from Wikipedia, the free encyclopedia

As contraception , contraception, contraception or contraceptive protection methods are referred to the likelihood of conception and pregnancy despite a completed Vaginalverkehrs decrease. The contraceptive pill and condom are particularly common today .

Even in ancient times , sexual partners who did not wish to have children tried in various ways to reduce the chance of conception, but it was only since the 20th century that safer and more reliable methods have become available.


Contraception is based on one or a combination of the following:

Ovulation can currently only be prevented by hormonal methods, and nidation by intrauterine devices (spiral, Gynefix). Most methods prevent the egg cell and sperm from meeting in a variety of ways.

Pearl index

The Pearl Index is used to assess the safety of the various methods . It shows how many women out of 100 become pregnant on average if they use the specified method of contraception and have sexual intercourse regularly for a year. The lower the Pearl Index, the safer the method.

With regular sexual intercourse without any form of contraception, the Pearl index is around 82 for 19–26 year old women, 86–87 for women between 27 and 34 years of age and 82 for women between 35 and 39 years of age, depending on age. From the age of 50, fertility ceases with menopause .

Method security and application security

The security of most methods depends crucially on correct application. The cause of failure of contraceptive methods are mostly application errors. Therefore, method security , i.e. failure despite optimal application, and application security , i.e. the practical consideration of application errors, are significantly different for most methods.

Natural methods

With the so-called natural methods of conception control, also called natural family planning or natural conception control, the fertile days in the woman's menstrual cycle are determined in order to be able to have sexual intercourse during the infertile days without further measures. When determining the fertile days, it is necessary to take into account the lifespan of the sperm in the woman's fallopian tubes. During the fertile days is either abstinence ( abstinence ) practiced or employing other methods of contraception, whose safety has to be considered then separately.

The natural methods are mostly based on the menstrual cycle of women, since a healthy, fertile man is in principle always fertile, except z. B. after a RISUG treatment. Another method, in which neither hormones nor chemical or mechanical barriers prevent the egg cell and sperm from uniting, which a man can actively practice, is coitus interruptus , which is, however, considered extremely unsafe for preventing conception. On the other hand , when engaging in sexual activity, avoiding vaginal intercourse and practicing other practices such as cunnilingus and fellatio can prevent sperm from entering the vagina.

To prevent vaginal intercourse, the hormone measurement, temperature method , billings method and the combined symptothermal method can be supported by contraceptive computers in the application and interpretation of the results. There are also programs and online offers that enable the measurement values ​​to be recorded and automatically evaluated on computers.

method description Pearl index
Hormone measurement Measurement of the hormones involved in the cycle using test strips in the woman's morning urine to determine ovulation 5-6
Temperature method Observation of the morning basal temperature to determine ovulation 0.8-3
Billings Method Observation of the condition of the cervical mucus to determine the time of ovulation 5-15
Symptothermal method Combined evaluation of temperature and mucus according to the rules of the NFP working group 0.26-2.2
Calendar method according to Knaus-Ogino or using a birth control chain Calendar method that estimates the typical fertile days from the cycle; is used in the third world in the form of the birth control chain 9-40
coitus interruptus The man's ejaculation takes place outside the vagina. One of the uncertainties of the method is that sperm can escape before the effusion or that the man withdraws too late. 4-18
LAM (breastfeeding infertility) With the Lactational Amenorrhea Method (LAM) during breastfeeding (1 to 6 months after birth), the hormone prolactin acts as an ovulation inhibitor 2

Mechanical methods

The mechanical methods are based on the fact that the entry of sperm into the uterus is prevented and thus no sperm can reach the fertilizable egg.

method description Pearl index
For the man:
condom Sheath, usually made of latex , which is rolled over the erect penis 2-12
For the woman:
Femidom "Female condom" 5-25
(vaginal pessary)
Barrier in the vaginal vault; Protection very dependent on experience, higher security in combination with spermicides 1-20
Cervical cap made of latex or silicone, closure of the cervix , higher security in combination with spermicides 6th
Contraceptive sponge small sponge made of polyurethane foam soaked with a spermicide; is inserted prior to intercourse in the vagina and in front of the cervix placed 5-10
LEA contraceptivum Barrier contraceptives, safer in combination with spermicide (safety is stated by the manufacturer as much better than by the FDA) 2–3 (Manuf.)
> 15 (FDA)

Condom and femidom are currently the only contraceptives that also protect against sexually transmitted diseases such as HIV infections ( AIDS ), gonorrhea or syphilis and should therefore be used independently of other contraceptives if there is a need for protection.

Hormonal methods

For hormonal contraception in women, estrogens and gestagens are used, namely the synthetic analogues of the natural hormones, as these achieve the contraceptive effect in significantly lower doses and with fewer side effects.

Combination pills contain an estrogen and a progestin. With the micropill predominantly used today, ethinylestradiol is used as the estrogen in almost all preparations available on the market . Depending on the progestin used, a distinction is made between the outdated 1st generation with norethisterone or lynestrenol , the 2nd generation with levonorgestrel , the 3rd generation with desogestrel , gestodene or norgestimate and the 4th generation z. B. with dienogest , drospirenone , chlormadinone acetate or cyproterone acetate . The risk of thrombosis is higher for micropills of the third and fourth generation than for micropills of the second generation. The primary principle of action of all micropills is the prevention of ovulation ( ovulation inhibition ). They also change the consistency of the cervical mucus plug ( cervical mucus ), making it difficult for sperm to pass through.

In contrast to combination pills , the minipill as a single preparation contains only one progestin. Conventional minipills contain levonorgestrel as an active ingredient and only act on the uterine lining and cervical mucus, which means that the Pearl Index is significantly higher than that of the micropill. The so-called new minipill contains the active ingredient desogestrel and also reliably prevents ovulation, which achieves a pearl index comparable to the micropill.

The morning-after pill is suitable for emergency contraception if unprotected sexual intercourse has taken place, but conception is undesirable. The earlier it is taken after unprotected intercourse, the more effectively the probability of conception is reduced. The primary principle of action of the morning-after pill is inhibition of ovulation; there may also be an anti-nidation effect. In particular, emergency contraceptions with the active ingredient levonorgestrel are less effective in obese women; pregnancy is up to four times more likely despite the morning-after pill . Contraceptions with the active ingredient ulipristal acetate are also less effective in obese women. A more effective alternative for patients with a BMI over 25 could be the subsequent implantation of a copper intrauterine device.

method description Pearl index
Birth control pill , micro pill Estrogen and progestin, primarily inhibition of ovulation, also changes in the cervical mucus and the uterine lining 0.1-0.9 (with ideal application)

1–12 (practical value for typical application)

Mini pill Levonorgestrel as progestin ( 28 mini , Microlut , Micro-30 Wyeth )
Changes in the cervical mucus and the uterine lining
New mini pill Desogestrel as progestogen ( Cerazette ) inhibits
ovulation, changes the cervical mucus and the uterine lining
Three-month injection Medroxyprogesterone ( Depo-Clinovir )

Norethisterone ( Noristerat )



Vaginal ring Ethinylestradiol and etonogestrel ( NuvaRing , Circlet );
gradual release through the vaginal mucosa; the ring is worn in the vagina for 21 days, followed by a seven-day break
0.25, 1.18
Hormonal patch Ethinylestradiol and norelgestromin ( Evra )
transdermal drug delivery; A new patch for three weeks, then a week off
Contraceptive sticks subcutaneous implant with etonogestrel ( Implanon NXT )
plastic rod is inserted under the skin of the upper arm, works for up to three years, can be removed at any time if desired
Hormonal IUD Intrauterine device with levonorgestrel ( Mirena or “jaydess”)
T-shaped plastic body releases the hormone directly in the uterus, works for up to five years, can be removed at any time if desired; Changes in the cervical mucus and inhibition of nidation due to changes in the uterine lining


Morning-after pill Levonorgestrel ( PiDaNa )
ulipristal acetate ( EllaOne )
emergency postcoital contraception

There are population-representative studies for the Federal Republic of Germany on the pharmacoepidemiology of the use of contraceptives. These provide reliable data on sociodemography , multimedia , morbidity and many physiological data such as B. blood pressure , lipid status , blood sugar u. a. for users of hormonal contraceptives. Although hormonal contraceptives are among the most frequently used drugs worldwide, so far there are mostly only pharmacoepidemiological studies that use secondary data from commercial data collections or data from cohort studies to answer important questions about the safe use of the various preparations.

Pill for man

There is no hormonal contraceptive for men, the so-called “ pill for men ”. An Australian research group is currently working on a combination of the alpha receptor blocker tamsulosin and a P2X1 purinoceptor inhibitor, which could ensure safe contraception in men. Twice the daily dose of tamsulosin (0.8 mg / day) alone leads to a reduction in the volume of ejaculate by almost 90% and in 35% of cases to "dry" ejaculation , but this is not sufficient for contraception.

Combinations of testosterone and progestin are also being tested.

Chemical methods

Spermicides are available in the form of ointments, gels, suppositories, foams or sprays. Most preparations are based on the active ingredient nonoxinol-9 , but more rarely also on lactic acid , boric acid or salicylic acid . Spermicides are inserted into the vagina before intercourse and work by either killing sperm or making sperm less mobile so that they are no longer able to reach an egg.

The exclusive use of spermicides is comparatively unsafe, but in combination with mechanical contraceptives such as condoms, pessaries or cervical caps they increase their effectiveness considerably. However, it should be noted that only water-soluble chemical contraceptives are used, as preparations based on oil and fat can make the rubber wall of the barrier method permeable.

Unpleasant irritation of the mucous membranes can be a side effect of spermicidal preparations.

method description Pearl index
Spermicides in the form of ointments, gels, suppositories, foam or sprays applied in the vagina of women 3-21

Surgical methods

method description Pearl index
Sterilization of the man ( vasectomy ) Surgical procedure in which the vas deferens in the man's scrotum are cut. 0.1-0.25
Sterilization of the woman Surgical procedure in which the fallopian tubes are tied off or cut. 0.01-0.3

In Austria, sterilization or vasectomy without an evident medical indication on people who have not yet reached the age of twenty-fifth is punishable (Section 90 StGB).

Intrauterine devices

Intrauterine devices (IUD) are objects that are inserted into the woman's uterus and that prevent a fertilized egg cell from implanting through mechanical stimulation of the uterine lining. Copper- containing “spirals” are also supposed to kill or deactivate sperm by secreting tiny amounts of copper. IUDs are considered to be very safe and long-term contraceptive methods.

Hormonal intrauterine devices are donating the items IUS treated and are not discussed again with.

method description Pearl index
Copper spiral Plastic objects with copper in the uterus, nidation-inhibiting 0.9-3
chain (GyneFix)
Alternative to the conventional copper spiral. GyneFix consists of copper cylinders lined up on a thread and is fixed to the wall of the uterus so that it is much less likely to slip or be expelled. 0.1-0.5
Copper bead ball A newer design of the copper chain, which expands in the shape of a ball in the uterus and therefore does not need any fixation in the uterine wall and should therefore be particularly gentle. unknown 0.3 - 0.8
Gold spiral Like the copper spiral, but with a gold core for better compatibility.


In the breast-feeding barrier methods how can condom , diaphragm or cervical cap be applied, with a diaphragm and cervical cap must first be re-adjusted in size. In the case of hormonal contraceptives , a distinction must be made according to the type of hormone: Estrogen- containing contraceptives are unsuitable for breastfeeding, as they can affect milk production and, moreover, estrogen can pass into breast milk; Hormone preparations based purely on progestin , such as the minipill , the three-month injection , the contraceptive stick or the hormonal IUD are possible.

The breastfeeding even suppressed may ovulate, the effect is not safe and provides only under special, very strict conditions specified protection from a subsequent pregnancy, see: Breastfeeding and prevention and Lactational Amenorrhea Method .


According to statistics from the Federal Center for Health Education, 53% of adult couples in Germany use the pill (37% only use the pill), more than a third use condoms (37%, including 20% ​​only use condoms). 10% use the IUD for contraception and 5% of both women and men use sterilization. Less than 10% choose other methods. Adolescents behaved similarly in 2010; here too the pill (70%) and condom (52%) are by far the most important contraceptives.

The Swiss health survey of 2017, a representative survey by the Federal Statistical Office , showed that 33.9% of 15- to 49-year-old women with the condom, 27.0% with the pill, 11.7% with the IUD, 8, 5% through sterilization (man or woman), 5.1% using other hormonal methods (plaster, stick or three-month injection) and 3.4% using a natural method. The Swiss Prevention Report shows more detailed figures over time.


Even in ancient times , women tried to protect themselves against unwanted pregnancy by various means and practices, as old records show. An Egyptian recipe from around 1525 BC. BC read: "Put grated acacia leaves mixed with honey on a gauze bandage that you insert into the vagina." This type of tampon may well have had an effect, since the juice of the acacia contains lactic acid , which is an effective spermicide .

Most indigenous peoples around the world, as well as from ancient Europe to the early modern period, have spoken that plant-based contraceptives were used. This type of contraception, which continued to exist at a later date, is now receiving renewed attention in scientific circles.

The philosopher Aristotle reported that women rubbed the part of the “womb” that comes into contact with the male semen with cedar oil, lead ointment or incense mixed with olive oil for contraception. The lead ointment was highly toxic, but the oil actually reduced the mobility of the sperm, as Marie Stopes confirmed in the 1930s after research. She had opened a birth control clinic in London in 1921.

Rabbis advised around AD 300 that a sponge be inserted into the vagina to suck up the semen. This method is also said to have by no means been nonsensical. An Indian contraceptive recipe has been handed down from the 8th century. Then the vagina was rubbed with a mixture of honey and ghee or "closed" with rock salt mixed with oil . The sticky honey was supposed to reduce the mobility of the sperm, and rock salt is also considered a spermicide today. The Persian doctor Ibn Sina (980-1037), also known as Avicenna , already lists 20 different contraceptives in his medical encyclopedia. In the 15th century, for example, a friar named Hans von Schwartach who was in charge of medical tasks wrote down both contraceptive and contraceptive recipes.

Since when condoms were used for contraception is controversial in research. The first reliable evidence of this is the treatise De iustitia et iure by the Dutch moral theologian Leonardus Lessius , SJ , published in 1605 , who condemned this practice as immoral.

In Germany, the Flensburg doctor Wilhelm Mensinga (1836–1910) pioneered contraception. Between 1872 and 1882 he developed the occlusive pessary and tested it in long-term studies on twelve women until he finally went public in 1882 with his treatise On Facultative Sterility from a Prophylactic and Hygienic Point of View under the pseudonym C. Hasse. His pessary was in use especially in the Scandinavian countries, the Netherlands and the USA until the 1950s.

From the end of the 19th century onward, generally understandable medical literature that provided information on contraception options became widely available, which in Germany around 1900 led to the first sharp drop in the birth rate .

On August 18, 1960 in the USA and on June 1, 1961 in Germany, the first hormone pill for contraception was approved as a hormonal contraceptive or brought onto the market.



Contraception is basically allowed in Judaism . The couple should nevertheless strive to fulfill the commandment “Be fruitful and multiply and fill the earth” (Gen 1.28 EU ) through at least two children (both sexes).

Contraception is permitted in cases when pregnancy could pose a risk to the mother or to the birth of further children, for example in the event of health or financial stress, in the case of very young women, while breastfeeding. Contraception methods with a spermicidal effect or mechanical barrier contraception are not permitted. However, hormonal agents are a recognized and permitted means of contraception according to Jewish law ( Halacha ).


Roman Catholic Church

The Catechism of the Catholic Church (KKK) differentiates between conception regulation and contraception (cf. KKK nos. 2368, 2370).

Temporary abstinence and methods based on introspection and the choice of sterile periods ( ovulation calculator) are included in the regulation of conception in marriage, which married couples are allowed to use because they correspond to the objective criteria of morality (CCC No. 2370). This was also recorded in the encyclical Humanae Vitae . The regulation of conception is permitted there for reasons “arising from the physical or emotional situation of the spouse or from external circumstances”.

Artificial contraception, on the other hand, is seen as an objectively contradictory gesture by the married couple, as a "not-quite-giving yourself". This is understood to mean any act "which, either in foresight or during the performance of the conjugal act or after it, during the course of its natural effects, aims to prevent reproduction, be it as an end or as a means to the end." KKK No. 2370, Encyclical Humanae Vitae , 14)

A natural law- based difference between the behavior in the case of contraception and contraception is defined as follows: “In the first case, the married couple legitimately make use of a natural possibility; with the other, however, they prevent the process of procreation from taking place naturally. "( Humanae Vitae , 16)

In the apostolic letter Familiaris consortio, Pope John Paul II assigned the pastoral leadership of the Church the task of creating the prerequisites for normative recognition, especially of the encyclical Humanae vitae .

If there are serious reasons, such as rape, or if there is a risk of such, contraception may be allowed. When religious women in particular were raped by insurgents during the Congolese civil war at the beginning of the 1960s , the church allowed the preventive use of contraceptives on the grounds that this was a matter of preventing the consequences of an act of violence. Since then, contraceptives have also been used in Catholic hospitals. The permit was later also valid during the Bosnian War , when rape, especially by religious sisters, was used as a targeted means of warfare.

At the beginning of 2013 it was reported that a raped woman had not been treated by two Catholic hospitals in Cologne because the doctors were unable to prescribe the so-called “ morning-after pill ”. In February 2013, the German Bishops' Conference therefore stated that women who have been victims of rape can also be given the so-called “morning-after pill” in Catholic hospitals, provided that it has a preventive and not an abortive effect. Cardinal Meisner had previously expressed the following regarding the assessment of the central active principles of such preparations: “The church can only explain the moral principles. The individual doctor in a Catholic institution must then conscientiously familiarize himself with these principles and thus come to a responsible decision. ”Regarding the church position, he explained:“ When it comes to rape, it is not about the holistic nature of a loving act, but about prevention a criminal fertilization. ”The president of the responsible Pontifical Academy for Life has publicly supported this line of the German bishops with the reference to the corresponding 50 years of practice in Catholic hospitals as well as to the encyclicals Casti connubii and Humanae vitae .

In 2018, Pope Francis declared that artificial contraceptives should also be accepted for women in poverty as long as they are not abortive. Condoms , diaphragms and, as a last resort, tube ligatures are possible artificial contraceptive methods. These have no abortive effect and have no harmful effect on the female body.

Orthodox Church

There are different views on contraception in the Orthodox Church . When the methods used were still unsafe and often harmful to health, contraception was strictly rejected. Today it is accepted by most theologians and confessors, albeit only within marriage; the partners should decide according to their own conscience about their desired number of children and the intervals between births. The use of anti-nidation contraceptives such as the intrauterine device and the morning-after pill is rejected as their use is considered to be an early stage abortion .

Anglican Church

In 1930, the General Assembly of Bishops of the Anglican Communion declared contraception permissible under certain conditions. While the bishops at the 1908 Lambeth Conference expressed their grave concern about any form of contraception, the 1930 conference stated that where the couple felt a moral obligation to limit the number of their children or to conceive to avoid at all, total abstinence is the first and most obvious way to do it. However, if there are morally sound reasons against abstinence, other methods could be used, provided that they are used "in the light of Christian principles". The 1958 conference stated that responsibility for the number and succession of children was a matter of the conscience of the couple "as acceptable to husband and wife."

Protestant churches

Protestant churches allowed contraception in decisions of 1951 and 1958. The Chairman of the EKD Council, Heinrich Bedford-Strohm , stated in January 2015 that the Protestant Church did not consider modern contraceptives to be something that should be prohibited. Good family planning, including contraception, is part of a good married life for Evangelicals.


Contraception in Islam is allowed under the following conditions:

  1. Mutual consent of husband and wife.
  2. It does not cause any (health) damage (to either spouse).
  3. It is not practiced permanently, but rather for a temporary period (therefore sterilization is not allowed).

One of the two main sources is the Hadith al-Buchari 5207, in which it was reported by a gabir : “We usually made use of the 'Azl [meaning coitus interruptus ] at the time of the Messenger of Allah, peace and blessings of Allah be upon him . "


In Ásatrú contraception is not prohibited. However, many Ásatrú communities are against a childless life.


With the Baha'i , contraception for family planning is in principle allowed (sexual intercourse outside of marriage, on the other hand, is not approved). Only the preventive sterilization of childless people with the aim of not wanting to have children is only recommended if a (further) child would harm the mother or family, since the main purpose of marriage is to bring up children. Otherwise, contraception and family planning are left to the believers themselves. Ultimately, every Baha'i can and should decide for himself in personal dialogue with God about questions of family planning and contraception.

See also


Web links

Commons : Contraception  - collection of pictures, videos and audio files
Wiktionary: Contraception  - explanations of meanings, word origins, synonyms, translations

Individual evidence

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  57. a b Vatican supports German bishops with morning-after pill ., February 23, 2013.
  58. ^ Press report by the chairman of the German Bishops 'Conference, Archbishop Robert Zollitsch, on the occasion of the press conference at the end of the spring general assembly of the German Bishops' Conference in Trier on February 21, 2013 (PDF; 55 kB).
  59. ↑ The doctor must come to a responsible decision on his own. ( Memento from February 8, 2013 in the Internet Archive ) Explanation from the press office of the Archdiocese of Cologne from January 31, 2013.
  60. Casti connubii
  61. Vatican Insider: German bishops' decision on morning-after pill is an example to be followed. February 22, 2013 .
  62. Sister: 'Pope may consider contraceptives permissible'.
  63. Is Francis abolishing the ban on the “pill”? Internal debate in the Vatican .
  64. Timothy Ware: The Orthodox Church. Penguin, ISBN 0-14-014656-3 , p. 296.
  66. Herder-Korrespondenz , 21, 1967, 436.
  67. ↑ The pill ban remains a matter of dispute between the denominations .
  68. With this statement the reporter wants to point out that neither the prophet Mohammed nor the revelation of the Koran issued a ban.
  69. David J. Krieger, Christian J. Jäggi: Nature as a cultural product. Cultural ecology and environmental ethics. Birkhäuser Verlag, 1997, ISBN 3-7643-5488-7 , p. 170.