No plastic, no contraception!
Covert contraception
Considered normal in most developed countries, fertility control is the result of slow changes initiated in the late 18th century. It was manifested in several ways, according to moral and legal requirements, depending on the reasons invoked: to prevent having illegitimate children or limiting pregnancies for economic, medical or even aesthetic reasons.
For a long time, these expectations exceeded the supply of effective measures. Their use was only tolerated, under medical supervision, to avoid resorting to abortions that were necessarily clandestine in nature as they were prohibited. This is why the early 20th century saw the development of occlusive pessaries such as the cervical cap, used to cover the cervix, designed in 1838 by Wilde in Germany, and the diaphragm, developed in 1882 by his countryman under the pseudonym of Mesinga.
Despite the introduction of flexible plastics such as rubber and celluloid in the 1920s, these very intrusive single-use or reusable products were expensive and required gynaecological supervision due to frequent complications. In short, no available products enabled women to be masters of their own contraception and their own sex lives as a result!
New polymers for birth control
Despite the legal restrictions placed on contraceptives, the creation of the International Planned Parenthood Federation (IPPF) in 1953 enabled associations helping women to control their fertility to take a role in the prescription of contraceptives.
Demand focused mainly on the new natural latex or silicone diaphragms and caps manufactured in English-speaking countries. Although their use required consulting a physician, and the systematic use of spermicides, the quality of the materials made this type of contraception less problematic.
The advent of the less obtrusive contraceptive pill and IUD in the 1960s diminished the appeal of contraceptive barriers in Europe. However, this did not stop them from being distributed elsewhere in the world.
The appearance of new manufacturers in emerging countries even revived innovation. The 80s saw a new concept make its way onto the market: spermicidal vaginal sponges made from polyurethane foam.
In 2010, the Virginia-based Conrad Institute developed the one-size SILCS anatomical diaphragm, usable without a medical prescription, for developing countries. The American ReProtect laboratory will soon be launching a polyurethane model, a first, with contraceptive and microbicidal properties.
IUDs: copper is not the be-all and end-all
Doctor Ernst Gräfenberg is better known for discovering the G-spot than for inventing the first IUD in 1928. And with good reason! As effective as it was dangerous, its ring covered in a zinc, nickel and silver alloy wire often caused severe infections in addition to the inflammation of the uterus that served to block fertilization.
In the early 1960s, gynaecologists who were convinced of the value of the process decided to create a biologically inert intrauterine device (IUD) that was flexible enough to match the uterus' T-shape without causing any damage. Laboratories were quick to launch several models of IUDs, in improved anatomical shapes, made from ethylene vinyl acetate, nylon and polyethylene. However, without metal, the inflammatory reaction prohibiting implantation of the embryo, although less damaging, turned out to be less efficient.
This is why Doctors Zipper and Tatum created a new IUD in 1969, based on a copper wire spiralled around a polyethylene stem. The joint effectiveness of plastic and metal was such that many models of the same type are still in use to this day. Thanks to the success of the pill, several researchers laid out plans to combine the IUD's inflammatory reaction with hormonal contraception in the late 1970s. A few models were approved, including Bayer's Mirena comprised of a plastic reservoir stem covered in a polymer membrane that released synthetic progesterone at regular intervals.
Plastics make the pill easier to swallow
Despite losing favour over the past years, the pill remains the most used contraceptive in developed countries.
Among the more serious reasons for abandoning it, physicians and their patients cite the side effects and contraindications linked to hormonal contraception. However, the disadvantages of having to take it on a daily basis, with the sword of Damocles of forgetting and becoming pregnant hanging over their heads, are serious issues for this method of oral contraception. For instance, for very young women or those who travel frequently as part of their jobs.
Some laboratories developed alternative means of hormonal contraception, with shorter or longer activation times, specifically for these women. Subcutaneous implants comprised of a cylindrical polyethylene stem that releases a constant dosage of progestin over the course of three years, for instance. Ethylene vinyl acetate vaginal rings, both flexible and porous, release a mix of oestrogen and progestin over the course of a single cycle. And the hormonal cocktail diffused through the polymer membranes of contraceptive patches only acts for a week.
