It’s time we fixed the gender contraceptive gap

People throughout history have sought a multitude of methods to prevent unwanted pregnancies. In Medieval Western Europe, women used lily roots as contraceptive coils and took herbal products to induce abortions, the Ancient Greeks prescribed potentially fatal solutions consisting of a copper salt, and the Ancient Egyptians inserted a solidified mixture of honey and sodium carbonate inside vaginas. Skipping ahead a few centuries to the contraceptive advancements of the modern world, these practices have largely faded away, but the gender responsible for implementing contraceptives has remained the same.

Contraceptive diaphragms, implants, injections, patches, coils, pills, and vaginal rings – one might think women are spoilt for choice, if one also ignored the catalogue of side effects shadowing them. Heavier, longer, more painful or irregular periods, vaginal bleeding, risks of infection, higher risk of breast cancer and blood clots, headaches, acne, hair loss, vomiting, severe diarrhoea, increased blood pressure, decreased sex drive, and mood swings, to name a few sacrifices women make for the sake of a healthy sex life. Conversely, men have two feasible options: vasectomies, which are usually permanent, or condoms, which are only 98% effective when used correctly and have the single side effect of potential embarrassment when they are caught being disposed of.

The US-based Male Contraceptive Initiative is devoted to “funding research into the development of novel methods of non-hormonal, reversible male contraceptives,” yet hormonal contraceptives are somehow acceptable for female use. I’m not saying it’s wrong to develop a contraceptive method which doesn’t alter men’s natural body chemistry – I’m saying it’s a double standard to fund one exclusively for men while neglecting the need for a female equivalent. It’s unfair to expect women to endure harmful side effects but not have the same expectations for men.

Luckily, hormonal pills which lower testosterone levels so sperm cannot produce are being developed in the UK. In the initial phase of safety tests, 5 out of 40 men reported mildly decreased sex drive and 2 described mild erectile dysfunction, but sexual activity was not decreased and none of the participants stopped taking it – I’d personally rather that than heavy bleeding from my genitals or cancer. A progestin hormone in a contraceptive gel blocks natural testosterone production in the testicles, reducing sperm production to low or non-existent levels, while synthetic testosterone in the gel maintains sex drive and other functions. This has now moved onto the next phase of testing.

But scientists predict these male contraceptives will take decades to become available to the public, for reasons largely down to a lack of funding. Allan Pacey, Professor of Andrology at the University of Sheffield, said: “Unfortunately, so far, there has been very little pharmaceutical company interest in bringing a male contraceptive pill to the market,” despite a recent 2018 YouGov survey finding over half of sexually active men would consider taking hormonal contraception. Professor Richard Anderson, of the University of Edinburgh, says: “I think that industry has not been convinced about the potential market.”

More needs to be done to develop a male hormonal contraceptive pill. It is archaic and plain sexist to continue placing all things remotely related to childcare as an exclusively female concern, and we must stop holding women ransom by declaring them fully responsible for pregnancy prevention and family planning. Both men and women are responsible for conception, so both should be equally responsible for contraception.

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Jim Gell

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September 2021
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