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The practice of contraception is as old as human existence. For centuries, human s have relied on their imagination to avoid pregnancy.

Ancient writings noted on the Kahun papyrus dating to 1850 BCE refer to contraceptive techniques using a vaginal pessary of crocodile dung and fermented dough, which most likely created a hostile environment for sperm. The Kahun papyrus also refers to vaginal plugs of gum, honey, and acacia. During the early second century in Rome, Soranus of Ephesus created a highly acidic concoction of fruits, nuts, and wool that was pl aced at the cervical os to create a spermicidal barrier. Today, the voluntary control of fertility is of paramount importance to modern s ociety. From a global perspective, countries currently face the crisis of rapid population growth that has begun to threaten human survival. At the present rate , the population of the world will double in 40 years; in several of the more so cioeconomically disadvantaged countries, populations will double in less than 20 years. On a smaller scale, effective control of reproduction can be essential to a woma n's ability to achieve her individual goals and to contribute to her sense of we ll-being. A patient's choice of contraceptive method involves factors such as ef ficacy, safety, noncontraceptive benefits, cost, and personal considerations. Th is article addresses the predominant modes of contraception used in the United S tates, along with the safety, efficacy, advantages, disadvantages, and noncontra ceptive benefits of each. An oral contraceptives dispenser is depicted below. Ortho Tri-Cyclen (Ortho-McNeil-Janssen Pharmaceuticals, Inc.) oral contraceptiv es with Ortho Dialpak dispensers. Image courtesy of Wikimedia Commons. For excellent patient education resources, visit eMedicine's Men's Health Center and Pregnancy and Reproduction Center. Also, see eMedicine's patient education articles Birth Control Overview, Birth C ontrol Barrier Methods, How to Use a Condom, Vasectomy, Tubal Sterilization, Und erstanding Birth Control Medications (Contraceptives), Birth Control Hormonal Me thods, Birth Control Intrauterine Devices (IUDs), and Emergency Contraception. Periodic Abstinence Coitus Interruptus Coitus interruptus involves withdrawal of the entire penis from the vagina befor e ejaculation. Fertilization is prevented by lack of contact between spermatozoa and the ovum. This method of contraception remains a significant means of ferti lity control in the developing world. Efficacy Effectiveness depends largely on the man's capability to withdraw prior to ejacu lation. The failure rate is estimated to be approximately 4% in the first year o f perfect use. In typical use, the rate is approximately 19% during the first ye ar of use. Advantages Advantages include immediate availability, no devices, no cost, no chemical invo lvement, and a theoretical reduced risk of transmission of sexually transmitted diseases (STDs). Disadvantages