For decades, women have controlled their reproductive health by taking pills, getting shots, wearing patches, having IUDs inserted and more, but men still only have two options when it comes to taking contraceptive responsibility: wearing a condom or getting a vasectomy.
Male birth control is in the works — a second potential male oral contraceptive recently passed human safety tests, and researchers are also developing injectables and a contraceptive gel — but scientists say it’ll be at least 10 years before it’s available for consumer use.
The first female birth control pill was approved by the Food and Drug Administration (FDA) in 1950, which meant that research to create that oral contraceptive started years before. So why has it taken so long to work on a version for men?
It’s not for lack of interest, said Dr. Christina Wang, a lead researcher on male contraceptives with the Los Angeles Biomed Research Institute (LA BioMed).
“Surveys have been done, and if you ask couples in a stable relationship, there’s two facts: first is the decision of family planning… and 75 percent of couples indicate that the decision is not the women’s, not the man’s, it’s the couple’s,” she said.
The second is that men are willing to accept responsibility over their reproductive health, with more than 50 percent of men in a survey across nine countries saying they would take a new method of male contraception.
“That is an unmet need,” said Wang.
So far, science hasn’t met that need. Wang is working on it, and she admits that male birth control is “way behind” what’s available for women, but says it’s slowly catching up.
That progress is slow, though, because of the multiple steps these studies have to go through, but also because of just how differently a male birth control pill works.
Hormonal female birth control works by preventing ovulation, with (most often synthetic) estrogen and progesterone suppressing a woman’s ovaries from releasing an egg each month
That’s only one egg once a month to stop, whereas with men, Wang said, “every day they make millions of sperm, so you need something that will be continuously able to suppress sperm production.”
That “continuous” caveat also means there will be no week of placebo pills with male birth control like there is with female oral contraceptives. If you stop the hormones, sperm production starts again.
Male birth control will also take more time to become effective once a guy starts swallowing those pills. The second male pill that recently passed human safety tests uses a modified testosterone that acts like a combination of the male hormone androgen and progesterone to decrease sperm production, but to get to the low level where contraception isn’t likely takes time — probably at least 60 days of use.
“The medication affects the maturation and production of sperm,” said Wang, but it takes about 74 days for sperm to mature, and the male contraception will affect only those developing sperm cells. Then, you also have to factor in waiting for all that sperm to come out through ejaculate.
Even vasectomies aren’t instantaneous in preventing pregnancy, Wang explained, because you have to wait for the already-produced sperm to clear. After a vasectomy, it can take about three months for a man to be sperm-free.
Male birth control may be more technically challenging, but Wang isn’t giving up — not just because it’s about time for men to bear more responsibility when it comes to contraception, but because when you bring men into that conversation, they’re more likely to take better care of themselves and in a way, take better care of their partners, too.
“It’s well known that if we have some way of getting men into a clinic to see us, to check blood pressure and routine things, it maybe also creates a habit, that they’ll go back to see doctors,” she said. “Female and male have behavior has different needs — females because of the gynecologist, going and seeing a gynecologist becomes routine, so they look after themselves apparently better than men. I think in generally, getting men into the system is an important thing.”
[These quotes are from an interview I did with the researcher for a freelance story that did not pan out.]
Kristin Toussaint 