Al-Akhawayni, a contributor to medieval Persian knowledge on contraception.

Modern scientific achievements in the field of contraception are clearly indebted to past studies. Al-Akhawayni Bukhari was a Persian physician in the 10th century. He lived during the 'Golden Age of Islamic Medicine' (9th to 12th century AD). This scientist recorded his knowledge on various medical matters, including contraception, in the book 'Hidayat al-Muta`allemin Fi al-Tibb' (Learner's Guide to Medicine). These 10th century views on contraception are explored in this paper through a discussion of Al-Akhawayni Bukhari's surviving book, the 'Hidayat' (Guide).

'Sexual chemistry' before the pill: science, industry and chemical contraceptives, 1920-1960.

The history of contraceptives met the history of drugs long before the invention of the contraceptive pill. In the first half of the twentieth century, numerous pharmaceutical laboratories, including major ones, manufactured and marketed chemical contraceptives: jellies, suppositories, creams, powders and foams applied locally to prevent conception. Efforts to put an end to the marginal status of these products and to transform them into 'ethical' drugs played an important role in the development of standardized laboratory tests of efficacy of contraceptive preparations; debates on the validity of such tests; evaluation of the long-term toxicity of chemical compounds; and the rise of collaborations between activists, non-profit organizations and the pharmaceutical industry. Chemical contraceptives were initially associated with quack medicine, shady commercial practices and doubtful morality. Striving to change the status of contraceptives and to promote safe and efficient products that reduced fertility in humans shaped some of the key features of the present-day production and regulation of pharmaceuticals.

[Barrier methods of contraception]. / Métodos anticonceptivos de barrera.

PIP: Vaginal methods of contraception were the earliest types used and some references to them date back to antiquity. Most of the vaginal contraceptive agents identified by the ancient Greeks, Indians, Japanese, and Chinese have been found in modern laboratory tests to have spermicidal properties, but it is doubtful that the methods were fully reliable or were used by many people. During the 19th century the condom, vaginal spermicides, and diaphragm became available. The development of nonoxynol-9 and other nonirritating but effective spermicidal agents improved vaginal contraceptives greatly by the 1950s, but starting in the 1960s newer methods began to replace the vaginal methods. Interest in barrier methods has been reawakened somewhat by concern about the health effects of hormonal methods. At present all barrier methods leave something to be desired. Failure rates of 3-30% for barrier methods in general have been estimated, but the higher rates are believed due to incorrect or inconsistent use. Theoretical failure rates of condoms and diaphragms have been estimated at 3/100 women-years, but in actual use failure rates may reach 15 for condoms and 13 for diaphragms used with spermicides. Use-effectiveness rates are greatly influenced by motivation. For a variety of reasons, the acceptability of barrier methods is low, especially in developing countries. New developments in spermicidal agents include sperm inhibitors, which impede the fertilizing capacity of sperm rather than attempting a spermicidal effect; a number of such agents have been studied and have proven more effective in animal tests than conventional spermicides. Neosampoon, a new spermicidal foam, has attracted an increasing number of users, especially in developing countries. A new condom, made of thin polymers and containing a standard dose of nonoxynol-9, has been designed to dissolve in the vaginal fluid. Further studies are needed of its acceptability, efficacy, and side effects before it becomes commercially available. 2 vaginal sponges, 1 of reconstituted bovine collagen and 1 of polyurethane containing nonoxynol-9, have recently been developed and the latter has successfully completed multicountry tests. Various new types of diaphragms that would require individual fitting are under study, as is a new long-acting cervical cap. Although vaginal methods have been studied and improved in recent years, their greater acceptance will probably depend on the attitude of family planning personnel, the motivation of the couple, and increased diffusion of information about them.^ieng

Barrier contraception: a comprehensive overview.

The barrier class of contraceptives used either alone or with supplementary spermicidal agents includes the most ancient of methods for the control of human fertility. Modern innovations have effected marked improvement in their efficacy and acceptability, so that they have become key means of controlling fertility in the world today. The traditional diaphragms and condoms decreased in popularity to some extent when methods such as the OCs and IUDs became available for general use. However, the plain or medicated barriers are regaining their rightful position in our contraceptive armamentarium as more and more questions are being raised about the real or potential adverse side effects of systemic and intrauterine contraceptives. There is evidence throughout the world of the growing popularity and use of locally acting mechanical and/or spermicidal contraceptive methods. Their impact upon the increasing world population can be expected to become even greater when the true need for the control of fertility becomes more generally recognized and appreciated.