Megan L. Evans, MPH
The George Washington University School of Medicine, Washington, DC, USA
This article reviews contraception methods utilized throughout history. These include female barrier methods, condoms, intrauterine devices, oral contraceptive methods, and ritualistic practices. A desire to control one’s fertility has been an issue that transcends time and has affected men and women for thousands of years. Various methods are reviewed from Ancient Greece and Rome to modern day contraceptives.
Keywords: contraception, condoms, birth control, fertility, intercourse
The idea of contraception has been around for thousands of years and has been documented through various forms of art and written word. A woman can be fertile for up to forty years; thus the desire to control one’s ability to procreate is not only a current issue, but rather an issue that transcends the ages.
Birth control methods throughout history have ranged from ritualistic and mythical to practical and effective. Many of the contraceptive techniques described below are not so different from the methods popular today.
Condoms are by no means a modern day method. Historically, condoms were used to prevent the spread of disease as there was little understanding of how women became pregnant. Records of condom use dates back to 3000 B.C. where King Minos of Crete, son of Zeus and Europa, utilized the bladders of goats to protect himself during intercourse (1). By 1000 B.C., Egyptians were using a linen sheath around the penis to protect from spread of disease. Little documentation or records of condoms have been found after this time period; although, there is some evidence from cave paintings and historical documents that a condom-like device was used in Europe and imperial Rome (2).
In the 1500s, a syphilis epidemic spread across Europe. It was at this time that Gabriel Fallopius, an anatomist and for whom the fallopian tubes are named, created a linen condom as a means to protect from the continuing spread of disease (2). This proved especially effective when soaked in an unknown chemical solution acting as a spermicide.
By the 1700s, manufacturing of condoms from animal intestines became popular. Unfortunately this method was expensive, resulting in reuse of condoms which led to an increase in infection and further spread of diseases (2).
In the 1800s, the tire company Goodyear discovered the practice of rubber vulcanization and began mass producing condoms as part of their product line (2). Interestingly, an advertisement for the Goodyear condom first appeared in The New York Times in 1861 as “Dr. Power’s French Preventatives (3).” By the 1920s, rubber cement was used to make condoms and by 1930, latex became the primary material in all condoms.
Female Barrier Methods
Throughout the history of contraception, it was common practice to insert foreign objects into the vaginal canal to avoid pregnancy. In the Ebers papyrus, a 20 meter-long scroll said to be found between the legs of a mummy dating back to around 1550 B.C., it was written that a pessary soaked in donkey’s milk was a notable method of preventing pregnancy among ancient Egyptian women (2). Women also used a resinous gum-like material to smear over the cervix as a barrier method. Further contraceptives mentioned in the Ebers papyrus discussed pessaries made of dung and fermented leaves of the acacia tree. Pessaries documented in Ancient Rome utilized honey and sodium carbonate that helped to create a thick, foam-like fluid that provided a block to the cervix (2).
In the tenth century, pessaries containing ammonium chloride and potassium carbonate were also used to prevent fertility. Additionally, pessaries were known to include sponges, small pieces of rags, and balls of Bamboo (2).
In the 1800s, the pessary reemerged as a primary birth control method, using both coco-butter and the chemical quinine as a barrier method (4). After the pessary was inserted into the vagina, it melted at body temperature and aided in preventing pregnancy by creating a thick, viscous fluid that provided an impenetrable barrier into the uterus.
Around 400 B.C., writers from the Hippocrates school discussed a contraceptive similar to the intrauterine device (IUD) of today. This particular apparatus was a hollow tube filled with mutton-fat that was inserted in a woman’s womb to keep the cervix open and to prevent pregnancy (2).
In New Zealand, small rocks were placed in a woman’s uterus to make her “sterile as stones (5).” Additionally, a Persian physician in the ninth century recommended dipping a tightly wrapped rod-shaped paper in ginger water and inserting it into the women’s cervix as a means to prevent pregnancy (6).
Historically, IUDs were not a popular method due mainly to their increased risk of infection and discomfort they may have caused the woman. However, in 1909 a German physician created the first modern IUD made of a silk suture (2). After this IUD, improvement of intrauterine devices continued throughout the 20th century and remains a popular method today.
Herbs and Rituals
In Ancient Greece, it was believed that the woman’s uterus was a separate entity from her body. Thus, if a woman desired pregnancy, a product providing a sweet odor was placed in the vagina to attract the womb to the sperm. On the other hand, if the woman did not desire a child, a foul smelling odor was pushed into the vagina, causing the uterus to move away from the sperm (2). This concept led to the idea of a ‘wandering womb’ that could wander far enough through the woman’s body and enter her brain, causing hysteria.
In Ancient Rome, women wore amulets and necklaces that helped to control their fertility. There were also notions that spitting into a frog’s mouth three times after intercourse would prevent pregnancy, or wearing a leather pouch filled with a cat’s liver on the left foot also blocked a woman’s ability to conceive (1).
Soranus, a Greek gynecologist during 200 A.D. suggested that women should avoid intercourse during their menses because this was the time women were most fertile. Additionally, he recommended a woman hold her breath during intercourse, followed by sneezing, and jumping up and down to prevent ejaculate from entering the womb (1).
Coitus interruptus, also known as the withdrawal method, was often practiced to help control fertility. Although this method was condemned by different religious leaders, it has been widely utilized throughout history.
Some early writers, including Hippocrates and Dioscorides, described mysterious potions and crude spermacides to aid in temporary infertility. In some of these early writings, it was particularly important for the woman to make violent movements with her body after intercourse to prevent the male ejaculation from reaching her uterus (2).
In the 10th century in Persia, women were told to jump backwards seven or nine times after intercourse to dislodge any procreation that resulted. It was believed that the numbers seven and nine held magical qualities and those particular numbers would either aid in preventing pregnancy or cause the termination of an early pregnancy (2).
Use of oral treatment to prevent contraception has also been around for centuries. Interestingly, in Greek mythology, Persephone, the goddess of spring, ate only pomegranate seeds to prevent her from conceiving her captor’s child, the god of death (1). Following this myth, women in Ancient Greece would eat vitex, pine, pomegranate, and pennyroyal to prevent contraception. Secrets of contraception would be shared at a women only festival called Thesmophoria (1).
Around 7 B.C., a flower called silphium, grown only in Northern Africa, was found to have contraceptive properties. Although the flower was incredibly expensive to ship, the demand for this contraception was incredibly high, causing the flower’s extinction by 300 A.D. (1).
Women all over the world utilized folklore, family secrets, and information from publications to prevent pregnancy. Peter of Spain, who later went on to be elected Pope John XXI in 1276, wrote a book with extensive information regarding the prevention of pregnancy and, perhaps, the termination of a pregnancy (1).
In the 1500s, there is little recorded documentation of oral contraceptive methods. This was most likely due to the widely held fear of witchcraft and persecution if any said publications were discovered.
Oral contraceptives did not reappear in main stream media until the mid-1900s when a young nurse by the name of Margaret Sanger pursued the research and discovery of an effective hormonal pill (7). With the financial backing of Katharine Dexter McCormick, a longtime supporter of women’s rights, Sanger was able to continue research on synthetic hormones and fund clinical trials for the first oral contraceptive pill (ocp). Enovid, the first ocp, was released in 1960 by G.D. Searle and Company (7).
Besides use of barrier methods, men also had means to prevent impregnating their partners. Early writers recommended drinking pulverized testicles of a mule or other infertile animal to induce sterility (2). Men were also encouraged to wash their genitalia with vinegar prior to engagement in intercourse.
It is clear throughout history that women and men have had desires to control their fertility through various methods. Control of fertilization has been a concept for thousands of years and remains an important issue for men and women today.
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