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Why Were New Male Contraceptives Needed?

New Male Contraceptives

New Male Contraceptives

This article summarizes the research of scientists around the world who are working toward new forms of contraception for men. Although several of these contraceptives are close to market, none are currently available. Some methods are still in the basic science stages, some have been tested in animals only, and some have entered the process of clinical trials required for government approval.

Men are Ready for New Male Contraceptives

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.

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. Another study found that over 60% of men in Germany, Spain, Brazil, and Mexico were willing to use a new method of male contraception.

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 return to their previous contraceptive methods. 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. 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 New Male Contraceptives

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. 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. 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.

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 mention 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”. 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. 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. 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 website 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 socio-cultural impediments to using these techniques as well as industry fears of litigation should they choose to market these novel products”.

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 activities.