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Why new male contraceptives?

Men are ready for them

Stereotypes about men are the most common source of skepticism about the feasibility of new male contraceptives. Many people believe that men are too irresponsible or untrustworthy to participate in family planning. Others believe that men won’t use a method of contraception that requires trips to the doctor or uncomfortable injections. However, numerous studies show that these beliefs are not grounded in fact.

Men already participate in family planning

Despite the drawbacks of the currently available male contraceptive methods, men around the world are already active and responsible family planning participants. The disadvantages of the two most common male contraceptive methods are not trivial: vasectomies are not readily reversible, and condoms have a high typical use failure rate. Despite this, one in three married couples in Australia and New Zealand rely on vasectomy for their contraception, one in six in the United States, and one in twenty worldwide. Condoms account for an additional 13% of contraceptive use in developed countries (UN 2003).

Studies show that men want access to better contraceptives. In a recent study of British men, 80% placed a hypothetical male pill as one of their top three contraceptive choices (Brooks 1998). Another study found that over 60% of men in Germany, Spain, Brazil and Mexico were willing to use a new method of male contraception (Heinemann 2005).

The idea that men cannot handle the responsibility of contraception is akin to saying men can not raise children — it is based on a variety of negative male stereotypes, which are contradicted by the available evidence and would be hotly contested by millions of responsible men and their partners.

Men will inconvenience themselves to get new contraceptives

The idea that men would not be willing to use pills, get injections, or undergo medical procedures for contraception is contradicted by all the available evidence. Again, men already undergo medical procedures for vasectomy, and the contraceptive preference study results reported above show their enthusiasm for a hormonal contraceptive.

The experiences of researchers prove that men will go out of their way to get access to new male contraceptives. Researchers are sometimes flooded with volunteers and men wanting more information. At the conclusion of a World Health Organization hormonal method trial, 85% of the volunteers would have preferred to continue rather than returning to their previous contraceptive methods (Ringheim 1995). This is despite the experimental nature of the contraceptive and weekly injections!

When presented with safe and reliable contraception, it is unlikely that men will reject a method because it involves a drug or a medical procedure. As is true of female contraceptives, different methods of male contraception will be accepted by different cultures (Heinemann 2005). It is unlikely that a single male contraceptive would be acceptable to all the world’s men; yet no female contraceptive is right for all women, and this certainly has not been a deterrent to the development of female contraceptives.

Women are ready for them

Most women try many different contraceptives over the course of their reproductive years. Sometimes this is because their needs change, or the type of relationship they are in changes; often it is due to dissatisfaction with their current method. There is still no completely satisfactory long-term female contraceptive. If new methods of male contraception were available, many women would encourage their partners to try them (Martin 2000). Contrary to popular stereotypes, women would trust their partners to use male contraceptives. Women already trust their partners to use condoms and get vasectomies.

Women are dissatisfied with their current choices

Satisfaction with current female contraceptive methods is dismal. Surveyed satisfaction rates are less than 60% for every method except tubal ligation, and the average woman has tried 3 or 4 different types of contraception (Rosenfeld 1993). This is because to be acceptable in the long run, a contraceptive method must be reliable, safe and reversible. Although there are many choices on the market — condoms, the pill, injections, implants, diaphragms, IUDs, jellies, foams, sponges, tubal ligation, vasectomy, and so on — every one of them falls short on one or more of these criteria.

Many contraceptives are simply not reliable enough for long-term use. For instance, condoms have a typical use failure rate of 13%, or one in eight. Sponges, caps, diaphragms, and spermicides are even more likely to fail (BWHBC 2005).

Of the methods that are over 99% reliable – the pill, tubal ligation and IUDs – most have significant effects on the woman’s health. Almost all women who stop hormonal contraception cite unacceptable side effects as a reason for quitting; nausea, headaches, weight gain, depression, loss of libido, or menstrual problems. Getting one's tubes tied is not readily reversible. Modern IUDs are safe and effective, but suffer from the stigma associated with the Dalkon Shield scandal.

Many of the experimental male contraceptives described on this site have the potential to satisfy these three criteria better than anything currently on the market. Further research would be extremely valuable to the many couples who do not wish to have children, but do not want to give up their health and future fertility.

Women trust their partners to use male contraceptives

In a survey of 450 Scottish women, 94% said “a male hormonal contraceptive would be a good idea” (Martin 1997). A later study that included Cape Town, Shanghai and Hong Kong showed that only 2% of the women surveyed would not trust their partners to use a male pill (Glasier 2000). In one study of Australian couples, women’s positive attitudes toward a potential male pill made their partners much more likely to report interest in trying it (Weston 2002). There is simply no evidence that women in committed relationships would not trust their partners to use a new male contraceptive.

New male contraceptives could be better than any existing methods

Some people are skeptical that effective male contraceptives are possible. They ask, “If these methods are so great, why don’t we hear more about them?” Many of these methods have little profit potential and are not being pursued or publicized by pharmaceutical companies, but this web site aims to spread the word. We do this work because we think that some experimental male contraceptives promise to be safer, more effective, more convenient, and easier to reverse than any existing female methods.

Heat-based methods could offer low tech, easily implemented, user controlled contraception. RISUG is effective immediately after an out-patient injection procedure, shows very few side effects, is effective for up to 10 years, and could also be reversed through an out-patient procedure. The work of researchers at Kings College London could lead to a true “male pill” with no effect on libido or secondary sex characteristics.

We need more studies on all of these experimental male methods. Further research and development is the only way to find out whether these methods are genuinely as attractive as they now appear.

Male contraceptives are not more difficult to develop

There is a common misconception that males’ reproductive biology is much more difficult to tame than females’. The reasoning goes something like this: “Women produce only one egg a month, but men make millions of sperm in a day...” But the National Institutes of Child Health and Human Development, NIH’s contraceptive research branch, strongly refutes this:

“The lack of progress in developing affordable, safe, effective, and reversible male contraceptives is due not to the biological complexity involved in suppressing spermatogenesis [the production of sperm], but rather to social and economic/commercial constraints... making these new contraceptives widely available on the market will require collaborative efforts that bring together the full spectrum of biological, epidemiological, and biobehavioral research and their political interfaces with the public. In the end, all of these factors must be addressed to help resolve sociocultural impediments to using these techniques as well as industry fears of litigation should they choose to market these novel products” (NICHD 2000).

Researchers are also impeded by our relatively incomplete understanding of the male reproductive system. The basic science of the male reproductive system is at least 50 years behind the study of women’s reproductive systems. Again, this does not mean male contraceptives will be more difficult to develop; there are already several in the development pipeline. It does mean it is time to take concerted social, political and scientific action.

References

  • Boston Women’s Health Book Collective (2005) Our bodies, ourselves: A new edition for a new era, 35th anniversary edition. Touchstone; New York, NY.
  • Brooks, M (1998) “Men’s views on male hormonal contraception: A survey of the views of attendees at a fitness centre in Bristol, UK.” British Journal of Family Planning 24: 7-17.
  • Glasier, AF, R Anakwe, D Everington, CW Martin, Z van der Spuy, L Cheng, PC Ho and RA Anderson (2000) “Would women trust their partners to use a male pill?” Human Reproduction 15(3): 646-9.
  • Heinemann, K, F Saad, M Wiesemes, S White and L Heinemann (2005) “Attitudes toward male fertility control: results of a multinational survey on four continents.” Human Reproduction 20(2): 549-56.
  • Lissner, E (1994) “Frontiers in nonhormonal male contraception: A call for research.
  • Martin, CW, RA Anderson, R Anakwe, A Glasier and DT Baird (1997) “Development of contraceptives: obstacles and opportunities.” New England Journal of Medicine 322: 482-85.
  • Martin, CW, RA Anderson, L Cheng, PC Ho, Z van der Spuy, KB Smith, AF Glasier, D Everington and DT Baird (2000) “Potential impact of hormonal male contraception: cross-cultural implications for development of novel preparations.” Human Reproduction 15(3): 637-45.
  • National Institutes of Child Health and Human Development (2000) “From cells to selves: reproductive health for the 21st century.
  • Ringheim, K (1995) “Evidence for the acceptability of an injectable hormonal method for men.” Family Planning Perspectives 27(3): 123-8.
  • Ringheim, K (1996) “Whither methods for men? Emerging gender issues in contraception.” Reproductive Health Matters 7: 79-89.
  • Ringheim, K (1996) “Male involvement and contraceptive methods for men: Present and future.” Social Change 26(3-4): 89-99.
  • Rosenfeld, JA, PM Zahorik, W Saint and G Murphy (1993) “Women’s satisfaction with birth control.” Journal of Family Practice 36(2): 169-73.
  • Schulman, A. (2000) “Too much to swallow? We’ve never had a male equivalent of the pill, but there are more prospects on the horizon than you might think.” Boston Phoenix, April 13-20.
  • United Nations Department of Economic and Social Affairs, Population Division (2003) “World Contraceptive Use 2003.” United Nations Publications; New York, NY.
  • Weston, GC, ML Schilpalius, MN Bhuinneain and BJ Vollenhoven (2002) “Will Australian men use male hormonal contraception? A survey of the postpartum population.” Medical Journal of Australia 176(5):208-10.
  • World Health Organization (1993) “Men find the prospect of male hormonal methods exciting.” Progress in Human Reproduction Research 3:3.


 


Use of existing methods
of male contraception

Use of existing male contraceptives in developed regions:

Developed regions pie chart

Use of existing male contraceptives in developing regions:

Developing regions pie chart

These data are from the United Nations Population Division World Contraceptive Use 2003. "Data on contraceptive use were compiled primarily from surveys based on nationally representative samples of women of reproductive age (15 to 49 years old in general)."

Reasons to develop new contraceptives in the news