable.citation needed It is permissible to use condoms so long as this does not cause any harm and so long as both husband and wife consent to their use, because this is similar to ‘azl coitus interruptus or “withdrawal”. But it reduces the sensation of pleasure, which is the right of both partners, and reduces the chance of conception, which is also the right of both partners. Neither one of them is allowed to deprive the other of these rights. And Allah is the course of strength.However, there are several schools of thought on this as well as other issues concerning Islamic morality. In Iran, a Shia Islamic country, contraceptive methods are not only taught to married couples, but also encouraged to youngsters through posters and advertisements.citation needed.
Main article Jewish views on contraceptionThe Jewish view on birth control currently varies between the Orthodox, Conservative, and Reform branches of Judaism. Among Orthodox Judaism, use of birth control has been considered only acceptable for use in certain circumstances, for example, when the couple already has two children. Conservative Judaism, while generally encouraging its members to follow the traditional Jewish views on birth control has been more willing to allow greater exceptions regarding its use to fit better within modern society. Reform Judaism has generally been the most liberal with regard to birth control allowing individual followers to use their own judgment in what, if any, birth control methods they might wish to employ.citation neededWhen Orthodox Jewish couples contemplate the use of contraceptives, they generally consult a rabbi who evaluates the need for the intervention and which method is preferable from a halachic point of view.citation needededit SikhismSikhs have no objection to birth control.citation neededWhether or not Sikhs use contraception, and the form of contraception used, is a matter for the couple concerned.citation needededit HinduismThere is no ban on birth control in induism.citation neededSome Hindu scriptures include advice on what a couple should do to promote conception thus providing contraceptive advice to those who want it.citation neededHowever most Hindus accept that there is a duty to have a family during the householder stage of life, and so are unlikely to use contraception to avoid having children altogether.citation neededBecause India has such a large and dense popultion, much of the discussion of birth control has focused on the environmental issue of overpopulation rather than more personal ethics, and birth control is not a major ethical issueSafe sex also called safer sex or protected sex is the practice of sexual activity in a manner that reduces the risk of infection with sexually transmitted diseases STDs. Conversely, unsafe sex is the practice of sexual intercourse without regard for prevention of STDs.Safe sex practices became prominent in the late s as a result of the AIDS epidemic. Promoting safe sex is now a principal aim of sex education. From the viewpoint of society, safe sex can be regarded as a harm reduction strategy. The goal of safer sex is education and risk reduction.In contrast to protected sex is unprotected sex, which can refer to The practice of sex without protection from pregnancy The practice of sex without protection from STDsAlthough safe sex practices can be used as a form of family planning, the term refers to efforts made to prevent infection as well as conception. Many effective forms of contraception do not offer protection against STDs.Terminology
Recently, and mostly within Canada and the United States, the use of the term safer sex rather than safe sex has gained greater use by health workers, with the realization the grounds that risk of transmission of sexually transmitted infections in various sexual activities is a continuum rather than a simple dichotomy between risky and safe. However, in most other countries, including the United Kingdom and Australia, the term safe sex is still mainly used by sex educators.edit Focus on HIVAIDSMuch attention has focused on controlling HIV, the virus that causes AIDS, through the use of condoms. However, as many STDs can be transmitted through other activities, some sex educators recommend that barrier protection be used for all sexual activities which have the potential for disease transmission, such as manual penetration of the anal or vaginal cavities, or oral stimulation of the genitals.edit Safe sex precautionsShunga print by Kunisada depicting turbationShunga print by Kunisada depicting masturbationedit Sex by yourselfKnown as autoeroticism, solitary sexual activity is relatively safe. Masturbation, the simple act of stimulating ones own genitalia, is safe so long as contact is not made with other peoples discharged bodily fluids. However, some practices, such as selfbondage and autoerotic asphyxia, are made considerably more dangerous by the absence of people who can intervene if something goes wrong.Modern technology does permit some activities, such as phone sex and cybersex, that allow for partners to engage in sexual activity without being in the same room, eliminating the risks involved with exchanging bodily fluids.edit Nonpenetrative sex Main article Nonpenetrative sexA range of sex acts, sometimes called outercourse, can be enjoyed by lovers with significantly reduced risks of infection and pregnancy. U.S. President Bill Clintons surgeon general, Dr. Joycelyn Elders, tried to encourage the use of these practices among young people, but her position encountered opposition from a number of outlets, including the White House itself, and resulted in her being fired by President Clinton in December of .edit Limiting fluid exchangeCondom machineCondom machineVarious devices are used to avoid contact with blood, vaginal fluid, and semen during sexual ctivity Condoms cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it. However, there is less research on its effectiveness than there is on latex.
Female condoms are inserted into the vagina prior to intercourse. They may also be used for anal sex, although they are less effective. A dental dam originally used in dentistry is a sheet of latex used for protection when engaging in oral sex. It is typically used as a barrier betwen the mouth and the vulva during cunnilingus or between the mouth and the anus during anilingus. Medical gloves made out of latex, vinyl, nitrile, or polyurethane may be used as an ersatz inferior dental dam during oral sex, or to protect the hands during mutual asturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the semen or the vaginal fluids of STD infectees. Although the risk of infection in this manner is thought to be lowcitation needed, gloves can be used as an extra recaution.Another way to avoid contact with blood and semen is penetration, but not by the penis, such as using properly cleaned dildos or other sex toys. If a sex toy is to be used in more than one orifice, a condom can be used over it and changed when the toy is moved. Fisting penetration by the hand, has its own risks, but the risk of HIV transfer can be reduced by latex gloves or a condom. Pegging, femaletomale anal sex with a strapon dildo, as promoted by sex educator Carol Queen does not involve fluid transfer.If a latex barrier is being used, any lubrication must not be oil based, as this can break down the structure of the latex and undo the protection it gives.edit Other PrecautionsAcknowledging that it is usually impossible to have entirely riskfree sex with another person, proponents of safe sex recommend that some of the following methods be used to minimize the risks of STD ransmission and unwanted pregnancy. Monogamy or polyfidelity, practiced faithfully, is very safe as far as STDs are concerned when all partners are noninfected. However, many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful, have used injection drugs, or were infected by previous sexual partners the same risks apply to polyfidelitous people, who face slightly higher risks depending on how many people are in the polyfidelitous group. For those who are not monogamous, reducing the number of ones sexual partners, particularly anonymous sexual partners, may also reduce ones potential exposure to STDs. Similarly, one may restrict ones sexual contact to a community of trusted individuals this is the approach taken by some pornographic actors and other nmonogamous people.Communication with ones sexual partners makes for greater safety. Before initiating sexual activities, partners may discuss what activities they will and will not engage in, and what precautions they will take. This can reduce the chance of risky decisions being made in the heat of passion.
Refraining from the use of recreational drugs, including alcohol, before and during sexual activity can protect against associated risks such as lowered inhibitions, decreased immune response, impaired judgment, and loss of consciousness.If a person is sexually active with a number of partners, it is important that they get regular sexual health checkups from a doctor. Anyone noticing unusual symptoms should get medical advice quickly as HIV is sometimes asymptomatic or symptoms will have a nonspecific nature and can even be misdiagnosed.edit Ineffective methodsNote that most methods of contraception other than the barrier methods mentioned above are not effective at preventing the spread of STDs. This includes the rhythm method, which is also commonly known as Natural Family Planning.The spermicide Nonoxynol has been claimed to reduce the likelihood of STD transmission. However a recent study by the World Health Organization has shown that Nonoxynol is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system. As a result condoms with a Nonoxynol lubricant are not to be promoted.Coitus interruptus or pulling out, in which the penis is removed from the vagina, anus, or mouth before ejaculation, is not safe sex and can result in STD transmission. This is because of the formation of preejaculate, a fluid that oozes from the urethra before actual jaculation. In opposition to conventional wisdom, some recent studies awaiting confirmation suggest that preejaculate may not contain sperm it can, however, contain pathogens such as HIV. In addition, open sores on either partner can permit transmission, as can microscopic breaks in the skin which arise due to friction, or other irregularities in the skin of either partners genitalia or other body parts.edit Dangers of anal sexUnprotected anal sex is a high risk activity regardless of sexual orientation. Research suggests that although gay men are more likely to engage in anal sex, heterosexual couples are more likely not to use condoms when doing so.Anal sex is more risky than vaginal, since being very thin tissues of anus and rectum can be easily damaged during such sex activities as anal intercourse or use of anal toys. Even slight injuries can become open gates for various bacteria and viruses, including HIV. This implies that anal sex does require some certain safety measures. First of all, any partners who practice anal sex should be aware of the necessity of using a condom. The condom must be put on properly, otherwise it does not provide reliable protection. Users should keep in mind that oilbased lubricants damage latex. For this reason waterbased lubricants should be used for anal sex. Those who have allergy to latex should consider use of nonlatex condoms, for instance polyurethane condoms that are compatible with both oilbased and waterbased lubricants.