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Summary
Mantalenakis SJ.
The evolution of contraception.
Hellen Obstet Gynecol 14(3):181-190, 2002
Correspondence: Serge J. Mantalenakis
23 Meg. Alexandrou Ave
54640, Thessaloniki, Greece
Tel/fax: +30310/814127
E-mail: sergmant@otenet.gr
In the beginning was sex, and then man was born, trying to separate sex from reproduction. For thousands years couples in several cultures and civilizations used several techniques and methods to control their fertility and avoid undesirable pregnancy.
Ancient Egyptian text in papyrus dating back to1850 BC said upper class women put various substances in their vaginas to block sperm. These included crocodile dung peccaries, different gums and a mixture of honey and sodium carbonate. Another Egyptian text from 1550 BC mentioned lint tampons soaked in the fermented tips of acacia shrubs. The mixture would have contained lactic acid, still used in spermicidal jellies. In the chapter Genesis of the Bible, Aunan was reported to practice coitus interruptus or withdrawal, that is ejaculation out of female genitals, a method still in wide use all over the world.
The Ancient Greeks practiced family planning using the safe period calling it "atokion". Aristotle described how to make the uterus inhospitable to sperm and the Hippocratic texts advised drinking copper sulfate to avoid pregnancy. Sanskrit texts from India recommended salt-water douches and also described the coitus obstructus which involved squeezing the base of penis at the time of ejaculation to redirect semen into the bladder. Islamic physicians of 9th-14th centuries advised to use of rock salt and oil balsam on the penis and tampons for women mixed with pomegranate pulp. Lemon juice was widely used in many cultures, and women of the Eastern Europe use half a squeezed lemon as a diaphragm, the citric acid acts as a spermicide.
Condoms date back to Egyptian times made out of animal intestine. In ancient Rome women used the bladder of a goat as a female condom. The Italian anatomist Fallopius invent the modern time the male condom in 1504. It was made of linen designed to prevent syphilis. Rubber condoms were available in 1880 providing protection against pregnancy and disease. Rubber diaphragms and caps were also coming into popularity. In 1930 the use of latex improved dramatically the quality of condoms and diaphragms.
The German gynecologist Ernst Grafemberg developed an intrauterine device in 1928. It was a ring prepared of silver wire and gut and was widely use. In 1934 Ota of Japan introduced a similar IUD. Although enthusiasm greeted both devices initially, it was soon replaced by skepticism and even condemnation and under the public pressure both were abandoned. The recognition of the itrauterine contraception came later in the early 1960`s, however, Grafenberg passed away in 1957 and never learn about the success of his invention.
The second International Conference for IUD`s was held in New York in 1964 and I was present and really impressed. Then I wrote a letter to my professor N. Louros. He replying stressed the danger of a pelvic inflammatory disease after the IUD insertion. The real new contribution in human contraception was the observation that progesterone and especially progestins the synthetic progesterone like acting hormones developed in 1950`s could block the ovulation. Gregory Pincus (1903-1967) and M.C. Chang (1908-1991) were the first in a classic publication in 1953 reported "the effects of progesterone and related compounds on ovulation and early development in the rabbit". Then Celco Garcia and John Rock confirmed the results on experimental animals in human. The first contraceptive pill in 1960 was approved by the US Food and Drug Administration. In 1967 the side effects on contraceptive pills were reveled. The quantity of the included estrogen was reduced drastically and new progestins were developed.
The new generation of the contraceptive pills considers to be safe and efficacious. Besides contraception pill offers several other therapeutic parameters, such as regulation of the cycle, protection from anemia, minimization of ectopic pregnancy etc. Hormonal and intrauterine contraception are the most effective methods for fertility control, condom is another popular method protecting also from AIDS. The permanent sterilization has a great preference in different countries, however, the traditional methods are still wide practicing.

BIBIOPAIA
1. M I. Ernst Grafengerg. E M & 1991; 4:1-5.
2. Pincus G, Chang MC. The effect of progesterone and related compounds in ovulation and early development on the rabbit. Acta Physioilogica Latinoamericana 1954; 3:177-83.
3. M I. Gregory Goodwin Pincus. E M & 1998; 10:113-7.
4. M I. Min Chueh Chang. E M & 1996; 8:115-8.


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