His or Hers? Male Contraception on the Horizon

Does the future of birth control lie with men?

Leaders of the conference The Future of Male Contraception, held in Seattle just two weeks ago, think it's a possibility.

The conference, sponsored by the National Institutes for Health, the University of Washington, and the World Health Organization, among others, presented a new world of contraception for men – beyond vasectomies and condoms.

According to a Science Daily article, birth control methods familiar to most women in the U.S. were discussed – a "testosterone-like" oral pill and a Depo-Provera shot (a once/every three month injection of progestin). And a vasectomy alternative, the Intra Vas Device (IVD), was presented, fresh from tests in its first U.S. study. A set of plugs inserted into the vas deferens that block sperm from traveling through the tube, the Intra Vas Device was successful at the end of six months in ensuring that 92% of the men studied had no sperm (or very little sperm) in their ejaculate. Longer term studies would need to be done to guarantee that fertility would return after the IVD was removed.

Despite these successes, drug trials and studies are only a first step towards making male contraceptive methods widely available.

"We could have something like the IVD on the market in four to five years, if we make an all-out effort with funding and focus. But if we continue with just a study here and a study there, it could be an eternity," says Elaine Lissner, director of the Male Contraception Information Project. Even with adequate funding for studies, buy-in from policy makers, pharmaceutical companies and the increasingly politicized FDA may extend that time line to five to ten years.

But is male contraception appealing to males?

Lissner says it should be. "If I were a guy, I'd want [birth control treatments] when I turned sixteen," Lissner told the University of Washington Daily Newspaper. She also says that not only will male contraception ensure that women will "no longer have to suffer through unpleasant hormonal side effects," but that "men will no longer have to contend with unplanned parental responsibilities."

Male contraception as a remedy for men needing to take on unplanned parental responsibilities seems like a stretch; when a man chooses to have sex with a woman, he is also choosing to take the risk that she may get pregnant and decide to keep the baby. Male contraception may make it less likely that a woman is purposefully able to get pregnant without her partner's knowledge, but "forced" fatherhood is a reality with which men who choose to have sex with women must contend.

As for the idea that women will no longer have to experience side effects from birth control, if women don't want to tangle with hormonal side effects, why should we expect or encourage men to? Heading straight to the source, I asked men and their partners if they would use more "diverse" methods of contraception for men. Jon, a 35-year-old, recently married man, says, "I do have concerns about ingesting hormones or chemicals… I would want to do a healthy dose of research before I started on any of them. Are there known risks? How effective are they?" But another man I spoke with said simply: "If I can eat a Twinkie, I can surely have doctor-approved hormones in my body to ensure responsibility."

Thirty-nine year-old Tracy, married with a child, when discussing the possibility of her husband using a male contraceptive, says, "It would be part of a conversation we'd have together about…his willingness to expose his body to whatever potentially harmful or benign side effects of hormones/chemicals might exist…I don't think I'd want him to be exposed to synthetic hormones and their side effects." On the whole, however, Tracy would consider using a male contraceptive with a long-term, monogamous partner, or with a non-monogamous partner but only if they were also using a method of sexually transmitted infection prevention as well.

All things being equal, though, male contraception may have a lot to add to family planning, releasing women from the stranglehold birth control can wield over their lives. Malecontraceptives.org, an informational web site that is now a project of the International Male Contraception Coalition (and originally founded to build upon the work of Elaine Lissner's Male Contraception Information Project) says "…we think that some experimental male contraceptives promise to be safer, more effective, more convenient, and easier to reverse than any existing female methods." That might just be music to a lot of women's ears (and eggs).

The development of contraceptive technology is only a first step towards embracing a more balanced responsibility for family planning and birth control. Will men use contraception that requires more effort than just stopping off at the pharmacy for condoms or more frequent attention than a one-time vasectomy?

Jon says, "I wouldn't use the plugs, let me just put that out there. But if the Depo shot stood up well I'd go for that one, just for the convenience of only having to do it every three months." Another man I spoke with said: "I love the idea of getting a shot or a pill or a plug and then being able to concentrate on having fun."

But will women trust men when they say are "on the pill"? Malecontraceptives.org says yes:

"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)."

When asked whether she would trust a man who told her he was using a contraceptive method, Alex, a 34-year old woman from Seattle, says, "I would trust him if he said he was taking it whether or not we were in a relationship." Tracy, however, says, "I would still assume that I should be taking charge of my own fertility with my method of choice. After all, no contraception is fool proof, and if I really did not want a pregnancy, I should take of care of myself…and doubling up could only provide extra assurance!"

Studies also show that men want better access to contraception. Again, from Malecontraceptives.org:

"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 political implications of male contraception are to be considered as well. Would the anti-choice activist community raise their hackles over contraception for men in the same way they do over women's birth control? In a Seattle Post-Intelligencer article, Dr. Bill Bremner, chairman of the Department of Medicine and director of the male contraception research center at the University of Washington, says, "This country has a pretty repressive history as far as reproductive use." Why haven't anti-choicers already taken note and made moves to block studies and funding or developed a political strategy against the development of these technologies? Their reaction (or inaction) on this subject may only serve to magnify their anti-contraception stance as a smoke-and-mirror for their fear and hatred of women's sexuality.

Also, will male contraception in some way allow women and the reproductive health movement to more thoroughly address the contradictions inherent in birth control access in this country? Women have struggled for decades to gain and retain access to birth control as a road to autonomy and equality. But while access to contraception is still a challenge for many, current methods can leave women in the United States fantasizing about throwing out their pills, taking out their IUDs or sitting for their last Depo-Provera injection. In other words, birth control is a burden, it's a hassle, and it frequently comes with some serious physical and psychological side effects. Is this what we want to "share" with men? For now, it certainly seems like our best option.

Jon says, "I do think this could be a shared responsibility between men and women, and really should always be a shared responsibility. I know that wouldn't work in every situation, but I also think that the situation where a shared responsibility will not work points to other large problems in the relationship." Another man I spoke with said, "Women have been bearing the burden for a long time now. It's about time that men started taking responsibility for where they do or don't put their sperm."

Supporting the development of more diverse and usable forms of male contraception will help expand the idea that family planning is a shared responsibility. An exciting and encouraging advancement for sure. But shared responsibility, while certainly a positive progression, does not mean equal responsibility. Whether or not more convenient and varied forms of male contraception become a reality, women may always need to shoulder most of the burden of birth control. As one woman I spoke with put it, "I would love this option, but if I was a single girl out there, I don't think I'd take my partner's word for it. The consequences are just too high for me. What if he forgot? I'd have to bear the burden of pregnancy or abortion."

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  • invalid-0

    It’s about time. Thank you for the article. It’s nice to hear there are a few men out there who would be willing to shoulder some of the burden.

    As far as side effects, well, women have dealt with them for the past 40 years, welcome to our little world.

    I am most interested to see how the right wings handle this. Will a male contraceptive pill “promote promiscuity?” Or does that only work for women? If you ask me, Viagra promotes promiscuity but yet we see that on commercials each and every hour we watch television. You’d think it was the best thing to ever hit the market yet birth control commercials are few and far between despite the fact that birth control pills can be used for many reasons other than birth control. If you ask me, freedom from debilitating cramps and bleeding every month for some women is a much higher cause than just getting a stiffy for 5 minutes of pleasure.

  • invalid-0

    I too am waiting with baited breath to see how the anti-choice community reacts to male contraception. But I can tell you already how they’ll react – quietly, maybe not at all. Opponents of reproductive justice, including access to contraception, do not have a problem with birth control as a concept. They have a problem with women exercising domain over their own sexuality and lives. As you say, anti-choicers have never had a problem with viagra being available to single men even though the point of the drug is to enhance sexual relations. Could you imagine a drug like this available to enhance women’s sexual pleasure without the Concerned Women for America launching a campaign that we’re encouraging little girls to have sex by making it available? Why is the widespread availability of Viagra not an encouragement to boys of all ages to have sex?

  • http://www.newmalecontraception.org invalid-0

    Thanks for the thoughtful article. Male contraception is about as far away from conception as you can get, so we can only hope that it won’t draw the same kind of ire as contraception for women does.

    I don’t think we’ll really know the reaction until there is a product on the market. If people want to make their voices heard to encourage policymakers to fund this research, there is a survey at http://www.MaleContraceptives.org (note the “s” at the end for the correct link). MCIP doesn’t promote research on hormonal methods because we don’t want to see men go through the same thing women have when there are better options out there, but MaleContraceptives.org, a separate organization, provides info about ALL the research, including hormonal.

    On the trust issue: Some of the most promising methods work long-term (6 months or even up to 10 years in one case), so a woman can go with her partner and see it done with her own eyes. And when woman tell me “I wouldn’t trust a guy in a bar who said he had that,” I always say, “If it’s a guy in a bar, there should be a condom involved anyway– end of story!”

  • invalid-0

    Thank you, Elaine, for clarifying what your organization as well as the malecontraceptives.org web site does and does not focus on (I corrected the links in the article, fyi).

    And I absolutely agree – regardless of what a man or a woman says they are using in regards to contraception, STI prevention should be in the forefront of their brains – Use a condom!!

    Thank you for your comment and your excellent work!

  • http://thewelltimedperiod.blogspot.com invalid-0

    …birth control is a burden, it’s a hassle, and it frequently comes with some serious physical and psychological side effects.

    “Frequently”, really?

    Also, one thing to consider with male contraception is that the risk/benefit assessment is quite different for males. The safety profile for a male method would have a much higher bar to pass since the risks of pregnancy are not a consideration.

  • invalid-0

    I’ve been looking forward to long-term, reversible male contraception for some time and I’m prepared to continue looking forward to it. It’s good to see that it’s being very actively investigated. I wouldn’t say it’s a stretch at all to suggest a male pill as a remedy for unexpected fatherhood. This in particular:

    …when a man chooses to have sex with a woman, he is also choosing to take the risk that she may get pregnant and decide to keep the baby.

    sounds like the man in question is selecting produce or taking the calculated risk of rolling through a stop sign. I think it’s important to acknowledge that sex between a man and a woman is not always preceded by calculating the failure rates of proposed combinations of contraceptives and multiplying by the expected cost of sending a child to college in 2025.

    We don’t have to absolve men of their paternal responsibility in order to acknowledge that sex is not a rational activity. No matter how many facts and figures we put on the chalkboard in twelfth grade health class, millions of years of evolutionary history suggest that sex will continue to happen when it happens, sometimes under less than ideal circumstances. And in a society that has made parenthood such a monumental undertaking, any mechanism we have to more effectively control our fertility is a welcome one.

  • invalid-0

    My long-time hunch is that because of AIDS, the majority of customers will be married men whose wives beg them to use it as a SUPPLEMENT to their own birth control. Single men who refuse to use condoms are not likely to use anything else, IMHO. (Though there will always be those teen boys who SAY they’re using something….)

    Of course, there’s still the dilemma of whether you’re going to trust your wife or long-term girlfriend when she says she’s on the pill and you can stop using condoms. Do you sneak off and get something from the doctor without telling her, or do you discuss it openly? (Keep in mind that the real-life failure rate of the female Pill is 6% – look it up.) After all, it’s no secret to women that men don’t like condoms.