February 20, 2006

The male contraceptive pill

An article I read last week discussed the merits of the male contraceptive 'pill', and it had me thinking. It turns out that the male contraceptive is not going to be as simple as the female one, and will involve an implant and regular injections. The early trials have had problems because very few man have volunteered to take part.

  • Would a man be willing to take responsibility for contraceptives, particularly when it involves a relatively invasive procedure?

  • Will women be willing to trust men with keeping up the medication regularly or being honest about whether they are protected, bearing in mind that it's the women who's left, literally, holding the baby?

  • Do men feel strongly that they should have the chance to take responsilibity for their fertility, and have more options than just condoms?

  • Do men feel that it's a woman's job to worry about such things and they shouldn't need to consider it?

  • Will there be a stigma surrounding the treatment since it involves the release of a female hormone: will some men feel it would undermine their masculinity?

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  1. I suspect male hormonal contraception may be effective but only under certain circumstances. For example, in a committed relationship the couple may prefer the male option if say, they don't like condoms and the woman reacts badly to the pill. however, for a couple who have already had children a vasectomy would probably still be the easiest option!

    I think the 'pill' may not catch on in younger men out to have a 'good time' because they would be mad not to use a condom with STDs being so rife.

    20 Feb 2006, 13:23

  2. Hah. The rate of uptake will be minimal. There is no way that any man would submit to treatment knowing that it would involve the release of a female hormone – oestrogen? – and I challenge other men to admit to that. Thus I am both cynical and skeptical.

    20 Feb 2006, 13:40

  3. I currently have no reason to be interested in my own fertility, let alone that of anyone else; as such this is rather academic for me. However, I don't see any reason to object to a pill containing female hormones any more than a pill containing other drugs.I'd be more bothered about the whole 'surgical procedure' thing.

    The other issue is that I'm horribly unreliable, and can't be expected to regularly eat meals or sleep, let alone take pills. Anyone trusting me to do so wouldn't know me well enough to be interested in my fertility.

    I suspect I am something of a minority on this issue.

    20 Feb 2006, 14:37

  4. That's a brave admission, Alex! I wonder how many men would admit to agreeing with you??? However, there were many concerns about the side-effects of the female pill when it was first developed, yet now millions of women take it. If women mess with their homone balance to avoid pregnancy, why is it unreasonable to expect men to at least consider it?

    The female hormones used in the current trials are, I think, prolactin and progestin. These turn off the normal signals that control sperm production, but also switch off production of testosterone, which is why the men also require regular testosterone injections.

    20 Feb 2006, 14:37

  5. In principle I am not against the whole idea, as I feel that contraception is the responsibility of both parties. I fail to see the use outside of a long term relationship, as only a fool wouldn't use condoms. In a long term relationship I do see the benefits, although the "surgical procedure" and regular injections do make me feel slightly uneasy. Methinks I would have to do a substantial amount of research before considering it myself.

    20 Feb 2006, 14:50

  6. Indeed, Hywel. I would imagine that the male 'pill' would be used in the same circumstances as the female pill is now: mainly in long-term relationships, but also as a backup for condoms.

    20 Feb 2006, 14:55

  7. Colin – I wonder whether you have confused this contraceptive pill with a fertility enhancing pill like viagra. If indeed the option of condoms didn't exist for men I'm sure we would be running over each other to obtain the pill. However, because of latex (we laud and honour thee, oh majestic one) I can't see that the average men, unless he is atypically cautious and responsible will subscribe to the treatment.
    Sarah – its a lot easier when one is only attracted to members of one's own gender (and yes, I do realise that I have just admitted that I'm not the most qualified person to pronounce on this subject). Actually I was airing a general longstanding disgruntlement against men who are morbidly scarred of femininity and all it perceptively entails… and I was rather hoping that an enlightened fellow student would jump up and protest that he would have no objection whatsoever to an increased incidence of female hormones circulating inside him… (hint, hint)

    20 Feb 2006, 15:43

  8. Aha, I see! I, also, would have hoped that someone may have objected…

    I don't necessarily think that, just because you will not yourself face a situation, you shouldn't be fully entitled to your opinion: I'm sure you're perfectly capable of considering the position of a sexually active heterosexual man.

    20 Feb 2006, 16:21

  9. Colin – I wonder whether you have confused this contraceptive pill with a fertility enhancing pill like viagra.

    Er, what makes you think I've mistaken it for what is more or less the exact opposite of what it is? I said I wasn't interested because it isn't an issue for me; I've more use of LaTeX than latex.

    As I said, I wouldn't object to being treated with female hormones if it were a proven treatment that would actually benefit me. This doesn't yet qualify for either.

    20 Feb 2006, 16:26

  10. Personally I'm with the comments about its use outside of a stable relationship and the incidence of STD's.

    If it is used within a stable relationship, is there not an issue of side effects (as I know there are with the female contraceptive pill)? As far as I understand it, one of the side effects is a reduction in testosterone, in men this can cause the increase in oestrogen resulting in physiological changes that are not particularly welcome (development of breasts and shrinking of the penis). Testosterone replacement injections would work part of the way to preventing this, but our bodies are much better at regulating hormone balance on their own (ask any diabetic).

    While this may look like I'm making excuses for men not taking it, I know there are alternatives to the female contraceptive pill for women. I know friends who are fatally allergic to forms of the pill and they seem to be able to cope with an IUD with no ill effects.

    20 Feb 2006, 16:40

  11. Richard, I agree that the side-effects should be considered/examined before using the "male pill" but I think that it's a good thing that there is another option for couples, one that the man can be responsible for (aside from condoms, which are horrible!)

    20 Feb 2006, 16:47

  12. I wouldn't want my bloke to take it, and not because I don't trust him to remember etc. (I'd trust him more than I'd trust myself) It's just that my hormones are messed up enough as it is, so I wouldn't want to mess his up as well. I understand that these things would be tested, but the female pill was tested and still messes up some women (I won't take it for that reason as well as others).

    20 Feb 2006, 18:15

  13. Hmm not sure I like the sound of "implant" and "invasive procedure" for something that may well turn out to be no safer than a condom. Also seems to be a bit complex, maybe in a few years if they can streamline it into one pill I'd reconsider, but not just now…

    20 Feb 2006, 18:22

  14. Leigh Robinson

    There is no way that any man would submit to treatment knowing that it would involve the release of a female hormone oestrogen? and I challenge other men to admit to that.

    Rubbish. Your average intelligent man would not be bothered at all.

    As for using the actual 'pill' as it is proposed here I probably wouldn't. Simply because it seems too complicated and complicated things go wrong easier.

    I know that ideally the responsibility of pregnancy should be spread between the sexes.Though I can't help but think I would feel happier if this research money were being put to 'better' uses, i.e cancer and AIDS drugs, gene therapy, etc…

    20 Feb 2006, 19:40

  15. Colin – I apologise for mis-reading your comment… good quip btw.
    Richard Holland – I understand your concerns about unwanted physiological changes of long term use. In fact the proposed pill does apparently come with a testerostrone implant and a trial in Australia in 2003 showed that the pill was '100%' effective and free from unacceptable side effects. A recent attempt to put the treatment on trial in the UK, failed though, apparently because not enough men were prepared to volunteer. My comment, now probably hypothetical it would seem, was concerned with the question of whether men would accept the psychological changes that might result from a reduction in testerostrone and a resultant increase in oestrogen – i.e. less aggressiveness and sex drive (together with lower fertility) and greater emotion and empathy – or whether they would exhibit a kneejerk reaction to treatment that might cause a shift towards feminine behaviour.

    20 Feb 2006, 19:46

  16. Leigh – hehe – if you havd read on, you would have realised I was calling your bluff.

    20 Feb 2006, 19:50

  17. Sarah — about not trusting men, what about men not trusting women? Ok, so maybe I shouldnt take life lessons from One Tree Hill, but I suppose there can be an issue where men feel that their girlfriend becoming pregnant is their problem too, and might not trust that the girl is protected? I wonder if that really does happen though.

    20 Feb 2006, 22:01

  18. One of my lecturers last year, in a module that dealt with the social history of the Pill in Asia and Africa, mentioned that a male version of the Pill was actually developed in the 1970s, but wasn't properly trialled because of difficulties persuading men to volunteer. Don't know if it's true, but it's interesting.

    20 Feb 2006, 22:29

  19. While traditional masculnity espouses the importance of fertility and potency in regards in order for ideal masculinity to manifest itself, I think 21st century ideology looks at contraception, male or female, as an essential aspect of responsibility and control, and in a capatalist environment, being unable to support your child is as problematic as taking contraception in order to not have a child.

    I also think that women generally feel more comfortable in control of something that, as Sarah says, remains the fundamental responsibility of them. I know that as much as I trust my partner, it is my responsibility and I am also thus prepared for a situtuation if it occurs, and I am in control and can manage it.

    It is also important to ensure condoms are used, and perhaps contraception and birth control literature should be more focused on men as, at the moment, it is really the only form (apart from abstinence [!]) that men can use as a form of contraception, yet women are often more likely to attend clinics/doctors surgery in reagrds to sexual health than men, and therefore are offered free condoms, not their male partners.

    All I'm trying to suggest is that there are particular gendered aspects of sexual health, and while a male contraceptive pill appears in theory as an ideal solution, social expectations around gender roles mean that it is unlikely to ultimately change sexual patterns.

    x x

    21 Feb 2006, 00:02

  20. Well i would say with my NHS hat on one should be using the "belt and braces approach" where the female uses a hormonal contraceptive and the male uses a sheath thus protecting from both STD's and pregnancy. This is the only truly safe approach. However i would say a male hormonal contraceptive may be very inmoprtant as the IUD is often (i'm told) uncomfortable etc, the pill has it's own side effects such as weight gain in the case of the combined pill, and the arguably best from of contraception from the state's point of view, depro-vera carries a one in ten chance of a permant bleed. Thus if the male contraceptive was to be developed into an injection needed every three month say it would be very useful. I hate to say this and i'm sure it applies to no one who will read this but there is a real problem with those less educated members of society to remember to take the pill, hence the NHS drive to increase the usage of depro amongst young people.

    Whatever the trust issues, and there will be men who won't take a contraceptive, a male pill of hormonal contraceptive ahs to be carefully considered as it may increase drastically the incedece of STD in this country as men will not on their own follow a belts and braces approach on their own, it therefore has to be a joint effort for the moment. Sadly.

    21 Feb 2006, 00:20

  21. It is interesting that the other forms of female contraception haven't really been mentioned here. As well as the oral contraceptive pill, new measures are constantly being invented for women, including injections and implants. With injections, women must be re-injected every 3 months, and will remain infertile up to a year after stopping treatments. (Thats quite scary) I don't know as much about implants, other than that they implant it in the upper arm, and it requires little or no maintenence. Given that women are seriously considering these measures, I hardly think that the objection of men that 'its a bit scary' qualify – its time that men took responsibility for their own 'little soldiers'. That said, most women would probably be happier knowing that they were taking care of themselves – I'm on the pill because I know that whatever may happen, I have taken care of my own protection (STD issues notwithstanding). As people have also mentioned here, doubling up on protection is not a bad thing, and if I were to start dating a guy who was on the male pill, I doubt I would stop taking the pill, or encourage him to do the same. It's more of an equality thing than anything else – guys need to start taking responsibility for themselves, regardless of whether they are in a relationship, or after more casual sex. Plus, us girls suffer in the name of safety, while guys swim along with a condom or two in their wallet!

    21 Feb 2006, 12:10

  22. Geetanjali – Indeed, that is a completely valid point. Men and women are equally capable of deception, and I'm sure it does happen in some cases: say if a women wants children but her partner isn't so keen.

    21 Feb 2006, 13:59

  23. I certaintly wouldn't be bothered about the hormones in the 'pill', it's the "implant", "invasive procedure", and "regular injections" that would bother me, especially as I'm not at all fond of needles – that said it's still something I'd consider in a long-term relationship where the pill wasn't an option for the girl due to side-effects.

    I think one issue that crops up here is a reluctence for guys to go messing with thier hormonal balence. Post-puberty, a guy's hormones would appear to be (and I don't know if this is actually true) more stable than those of females, and the idea of disturbing that balence might bother some people. The other side of this for the ladies is if a guy does start taking this 'pill' and you get into an arguement, he can always go "sorry, it's this pill, my hormones are all over the place!" :)

    21 Feb 2006, 17:55

  24. With regards to what Rachel and Christopher have said, Depo Provera can have a longer term effect on fertility – it is certainly effective, but I know far too many people who are having problems conceiving purely because of the Depo injection, 2–3 years after stopping it!!

    21 Feb 2006, 19:56

  25. Justin McInroy

    I for one have no problem with where the hormones come from, be they female or not. Surely anyone educated enough wouldn't mind and would only care about the side affects these cause and not about the "stigma" attached. Those who are less educated in society (please allow me the same latitude as you granted to Chris) would probably not really know/realise that they were female hormones as they are hardly the commonly heard of ones.

    Not having really read about this apart from this blog comment, the main draw back seems to be the possibility of not-very-nice side-affects and the unpractability of it. I'm sure that after a bit more development both the side-affects will be lessened and it will be made more practical ie in one form of delivery. I don't really think it matters what form that will be in, whether it be a pill, injection or implant, the thing which will matter will be the side-affects involved.

    On a slight side-note, a friend of my ex-girlfriend had an implant as she was totally useless at taking the pill and all the implant involves is going to an appointment every few months. It also solves the problem of if you are sick and therefore havn't ingested the pill.

    22 Feb 2006, 14:27

  26. Sylvia P

    "Would a man be willing to take responsibility for contraceptives, particularly when it involves a relatively invasive procedure?" No they are generally selfish bastards.

    "Will women be willing to trust men with keeping up the medication regularly or being honest about whether they are protected, bearing in mind that it's the women who's left, literally, holding the baby?" Well I don't think that women have a bigger hold on honesty.

    "Do men feel strongly that they should have the chance to take responsilibity for their fertility, and have more options than just condoms?" Doubtful…

    "Do men feel that it's a woman's job to worry about such things and they shouldn't need to consider it?" Yes!

    "Will there be a stigma surrounding the treatment since it involves the release of a female hormone: will some men feel it would undermine their masculinity?" Probably

    24 Feb 2006, 23:33

  27. kevin banton

    where do i sign up to go on the trials? i'm married, have one child but dont want any more and dont fancy a vasectomy? seriously now, how do i get on the trials?

    20 Apr 2006, 18:51

  28. Paper Nest

    I agree with Rebecca Northmore and her opinion regarding gender stereotypes, as human beings we are conditioned to be quite critical, even wary of anything which changes the status quo and this includes anything on scientific grounds such as this pill. Mix this with other typical human characteristics such as prejudice and moral arguments and we are a pretty tough crowd, men and women will never totally understand each other–least of all our reproductive cycles and systems (emotionally anyway) and yet men and women complement each other in so many ways

    29 Apr 2006, 16:53

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