It takes two to tango, as that old chestnut goes, but when it comes to contraception, it’s still mostly thought of as solely the women’s responsibility to bear the brunt of any consequences.
It’s a tale as old as time, with this patriarchal process of thought flavouring even the founding father of medicine’s perspective of childbirth. Dating back to 400 years BC, Hippocrates wrote: ‘When a woman has intercourse, if she is not going to conceive, then it is her practice to expel the sperm produced by both partners whenever she wishes to do so.’
As the 1960s heeded the advent of the revolutionary contraceptive pill, it helped spearhead women’s sexual liberation. Now, nearly six decades on, over 150 million women across the world are on the combined pill or ‘mini-pill’. Since then, a whole suite of contraceptive options for women have been made available, but it often begs the question if – and when – there could be a viable alternative contraceptive for men.
While there have been numerous attempts to develop ‘a male pill’, a recent drug that temporarily immobilises sperm has had positive results when being tested on mice. However, should this drug ever come to fruition, would men even be prepared to share the burden of responsibility when it comes to contraception?
Research strongly suggests they would: a poll by YouGov found that one in three sexually active men would consider taking a male contraceptive –around the same percentage of women in the UK on the pill.
Thomas Ling, 30, is someone who would happily take a contraceptive. Having been in a monogamous relationship with his fiancee, Anna, 30, for seven and a half years, he is keen to help share the burden, particularly as his partner has frequently expressed her preference to give up her hormonal contraception.
‘Absolutely I’d take it,’ he tells Metro.co.uk. ‘Why not? It’s merely shouldering responsibility. You’d have to be a jerk not to do it.
‘It would be a really great thing for women – it would mean they’d have more of a choice, rather than simply being expected to take a hormonal contraceptive potentially long term.
‘The biggest impact will be how men see women – they’ll have a bit more understanding of what women have been forced to deal with for decades.’
Science writer Thomas adds: ‘I definitely consider myself a feminist, but when first hearing about the side effects such as acne and mood swings, there was a small voice in my head saying “yeah, I really don’t want those. Why should I have to change my body?”. This was obviously then followed a second later with the thumping realisation that’s how women have been forced into feeling for decades.
‘Honestly, it would feel great to help my fiancee. Men can feel fairly helpless in this arena – a lot of the time it can feel like supporting from the sidelines. Although there may be some side effects, it would just be a loving thing to do.
‘Anna knows I’m a creature of habit, so she could trust me to take the pill. However, that doesn’t necessarily mean all men would take it reliably, especially as biological stakes are lower for them.’
Jack Ashton, 26, is also similarly willing to opt for a male contraceptive but voices more reservations.
‘I would take it myself, but I believe men might be laxer about taking a contraceptive religiously,’ he admits. ‘We don’t have the burden of carrying a child.
‘I also feel it would most benefit couples. If I was a woman having casual sex, there is no way I’d just take a man’s word that he was on the pill – I’d want to keep using my own contraceptive.’
Jack adds that the severity of side effects may stop him from wanting to take the pill if they caused significant disruption to his life.
‘At the moment, we use condoms and my girlfriend has the implant,’ he says. ‘If I was on contraception that had really bad side-effects, I’d have to consider whether it’s the best option for me to keep taking it. We’d have to discuss the best path for both of us, as neither of us want children yet.
‘It’s striking that balance. I don’t want her to suffer side effects if they’re really debilitating, but also I shouldn’t have to either.’
It would be easy to scoff at men not wanting to endure the side-effects associated with hormonal contraception, considering women face mood-swings, break-outs and headaches when on the pill or other hormonal equivalents (and that’s not including the rarer, more severe side effects such as blood clots and even breast cancer).
However, the increasingly shaky counterpoint is that the side-effects of female contraceptives outweigh the adverse health effects of an unwanted pregnancy: as men do not directly incubate and birth children from their own bodies, it makes it harder to justify more problematic side effects.
A large-scale study on a male hormonal contraceptive, sponsored by the World Health Organisation, was shut down over health concerns in 2016. The most common side effect was acne, which in some cases was severe. However, the more worrying concern was the extremity of the mood swings – one participant started to experience depression, while another reportedly attempted suicide. Nonetheless, the majority of male participants said they would have continued using the contraceptive if the study had not been halted.
It’s also worth noting that the female contraceptive pill was approved before there were widely adopted formal standards; should it be in development today, it may have had to jump through significantly more hurdles before being rolled out for wider use.
Whether it’s a genuine concern for wellbeing or symptomatic of sexism streaked through society, many experts believe that a hormonal contraception for men simply won’t progress to later stage trials or eventual funding.
‘Men simply cannot tolerate side effects,’ Dr Sabatino Ventura, a senior lecturer in Pharmacy at Monash University, explains. ‘For a male contraceptive to have any widespread success, it needs to be non-hormonal.
‘There’s also the issue of funding. A lot of pharmaceutical companies don’t want to put money in because they have an opinion that even if a male contraception does make money, it’ll just take a chunk out from the female contraceptive they already have in the marketplace.
‘It may be a generational thing. Those who tend to be in charge of these pharmaceutical companies are older men fixed in a particular mindset. It may take a long time for this to change.’
Dr Ventura adds that the slow progress of developing a male contraceptive may also be rooted in the fact it’s significantly more difficult.
‘Men make 1000-2000 sperm every second, whereas women make one egg a month,’ he says. ‘An ejaculate has 100 million sperm in it and you have to stop all of that sperm to make sure a man is infertile.
‘It also must be a drug that’s easy, convenient, and reversible. Anything that requires a procedure is unlikely to be successful in men.’
Dr Ventura does have skin in the game. Working alongside the Male Contraceptive Initiative – a US based company hoping to make a non-hormonal male contraceptive – research he conducted in 2013 discovered a way to block a couple of proteins that controlled the movement of sperm. Men would still be able to ejaculate, only his medication would send signals to the brain telling sperm not to be launched. The research also showed that Ventura’s drug may also be able to help with erectile disfunction.
If it sounds too good to be true, it’s partly because it is: Dr Ventura’s research was conducted on genetically modified mice. While the results showed it worked on them with no side effects or behavioural changes, scientists have to now create a human equivalent that relies on a chemical component rather than genetic tampering. This means a great deal more research and clinical trials, perhaps several decades worth, still needs to be done before we see Dr Ventura’s efforts ever come to market.
However, that doesn’t mean that we’re still multiple generations away from seeing a male contraceptive – researchers at the University of Edinburgh believe their offering could potentially hit the shelves within the next decade.
Human clinical trials are currently underway for their contraceptive gel. A mix of testosterone and nestorone, the gel is rubbed and absorbed into the shoulders – continued use over three months sees a man’s sperm count drop to zero. Should the gel stop being applied, it would take a further three months or so to see the sperm count return to pre-gel levels.
‘Nestorone turns off the signalling part of the brain and tells the testicles to stop producing sperm,’ explains Dr John Reynolds-Wright, who is a researcher on the study. ‘That would work as a contraceptive itself, but it would lead to really low testosterone levels such as low mood, low energy, and low sex drive.
‘We then add the testosterone back in to counter those symptoms – but the body has stopped producing sperm. It takes around 12 weeks for the sperm count to have reduced to nothing.’
The gel is certainly simple and easy enough to squeeze into your daily routine – after showering and spritzing aftershave in the bathroom, men would merely need to rub some gel into their shoulders before getting dressed and going about their day.
Giving men a wider ability to engage with contraception is going to be such an important step for us in society
For Thomas, the gel sounds like an ideal contraceptive. ‘One of the most important things about getting men to take a contraceptive is convenience, and the gel sounds like something you can adapt into your life really easily,’ he says. ‘It may also appeal to men who are more squeamish about taking pills.’
Jack, however, explains he’d actually rather take something more medicalised for a contraceptive.
‘A pill or an injection is something you can do and just know it’s working,’ he explains. ‘I feel with a gel there’s more of a margin of error – I’d worry I haven’t applied enough or it’s not got into my system properly.’
There’s still 18 months left of the trial for results to be documented, but to Dr Reynolds-Wright, things are so far looking promising – even if the treatment is hormone-based.
‘Our most prominent side effect is acne, namely on the shoulders where the gel is applied,’ he explains. ‘We’ve seen some mild mood changes, increases in sex drive – but that’s mostly been it. When the study concludes, we’ll be able to analyse how frequent side effects are and how widely they can be attributed – but so far, it seems to be a well-liked form of contraception.’
No matter how positive the outlook looks for the male contraceptive gel, there’s still a significant way to go.
‘We’ve got another year and a half until this study concludes, before planning Stage 3 studies, which would be wider scale human trials,’ Dr Reynolds-Wright explains. ‘That would need to happen over the next few years before the gel is authorised and licensed for use.
‘If things go according to plan, realistically, we could see the gel in use by 2030.’
For there to be a widespread uptake of the gel, Dr Reynolds-Wright believes it needs to be made available for free on the NHS, similarly to women’s contraception.
‘Around 1/3 of births in England are unplanned,’ he explains. ‘The people who are most at risk from unwanted pregnancies need it to be free at the point of access.
‘While I think the gel being free wouldn’t be integral to its widespread success, I do think it should be offered to men in the same way the pill is offered to women.’
Regardless, Dr Reynolds-Wright believes the gel, should it make it to market, would only be the beginning of male contraceptives.
‘I do see this being as revolutionary as the iPhone,’ he says. ‘This could shift the dynamics of how reproductive autonomy sits for people.
‘But we can’t just stop at this gel. There needs to be a broad range of options, longer acting methods, pills, gels, injections, implants so men, just like women, have several options to choose from.
‘Giving men a wider ability to engage with contraception is going to be such an important step for us in society. It really could change everything.’
Do you have a story you’d like to share? Get in touch by emailing [email protected]
Share your views in the comments below.
Source: Read Full Article