 In our previous video we discussed about two different type of contraceptions, artificial contraceptions and in this video we are going to look at few more. But before we do that let me tell you that I was really curious to know why is the need of another birth control method when there is already condoms and spermicides out there in the market. Well when I looked up I found that back in 1940s the world population kind of exploded in the scientific community back then wanted a more effective and more powerful type of contraception and that is how few more got created. So rather than just jumping into the name of that birth control method let me give you a back story of how that birth control method came into existence. That would be more fun right? So for that I have this hypothalamus here and then the uterus and the ovary and some communication going on through hormones between the two. Alright now let's begin our story. So the story starts somewhere in the 1940s when the world population kind of exploded and to find out solutions scientists at that time thought of studying pregnant women. And in pregnant women they have found that during pregnancy there is no ovulation that means there is no release of egg. Then later they found out that it is due to the very high amount, extremely high amount of progesterone in her body. Well if you are wondering why that happens let me tell you that in the initial stage of pregnancy it is the ovaries that starts producing progesterone and later when the placenta is well established it is the placenta that starts producing progesterone. And when the progesterone levels are very high it sends a signal back to the hypothalamus that hey Mr. hypothalamus stop, just stop producing gonadotropin releasing hormone. And if that is done it will not send a signal to anterior pituitary right? And if there is no signal anterior pituitary won't release follicle stimulating hormone or luteinizing hormone and if these two hormones are not released that means there will never be ovulation. So what they found out that it is the progesterone, the protagonist of the show who can stop ovulation. So scientific community thought of mimicking progesterone by creating artificial progesterone. They are now available by different names like progestin or progestogen or maybe simply we call it synthetic progesterone and they are made available as contraceptive pills for women and taking of wedge would stop ovulation. And later scientists found that apart from stopping ovulation progesterone also thickens the cervical mucus thereby stopping the sperms or making it hard for the sperms to swim up to the uterus. And not just that progesterone also makes the uterine wall extremely thin not suitable for implantation which also became a downside because extreme thinning of the uterine wall caused heavy bleeding and that is when scientists came up with the idea of adding estrogen with progesterone. Estrogen helps in proliferating or keeping the uterine wall intact. Estrogen is also made synthetically and it is available by the name estradiol. So this is it, this is how birth control pills came into existence. So this pills can contain only progestin and the example is mini pills or as we just discussed the pills can also have a combination of progesterone and estrogen they are mainly referred to as combined oral contraceptive pills. And the examples are Maladi, Malael, etc. And since we are talking about pills let us also talk about something called the emergency contraceptive pills which has both progesterone and estrogen and they are called emergency because it is given to a sexually assaulted female or to a female after having an unprotected sex. It is also called morning after pills and is available under the family welfare program in India since 2002. A very common example is Mifpristone and apart from Mifpristone another very popular emergency contraceptive pill is I-Pill. And apart from pills in emergency situation where there has been a sexual intercourse without consent there is another way to stop pregnancy and that is by putting in some device into the uterus and we call them the intrauterine devices and we will talk more about it later in the video. Now this pills definitely stopped ovulation or stopped pregnancy but it had a lot of side effects like vomiting, nausea, headache because after all it is playing with the body's hormone levels you see the hypothalamus pituitary and ovarian excess is all disturbed and due to all this downsides right from 1960s scientists started finding out alternatives to this estrogen and progesterone pills and do you know who in the world was successful in doing that? It was the Central Drug Research Institute of India that is in Lucknow they designed a chemical called St. Chromane that had very mild estrogen and a very strong anti-estrogenic property in it and it stood in the way of implantation. It is available by the name Saheli in the market and is distributed for free in India by the government. So the St. Chromane drug not only didn't have all the side effects that the progesterone and estrogen pills had but also the dosage of the pills were very low. When it comes to progestin or only progesterone pills it is advised to be taken every day of the month. Some combined oral contraceptive pills are asked to be stopped only for 7 days a month but when it comes to St. Chromane just one pill per week is prescribed. So along with the side effects St. Chromane also minimizes the drug intake in the body which is good right? So this was all about pills where we discussed about hormonal and non-hormonal pills. Now let's move on to another contraceptive method, an artificial method which is known as intrauterine devices and by the name you can already guess that these are devices that are put inside the uterus therefore it is called intrauterine and just like pills these are also of different types and the first one that we are going to talk about is lipis lube. So lipis lube is made up of flexible plastic mainly of polyethylene and is double S in shaped as you can see. It comes in different sizes and shapes depending on the size of the uterus but how they prevent pregnancy is not completely understood but they seem to interfere in some manner with the implantation of the fertilized egg in the lining of the uterus and the thread you see that's hanging down in the vaginal area that is to remove the intrauterine devices whenever required. So this was lipis lube and since this intrauterine device do not release any hormone or any kind of chemical this device is also called inner device. And also in the long run doctors found it to be quite inefficient and therefore it is no longer in use now. Now let's move on to another intrauterine device which is very popular and we call it the copper T. So as you can guess it got its name because of the shape it has that is the shape of a T and also copper coiling around it. And in the uterus it sits somewhere here like a T along with its threads flowing down the vagina so this copper T functions by releasing very small amount of copper into the uterus approximately 50 micrograms per day and those copper attracts a lot of immunological response into the uterus by bringing in toxic cytokines and those cytokines suppress the sperm mortality so that the sperms cannot swim all the way up to the egg to fertilize it. So that is how copper T works and this copper T also comes in different variations some can be left in the uterus for 5 years some for 10 years so it is comparatively a long duration birth control method. Alright now let's move on to the third one hormone releasing IUDs. So these are hormonal intrauterine devices and like copper T it also sits in the uterus the same way with its thread hanging down so that it can be taken out whenever required and this intrauterine device releases hormones mainly progesterone and it acts the same way as progesterone acted when we discussed about the pills. It suppresses any change in this endometrial lining so that implantation cannot take place moreover it also suppresses ovulation and since it plays with ovulation it also plays with the normal menstrual cycle so hormonal IUDs disrupts the menstrual cycle and this is how the hormonal IUDs work. So these are the 3 intrauterine devices that stands in their own unique way against pregnancy but one thing that is common in all different type of intrauterine devices is that they are after all foreign substances that are inserted into the female uterus right. Now what happens when something foreign enters the body whether through a cut or a wound let's say bacteria or viruses enters our body what happens then? Well our body's immune system gets super activated right so when a foreign substance is in the uterus a lot of immunological reaction takes place in the uterus it brings in a lot of local inflammatory reactions and that in turn ends up killing the sperms. So this was all about IUDs we will talk about few more artificial method in our future video but before we end this video let's talk about the downsides of this IUDs because after all artificial methods will always have their side effects right. So first thing is that they are not very easily available you need to approach a doctor or a gynaecologist to get these things inserted into the body there are also instances of women complaining of worse cramping and back aches after putting in the IUDs and especially during the menstrual cycle and again since it releases some substances it disturbs the body's balance of hormones or ions right. So these are the side effects. Alright so in this video we have discussed about IUDs and pills in our future video we will talk in detail about the surgical methods of birth control.