Name that contraceptive method!

The first versions of this method date back to Ancient Greece, where they were fashioned from animal intestines and bladders.

The first documented use of a condom was in around 3000 B.C. by King Minos of Crete, who was said to use a goat bladder to protect his partners from “scorpions and serpents” in his semen. Historians debate whether the bladder was deployed as a male or female condom.

While animal organs remained in use for centuries, rubber vulcanization during the Industrial Revolution led to the widespread use of rubber male condoms, and the 1920s invention of latex, the most common material in use today, led to a second revolution in condom innovation. Today, innovators are pursuing next-generation male condoms made of materials including hydrogel, collagen, graphene, and more.

There are also several female condoms currently on the market. One more recent innovation is PATH’s Woman’s Condom, which is designed so that the main pouch of the condom is compressed into a narrow rounded capsule which makes it easier for women to insert.

The US Food and Drug Administration (FDA) approved the first version of this method in 1960: within 2 years of distribution, it was in use by 1.2 million Americans.

The first birth control pill was effective, simple to use, and extended reproductive control to millions of women—but also contained higher than necessary hormone doses of 100 to 175 µg of estrogen and 10 mg of progesterone, which led to significant concern over side effects. The modern pill has 30 to 50 µg of estrogen and 0.3 to 1 mg of progesterone doses, dispelling many concerns about adverse effects.

Today, scientists are also working on the development a birth control pill designed for men. While still in clinical trials, this oral contraceptive uses a combination of androgen, testosterone, and progestin to impede sperm production.

The first documentation of this long-acting, reversible contraceptive method was in 1909, when Dr. Richard Richter reported on his product made of silkworm gut. Over the next century, subsequent versions were developed made of silver, copper, and plastic.

IUDs are one of the most commonly used methods of long-acting, reversible female contraception and can be used for between 3 to 12 years. Today, they are primarily made of plastic. There are two types: 1) hormonal IUDs, which use progestin to impact the lining of the uterus and cervical mucus to make it more difficult for sperm to reach an egg; and 2) copper IUDS, which have copper wire coiled around them which produces an inflammatory reaction in the uterus that interferes with sperm movement.

Invented in 1842, this barrier method is one of the oldest contraceptive methods. Decades of legal restrictions in the United States slowed its introduction to market, but by the 1930s, it was one of the most frequently prescribed forms of birth control in the United States.

The diaphragm is a barrier method of birth control, usually made of rubber, with a firm rim and either a flat, coil, or arcing spring which is placed in front of the cervix to prevent sperm cells from entering. While there has been little innovation in the diaphragm space in the last half century, in 2015, PATH and Conrad introduced the SILCs diaphragm, marketed under the name Caya diaphragm, the first new diaphragm design to enter many global markets in 50 years. The product incorporates adaptations recommended by test users, including a tab that makes it easier for users to remove.

More than 30 million women in 90 countries have used depot medroxyprogesterone acetate, or DMPA for short, a version of this long-acting contraceptive method that was first approved in 1992 under the brand name Depo-Provera.

Contraceptive injections may contain either the hormones progestin or a combination of progestin and estrogen and can last either two to three months depending on the option used. While the long-acting nature can offer convenience to users, one significant barrier to use in low- and middle-income countries is the need for consistent health care visits for it to be administered by a trained provider. PATH and Pfizer’s Sayana Press is a new formulation of the contraceptive Depo-Provera that is helping overcome this challenge. This three-month product is packaged in the Uniject injection system—a prefilled, auto disposable syringe device—for ease of use and approved in some countries for women to self-inject, giving women the ability to take home a longer supply and make less frequent visits to health facilities.

This method, for which development efforts were initiated over 40 years ago, generally provides protection for a month at a time; however, a version approved by FDA in 2018 provides a full year of sustained protection while being fully under control of the women using it.

The Population Council’s One-Year Contraceptive Ring is the first and only contraceptive that provides an entire year of protection while being fully under a woman’s control, because she can insert and remove it herself.

In addition to contraceptive-only rings, innovators are pursuing development of vaginal rings that protect women against unintended pregnancy and sexually transmitted infections at the same time. For example, the International Partnership for Microbicides is developing a Dapivirine Contraceptive Ring, an adaptation of their HIV prevention ring, that combines dapivirine (an antiretroviral to protect against HIV) with levonorgestrel (a contraceptive to prevent pregnancy).

This weekly contraceptive method was first introduced in 2002 and uses a novel administration route to deliver hormones that allows convenient dosing intervals and ease of use and removal.

The birth control patch, also known by the name transdermal contraceptive, is a method of hormonal contraception. It is a small, square, three-layer patch that looks like a plastic bandage. It sticks to the skin and gradually releases hormones into the body to prevent pregnancy. Users replace it once per week for a total of three weeks, skipping the fourth week.

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