Medical Aspects

The ability of individuals to regulate their own childbearing represents one of the great medical advances of the twentieth century. As a result of demographic trends, which indicate an earlier onset of sexual activity and smaller family size, a woman may spend as long as thirty-five years purposefully avoiding pregnancy. An array of contraceptive methods is necessary to provide individuals with options that are most appropriate to their lifestyle, motivation, desire for effectiveness and convenience, and acceptance of medical risk. Two fundamental trends have affected contraceptive practice since 1960: the development of safe, continuous, and highly effective hormonal contraception, and more recently, an increased awareness of the role of barrier contraceptives for the dual purposes of pregnancy prevention and protection against sexually transmitted infections.

Currently available contraceptive methods include permanent methods that cause sterility—such as vasectomy in men and tubal occlusion in women—and reversible methods. Reversible methods include oral contraceptives (OCs); subdermal implants (Norplant®); progestin injections (depot-medroxyprogesterone acetate; DMPA; Depo-Provera®); intrauterine devices (IUDs); barrier methods (male and female condoms, diaphragm, cervical cap, and spermicidal products); and "natural" methods such as celibacy, periodic abstinence (natural family-planning and fertility-awareness methods), and withdrawal.

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