Should Men Care That Male Birth Control Options Are Languishing?
For decades, experts and pundits have been predicting that a male birth control pill or breakthrough men's contraceptive was just a few years away. This week, for example, the Washington Times is reporting on the latest supposed breakthrough that researchers published this week in the Journal of Clinical Endocrinology & Metabolism.
The line this time is that a combination of testosterone and progestin holds the key to developing a male pill. Interesting, but don't hold your breath; there isn't much new here, and the researchers acknowledge there are still many kinks to work out. The study is actually a reanalysis of previously completed research—and there's nothing to suggest it will circumvent the problem that has previously stalled promising work in this area, namely the perception among drug companies that there's little money to be made in making a male contraceptive. In fact, that's one of the main reasons that the pharmaceutical firms Bayer and Organon jettisoned their male pill programs last year, according to Chemistry World.
Perhaps Big Pharma is right, but there are signs yet that new birth control options for men may eventually straggle to market. Just this week, the FDA approved a new device called SpermCheck Vasectomy. It offers men the option, for the first time, of checking whether a vasectomy has been effective in the comfort of their own home rather than having to drag themselves into the doctors office for a test. The device will be available online and in stores by the summer, a company spokesperson says. The same company, meanwhile, has other products—SpermCheck Fertility and SpermCheck Contraception—in the pipeline. SpermCheck Contraception will allow men to gauge the effectiveness of the various male contraceptive strategies that researchers hope will eventually make it to market.
But what exactly are those other strategies? And when will they be here? Malecontraceptives.org has a good rundown of the experimental options here. I won't hazard a guess as to which is most likely to succeed as promising options have stalled so frequently in the past, but Elaine Lissner, director of the Male Contraception Information Project for one, follows the options closely and has high hopes for two nonhormonal options that have been making strides recently. An injectable compound called RISUG has completed phase II clinical trials in India, she says, and it seems to prevent a man from fathering a child for up to 10 years—although it is readily reversible during that interval. Likewise, the Shepherd Medical Co. has received FDA clearance to perform a clinical trial on a type of implant that would function much like a vasectomy. Theoretically these "intra vas devices," which are sutured to the vas deferens (the tube that helps transport semen from the testes to the urethra), are removable. However, humans tests are required to see whether fertility can be restored after long-term use.
Both female and male activists for male contraception say there are ample reasons that men should start agitating for better contraception options. Lissner lays out a slew of reasons why men—and society, too—would benefit, including the fact that the current options for men are relatively unreliable. Two of the three options available to American men—condoms and withdrawal—have failure rates of 15 percent and 27 percent, respectively, after a year among couples who use them, according to the Mayo Clinic. The third option, vasectomy, is much more reliable, but its potential irreversibility is a serious drawback.
Warren Farrell, a masculinist and men's advocate who authored the book The Myth of Male Power, makes the case for men's contraception in more pugnacious terms. He argues that men can become victims when, say, a woman in a committed relationship actively manipulates a man into having and raising children that the man wasn't ready for by "forgetting" to take birth control pills. And he points to evidence that suggests some 10 percent of babies turn out not to be the progeny of the expected father when random DNA tests are done, suggesting to Farrell that many men help raise and support children who are not actually theirs. "The market for male contraceptives would be huge," he says.
With such provocative arguments floating around it's hardly surprising that the blogosphere is simmering with shrill commentary on the topic. There are women who seem to think men are Viagra-toting Neanderthals who have little commitment or tolerance for the intricacies of contraception. (Yesterday was Viagra's 10th birthday, by the way.) And men's activists who argue that women enjoy the power over the timing of reproduction only seem to egg them on. This post from the blog Feministing, for example, heaps scorn on a male Gizmodo poster who admits that the details of a recently announced experimental form of birth control—a radio-controlled sperm "tap"—make him queasy. That procedure, according to New Scientist, would involve injecting an 800-micron-long silicon polymer valve into a man's vas deferens with a hypodermic needle that would theoretically neutralize sperm by blocking it from passing.
For the record, the description of that particular procedure makes me a bit queasy, too. But there's a larger and more important point to make here than whether men or women endure more inconvenience or even danger from contraception. It's this: Good contraception options for men remain sparse even though the development of better ones are possible and would benefit both women and men. A good male contraceptive would allow couples to share the burden of birth control, give men a sense of control over their fertility, and probably cut the number of unplanned pregnancies.
But before I used any of these products, I'd certainly want good evidence that it was safe. And there's no way I'd go to the lengths that these two bloggers went to in entertaining efforts to counter their voracious virility: One spent months simmering his testicles in extremely hot baths, and the other created a custom pair of "suspensory briefs."
Let policymakers know whether you want more male birth control options—or not—by taking our poll. (And click here if you want to see the results of a recent survey of British men's attitudes on male contraception).
Take the poll below to let policymakers know where you stand.
Tags: birth control | men's health
Tools: 
Share
|
| Comments (11)
Reader Comments
don't expect a supply without a Visible Demand, P.1
Name an activist man who, regarding the demand for male birth control, has been on TV at least as much as those men who demand the right not to support their unwanted children. Pretty hard, isn't it? This seems to indicate the demand isn't that big, which would explain why the pharmaceutical researchers might be dragging their heels. Profit is supreme, you know. If Margaret Sanger and her followers were willing to go to jail to make condoms and diaphragms available to women, why don't we at least have lots of men on TV and the radio loudly protesting and FUNDRAISING for better male BC? (With all the proper safety tests, of course.)
Yes, AIDS means that single men will always be under pressure to use condoms. Yes, long-term/married couples tend to stop using condoms because both men and women dislike them. However, this doesn't have to be an issue of men trusting women (or vice versa) - just a matter of understanding that:
1) all methods can fail (the female pill has a real-life 6% failure rate, according to the Alan Guttmacher Institute) so it's just plain dumb not to use two methods each and every time, and
2) if YOU don't want a pregnancy, it's YOUR job to control your own fertility. If BOTH sides use BC, where's the problem?
BTW, even if she's using an IUD, there's still the risk of ectopic pregnancies, which can be fatal to her, so don't try to argue that there's no need for a backup contraceptive in that case.
If and when we get better methods for men, men everywhere could actually say to women "you can have a baby only when you give me what I want." Or, at least, they'd have 99% peace of mind while they were still using condoms in the relationship, since they'd secretly know that a pinhole wouldn't make much difference.
Male contraception
I just want to say thank you for your thorough investigation of this, your measured response, and crystalline yet intelligent writing style.
Don't expect a supply without a Visible Demand, P.3
This is part 3 - in the hopes part 2 shows up first.
Better methods of male BC will:
1. Help prevent unwanted fatherhood.
2. Help prevent unwanted abortions.
3. Give men more bargaining power with women who want babies.
4. Alert men to paternity fraud much sooner.
5. Help men who use BC implants to think twice before having them removed. (Obviously, pills are too easy to forget to use, like condoms.)
With all those benefits, why are men just sitting around and waiting?
However, I also predict the main users will be these relatively small groups:
1. Married men whose wives beg them to use the new methods as backups. (I'd guess that many men who are sick of using condoms for years feel that one male privilege of marriage should be not having to use male contraception.)
2. Men who are just plain paranoid about unwanted fatherhood but who won't get vasectomies. (A very small group - many men get vasectomies, including single men.)
3. Celebrities and other rich men, who are undeniably surrounded by golddiggers.
Granted, there are problems. One is that doctors have long claimed that "men don't want their genitals messed with," even when the method is nonhormonal. So men will have to convince doctors otherwise, true or not.
The other (this is a "problem" only in the minds of a few people) is that if the new methods catch on, "Choice for Men" aka "Roe vs. Wade for Men" will be doomed, though I suspect it always was doomed, given that most men didn't really seem to sympathize with it and male comedians always made fun of it. (Look it up.)
And, of course, the problem of teaching young women, over and over, never to trust any single man who tries to talk them out of using condoms.
Finally, about the "shrill commentary," (yes, men were mentioned as well as women) it's true that women can be pretty harsh and cynical on the general subject. ("I wouldn't trust him!") However, again, one complaint remains quite valid - why do many men complain publicly about their lack of post-conception options but never about their lack of pre-conception options? Whatever happened to "prevention is better than cure"?
Oh, and thank you, Marty of CA!
Don't expect a supply without a Visible Demand, P.2
However, unless American men start demanding contraceptive implants LOUDLY, they may never get them. Why? Profit, again. See below.
(I would provide the link, but somehow it keeps being blocked, so you need to search on "Are You Using Anything?" by Cara Gardner, The Inlander. It's about the benefits of implants and why they don't get a lot of publicity because, unlike pills, they can't be sold over and over again. It's two pages long. Granted, it's from 2004.)
Not to mention that more options for men won't help much if the anti-female contraception movement keeps going forward.
Lastly: I like to imagine a subway billboard like this:
"Don't believe in abortion?
"Don't want her to get pregnant either?
"Men.....Get RISUG. Take control of your OWN life."
And parents (single or not) could say to their sons:
"You use (male contraceptive X) to protect yourself and your future in
case she makes a mistake. That's why I'm taking you to the doctor for
that. However, a gentleman ALWAYS uses condoms to protect his partner -
preferably until he's married. There are plenty of very bad diseases
besides AIDS, you know. Some are permanent, and some can be caught
easily by boys."
Of course, given how strong the temptation would be to refuse to use
condoms, it might be better to wait until the boy is actually used to
buying and using them, macho-wise. That is, until he's 20 or so.
Male contraception
After I have a couple of kids I will immediatly get myself steralized (get them to take a huge chunk out so that there is no chance of it accidently fixing its self latter) but I do want a couple of the little guys first. But before that I would like to have a house for my family and be "setup" properly in my life to have a child. Give me one more year and I'll be there in my life, if I have a child now..... It would be much more difficult for me to get to that goal.
As the husband of a roman catholic it is difficult for me to get her to use birth control and she gets frusterated that I can't "just pull out."
She is very firm about not having children until she's 25 but when she wakes me up in the night she doesn't care about anything else.
In conclusion:
If I had a pill or anything else that I could take that would allow me to take control of our birth control I would. She wouldn't be breaking the rules of her religion and it would be much easier for both of us. I think the market for this could be very large. Every couple that is using anything other than a condom should be interested in it.
Note to masses:
All of the males/girls using needles on condoms would find a way to switch out the pills. That I have no doubt about. But this would give LONG TERM COUPLES the freedom to decide together when they want to have children, it would take a lot of the "accidently pregneant" burden away from the women.
Think about it, the 1-6% failure chance for the female pill combined with what we can assume would be the same failure rate for males....
What kind of math would that be in that? .1-.6% chance? .01-.06%?
Yes Please...
My anecdotal tale is from a college psych course debate on this topic. The men in the class overwhelmingly supported this option as a form of taking control of their reproductive lives. Sadly, the women, including the professor, in the class overwhelmingly presented the expected ridicule and disdain for men in their distrust on the topic.
We are asking for it and we want it. Unfortunately, until women are willing to address their own sexism and accept that men want to be engendered with self determination in their role in reproduction there will be a gulf in acceptance. For example, our campus has an office for female reproductive health, this needs to be changed to the men and women's office for reproductive health. I think a large barrier is the fragile female ego and sense of that their control is threatened in the realm of reproduction.
The Cost Conundrum
First, I don't think it's fair to say that "men don't want their genitals messed with".
Blanket statements like that make all men look lazy and foolish. The truth is development of these things will occur for men in the same way that they occurred for women: a combination of new drugs available and social pressure.
Women in the past were the ones solely responsible for children born out of wedlock; there was no such thing as unlimited child support and "deadbeat dads". Women pushed for the pill so that they could have the same sexual freedoms as men.
Now the tables are turned, and men want the same sexual freedoms that women enjoy today. 30 years ago, doctors and "professionals" made the same claims about women that they now make about men with regard to birth control, and they are as false today as they were then.
Regarding the issues of profitability and cost, one of the main reasons that women's birth control pills entered the market so easily was that the discovery of the base for the drug happened completely by accident; the base of the pill is a compound modified form of a naturally occurring plant substance discovered by a doctor studying herbal and "primitive" medicines with a tribe the in the Amazon rain forest. Therefor, there were virtually no real development costs, only costs to synthesize and refine. Unfortunately for men, there has been no such luck in a discovery.
It has become clear to humanity that the costs of developing safe and effective birth control far outweigh the costs of more people on this planet. The sooner everyone has access to options, the easier it will be for all of us.
The Cost Conundrum
>First, I don't think it's fair to say that "men don't want their genitals messed with".
>Blanket statements like that make all men look lazy and foolish.
Agreed, but doctors, generally, don't talk like that for nothing these days, since we Americans don't hang on their every word the way we used to.
And, as I implied, if men really want new methods of male BC sooner rather than later, they're going to have to do more to convince doctors (and pharmaceutical companies and their investors) of that fact than to talk "loudly" online. We all know the saying "talk is cheap." The male would-be consumer has to make himself a lot more visible (as in, doing radio/TV interviews and giving his real name, unlike in online chats) - and has to be willing to put his money where his mouth is. RISUG and the IVD already exist, and both are nonhormonal, so it looks to me as though the only thing now missing is "the social pressure." That, of course, includes money out of MANY individuals' pockets.
The Cost Conundrum
>It has become clear to humanity that the costs of developing safe and effective birth >control far outweigh the costs of more people on this planet.
I trust you really meant "benefits" not "costs"?
Sadly, far too many people - well-fed and educated or not - still DON'T see any benefits to birth control.
The Cost Conundrum
Oh, and here's how to start some pressure:
http://malecontraceptives.org/activism.php
Plenty of addresses to contact.
In the meantime, I have yet to see even an online petition to send to Congress (or elsewhere), demanding more funding for male BC.
Add your thoughts
Your comment will be posted immediately, unless it is spam or contains profanity. For more information, please see our comment guidelines.advertisement
iTunes
RSS
promiscuous behavior?
Considering that men have a tendency toward risky behavior, I fear a male pill would make men less likely to protect themselves in terms of STD's. Where the commitment implied by a pregnancy quickly induces men to use a condom (which also would protect them from many STD's) the male pill would not. The result could be an uptick in many STD's but a decline in unwanted pregnancies. This, though, would be a non-issue for married folks and would likely help ease the family planning burden as suggested in your article. Very interesting!
Mar 30, 2008 14:40:28 PM [permalink] [report comment]