From Herbs to Vasectomies: The History of Birth Control

August 31, 2023

In recent years there’s been a movement of women coming off hormonal contraception in favour of non-invasive and side-effect-free methods of birth control. Although the contraceptive pill was still the most used method of birth control in 2018 with 28% of the UK using it as their main method, condoms weren’t far behind with 27% of the country using it as their main method [1]. However, it can be argued that women are still expected to shoulder the burden of birth control and modern medicine isn’t prioritising women’s health. A clear example is the painful medical procedure of inserting an IUD or IUS that is currently done without an anaesthetic. In this article, we’re going to look back at the history of birth control and see if modern medicine is doing women a disservice.

The Pull Out Method:

The pull-out method is first mentioned over 2,500 years ago. It requires the man to remove his penis during penetrative sex before he ejaculates. However, due to human error and pre-ejaculate, the pull-out method is only 80% effective. Although the pull-out method is a natural, side-effect-free alternative to other methods of more invasive and hormonal methods, it does require women to trust in their partner, doesn’t protect against STDs and allows a 20% of pregnancy.

Herbs and Other Natural Methods:

In Indigenous America, women used herbs like black cohosh, thistles, stoneseed and flash hellebore to prevent pregnancy [2]. Thistles were boiled into a tea and believed to create temporary sterility and stoneseed was kept in cold water for hours and then ingested regularly to reduce fertility. However, women did experience side effects from these methods - nausea, fatigue and allergic reactions [3].

Indigenous women also used fertility tracking to prevent pregnancy. They knew when their body was fertile (around 6 days a month) by tracking their menstrual cycle and vaginal discharge. As the female body nears ovulation, vaginal discharge becomes stretchy and slippery ( sometimes compared to raw egg white). If used correctly, fertility tracking is 97% effective.

Another method recorded across the world is extending breastfeeding to reduce the chances of pregnancy [4]. Breastfeeding is 98% effective at preventing pregnancy in the first 6 months after a baby is born [5].

A strange method used in the 1700s was inserting lemons into the vagina or soaking a sponge with lemon juice. It was believed that the acidic nature of lemons acted as a spermicide and that the lemon or sponge blocked sperm from entering the cervix [6].

Introducing the condom:

The first condom was recorded around the 15th century in Asia and was usually made out of animal intestines or thin leather. Unlike modern condoms, these were made to be reusable. Condoms only started to be used in Europe (around the 16th century) as a way to prevent syphilis and other STDs. Due to this association, condoms were believed to be used by the immoral and sinful. The condom as we know it was created in the 19th century and made out of vulcanised rubber.

Some may wonder if immorality is still associated with the male condom, especially when having to buy condoms in public. A survey we conducted in 2020 noted that 100% of women interviewed felt uncomfortable buying condoms in person. Furthermore, condom companies seem to be comfortable with this ‘immoral’ association as condom boxes are designed in bold, risqué colours like bright red, black or purple. Condoms also seem to be marketed primarily towards men as they include ingredients that irritate female bodies, like fragrances, spermicide and unnecessary chemicals.

When used correctly, condoms are 98% effective and are side-effect-free. When building MyBliss®, our founders believed that condoms are a method of birth control that feels more shared between the sexes and is kind to female bodies. We wanted to show women that condoms are a safe birth control method and, in our minds, the best option for women’s bodies. In an effort to move away from the immoral association of condoms, we’ve designed our condom boxes to be female-focused and stylish and to use ingredients that nourish and protect women’s bodies.

The Contraceptive Pill:

The contraceptive pill was developed in America in the 1950s and became available through the NHS in 1961. However, it was only available to married women. It wasn’t until 1967 that it became available to all women. The contraceptive pill (combined and progestogen-only) prevent ovulation and thicken cervical mucus to prevent sperm from reaching the egg and thin the lining of the womb so a fertilised egg is unable to implant.

Since its launch, there have been concerns over the side effects of the pill linking its use to blood clots, strokes, heart attacks and diabetes. In the 1970s, there were reports showing that smoking while using the pill increased the risk of blood clots. In the 1980s, a study showed that taking the pill for four years or more increased the risk of breast cancer by 125%.

Nevertheless, there are studies that show a positive correlation between the use of the pill and a reduced risk of cancer in the ovaries and womb lining and pelvic inflammatory disease [7]. If used correctly, the pill is 99% effective.

There has also been concern about the increase in STDs due to dependence on the pill. Many women feel pressured not to use a condom when they are on hormonal birth control. Condoms are the only method of protecting against STDs and should be worn with every new partner and any partners who haven't had a STD screening.

Intrusive Birth Control Methods:

IUD or intrauterine device (known as the coil), was first launched in 1984 in America. The device releases copper into the womb, thereby altering the cervical mucus. When a woman is fertile, her cervical mucus changes to support the sperm travelling to meet the egg. By altering the cervical mucus, the sperm will be unable to reach the egg. The IUD also prevents a fertilised egg from being able to implant itself in the womb[8].

The IUS or intrauterine system (known as Mirena®), was launched in Finland in 1990. The IUS releases the hormone progestogen, which thickens the cervical mucus. Again this disrupts the sperm’s ability to reach the egg. Progestogen also thins the lining of the womb, so an egg is unable to implant. In some cases, the IUS even prevents ovulation altogether [9].

Both the IUD and IUS are 99% effective methods of birth control and last around 5-10 years. However, neither device is side-effect-free and the insertion itself (the coil is inserted through the cervix and into the womb) is known to be painful and uncomfortable. Healthcare professionals do not currently provide women with anaesthetic for coil insertion.

The contraceptive implant was released in 1990 and works by releasing progestogen into the body, preventing ovulation. Like the IUS, it also thickens cervical mucus, thins the lining of the womb and is 99% effective. The implant is inserted by a trained doctor or nurse into the upper arm after it has been numbed with a local anaesthetic. It’s 99% effective but will need to be replaced every 3 years [10].

The contraceptive injection (launched in 1992) works the same as the contraceptive IUS and implant. The injections will need to be re-administrated every 9-13 weeks. For women who are uncomfortable having injections, it can be a negative experience and the method also has side effects like weight gain, headaches and mood swings [11].

The intrusive methods of birth control have given women more freedom, but they require many women to experience side effects that, in some cases, lower their quality of life. These methods (as with the contraceptive pill) require women to shoulder the burden of contraception.

Male and Female Sterilisation:

Sterilisation is a method used by people who have decided to be childless and by those who have children but don’t want any more. It’s a permanent form of birth control (it's difficult to reverse).

The vasectomy (male sterilisation) was invented in the 1850s but was considered illegal in the 1930s and 40s. In 1974, it became widely available on the NHS [12]. Around 17-21% of men in the UK have had a vasectomy [13]. They are 99% effective and don’t have any side effects. A vasectomy is a relatively painless procedure and is done by numbing the scrotum with local anaesthetic and either cutting, blocking or sealing the tubes that carry the sperm from the testicles.

Female sterilisation (known as having your tubes tied) was invented in 1880 (although it wasn't like modern-day operations) and became legal in the UK in 1972. In 2018/19, around 13,000 women in the UK had the operation[14]. Unlike a vasectomy, female serialisation is carried out under general anaesthetic and involves blocking the fallopian tubes. If the operation is successful, it’s a 99% effective form of birth control.

Emergency Contraception:

The emergency contraception pill ( the morning-after pill) wasn’t launched in the UK until 1984. In 2009, it became available for women (aged over 17) without a prescription. A recent survey in the UK found that the morning-after pill was used by 1 in 5 women (aged 18-35) in a year [15]. The morning-after pill is often seen as a form of abortion which is wrong. The morning-after pill is a form of birth control and prevents ovulation. If used after an egg has been fertilised, the morning-after pill will not stop the pregnancy. The morning-after pill is 95% effective if taken within 24 hours of unprotected sex (or if birth control has failed) and if ovulation hasn’t taken place [16].

Emergency contraceptive pills work by disrupting normal levels of the natural hormone progesterone. Normal levels of progesterone help to prepare the uterine lining for the implantation of the egg and also tell the ovaries if there is a fertilised egg. If the ovaries think there’s a fertilised egg, they won’t release another egg.

The sexual health charity FPA reported that only 10% of women experience side effects from taking the morning-after pill [17]. Side effects include nausea or vomiting, dizziness, fatigue, headache, breast tenderness and lower abdominal pain [18].

Fertility Tracking Apps:

In recent years, technology has made fertility tracking more accessible and dependable for women. Through apps, women can easily track their menstrual cycle and identify when they are fertile. In 2018, Natural Cycles®, the first-ever contraceptive app, became certified. Natural Cycles® determine fertility through the changes in basal temperature throughout the menstrual cycle. Through these apps, women have a hormone and side-effect-free birth control method. On fertile days (around 6 days of the menstrual cycle), women can abstain from penetrative sex or use a barrier method like a condom. With proper use, Natural Cycles® is 98% effective.

In modern healthcare, Natural Cycles® and other fertility tracking apps are the only form of birth control created by women. Although hormonal birth control methods are beneficial and have progressed the women's rights movement, they put the burden of birth control and the side effects on women. By returning to the ancient birth control method of fertility tracking, women only need birth control when their body is fertile and can use non-invasive, side-effect-free barrier methods.

Since women have been able to enter the medical world, we’ve seen a focus brought to women’s health and quality of life and less invasive, impactful methods of birth control. Another example is female-founded MyBliss® redesigning the male condom and moving away from the ‘immoral’ and ‘sinful’ associations still felt from the 16th century. Through female-focused packaging and vagina-safe ingredients, MyBliss® have returned women’s confidence in this side-effect-free, 98% effective method of birth control.

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From Herbs to Vasectomies: The History of Birth Control

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