Contraceptive equity: why we need a male pill (2023)

The invention of the birth control pill was an important milestone in the women's rights movement. Since then, other long-acting reversible contraceptives (LARC) have been developed for women, and women now have a total of 11 methods to choose from, including barrier methods, hormonal methods, and LARC [1]. In contrast, men have only 2 options, male condoms and vasectomy, and neither hormonal methods nor LARCs. The discrepancy between the number and type of female and male LARCs is problematic for at least two reasons: first, because it forces women to shoulder most of the financial, health, and other burden of contraception, and second, because men women have reproductive rights and autonomy are being reduced by making women more responsible for contraception. A more equitable contraceptive regime can only be achieved through the development of male LARCs and the reconception of shared responsibility for contraception between men and women [2].

Currently, women bear most of the health and financial burden of contraception. In general, female methods tend to be more expensive than male methods[3] as most require at least a doctor's visit and some involve a refillable prescription. Currently, many insurance plans do not cover birth control, and of the 28 states that require insurance plans to cover birth control, 20 have opt-outs for religious or ethical reasons [4]. However, as of August 1, 2012, new insurance plans must cover contraception free of charge to comply with the Patient Protection and Affordable Care Act 2010 [5].

In addition to being more expensive, female methods have more serious side effects than male methods, in part because many female methods of contraception involve hormones, while none do men [6]. The most common reason women stop using contraceptives is because of adverse effects [7, 8], with discontinuation rates for most forms of contraception approaching 50% after one year of use [9]. Finally, the two available male forms of contraception, condoms and vasectomy, also pose less health risks than their female counterparts, female barrier contraceptives and tubal ligation [10].

In addition to financial and health considerations, there are also not insignificant disadvantages and burdens associated with contraceptive use: spending time and energy on contraceptive measures (e.g. knowing which medications may impair contraceptive efficacy), dealing with the medicalization of reproductive health, invasive interventions by physicians (eg, pelvic exam) and contraceptives (eg, IUD, Norplant), stress and anxiety about the possibility of unwanted pregnancy, dealing with the social consequences of contraceptive decisions, and possible moral guilt for contraceptive failure

While it is an advantage for men not to be responsible for some or all of these burdens, at the same time men's reproductive autonomy is undermined by the lack of male contraceptives, particularly LARCs. Given the condom's high failure rate of 16% in typical use, men who wish to preserve the possibility of biological childbirth cannot regulate their reproduction as effectively as women: many female LARCs have failure rates of less than 3% [ eleven]. The lack of effective and reversible options for men forces many men to rely on their partners for birth control. Men need to trust that their partners are using contraceptives correctly and consistently. Regardless of the circumstances in which pregnancies occur, men remain socially and financially responsible for the children they father.

Why are there so few male LARCs?

Historically, the use of contraceptives was linked to the actual sexual act, requiring men's participation (for example, through condom use or removal). Furthermore, because of their traditional role as heads of households, men were often involved in decisions about contraception and its use [12]. Long before the invention of the contraceptive pill, contraception began to shift from a shared (or even male-dominated) responsibility to a woman's responsibility. Because of the Comstock Act of 1873, an anti-obscenity statute that specifically lists contraceptives as obscene material and prohibits their distribution by mail or interstate commerce, women have had difficulty purchasing contraceptives, as private doctors and clinics are generally not very convenient, unobtrusive or accessible. 🇧🇷

When the contraceptive industry saw an opportunity to make big money (and they did, earning $250 million in 1938 alone), the contraceptive industry launched a campaign to encourage women to use their "feminine hygiene products" [13]. These new alignments between women and contraceptive responsibilities, and between contraception and private companies, paved the way for the success of the pill, whose overnight popularity reinforced women's role as consumers of contraceptives. The association of contraception with women has led researchers to focus almost exclusively on methods intended only for women. In fact, scientists did not begin to study new types of male contraceptives until the 1970s, 50 years after they began to study “modern” female contraceptives [14].

The immense and rapid popularity of the pill, as well as the subsequent focus of contraceptive research and development on female methods, led to an ideological shift: women became the locus of responsibility for contraception. After the invention of female LARCs, “men who no longer needed to use condoms or practice abstinence were essentially absolved of birth control decisions. Consequently, both researchers and service providers have focused almost exclusively on women” [15].

Another reason why male LARCs do not exist is the prevailing opinion that men do not believe they are responsible for contraception and are not interested in using it; therefore, there is no market for the product. However, empirical evidence often suggests otherwise. For example, one study found that over 70% of men feel that men should take more responsibility for birth control [8]. Furthermore, there is evidence that not only are men interested in using topical male contraceptives [16, 17], but also that 44 to 83 percent of men would use hormonal methods [18-20].

There is also a perception that women do not trust men when using contraception. Many major news articles corroborate this by saying that most women would react to male contraceptives like, “Are you kidding me? I can't even trust him to take out the trash!" [21]. In contrast, scientific studies show that women in committed relationships would trust their male partners to use new contraceptives [8, 19, 20]. Even if it were themselves While this may not be a representative sample, it seems safe to assume that women who agreed to participate in male contraceptive clinical trials because they knew it meant they could not use another form of contraception were confident in their partners the new contraceptives to use. [22] And many couples already rely on male contraception, which presumably means that these women trust their male partners to use them.[10,23] This discrepancy between media reports and empirical studies allows one to characterize the distinction between trust and confidence. of individuals and the confidence of the group explains [24]: "In general, many women have rather cynical opinions of men that do not reflect your opinions about individual men - especially your partner" [18].

Some claim that men are less motivated to use contraceptives because pregnancy affects them less than women [25, 26]. Aside from the fact that it is women who actually bear children, the main reason why pregnancy has long-term consequences for women is that women are expected to be the primary caregivers for children. This assumption is based on socially constructed gender roles. If men were expected to be the primary caregivers for children (or at least share the primary caregiver role equally with women), then pregnancy would have significant consequences for them as well. Men are more actively involved in raising children today than in previous decades; For example, 71% of children under age 6 have dinner with their parents every day [27], 15% of single parents are men, and 154,000 men in the US are stay-at-home dads [28]. This increased participation shows that pregnancy has significant consequences for men, a good reason why men want more control over their reproductive autonomy.

Shared responsibility for contraception

There is no doubt that the contraceptive situation for women in the United States is much better today than it was 60 years ago because of advances in contraception. That said, the current contraceptive situation is still unfair. Women assume most of the responsibility for contraception and the associated burden, while men have limited reproductive autonomy. In some ways, the current contraceptive treaty is more problematic than the old one because its injustices are often obscured, or at least brushed aside, by the dominant rhetoric about women's empowerment and equality. This dominant rhetoric sends the message that women should be happy and grateful for the current situation and even excludes complaints or suggestions for improvement.

For reasons of social justice, we must move towards shared responsibility for contraception. To do this, we need to dedicate more resources to developing male LARCs. However, the evolution of male LARCs is not enough: without changing prevailing gender norms of contraceptive responsibility, it seems unlikely that men will use contraception to the same extent as women. As summarized in the case of sterilization, the mere existence of a certain technology is not enough to change our current method of contraception. Although surgical sterilization is available to both women and men, tubal ligation is nearly three times as common as vasectomy in the United States, and this trend is repeating itself around the world. The disparity in rates cannot be attributed to the availability of technology or the procedures themselves: vasectomies are faster, easier, safer, and cheaper than tubal ligations. The alignment of womanhood with contraceptive responsibilities and childbearing in general goes a long way to explaining why tubal ligation is so much more popular [29, 30].

In short, we need both a technological shift, the development of male LARCs, and an ideological shift, the belief that both women and men should be responsible for contraception in order to achieve more equitable contraceptive regulation.

  • Ethics/Health Policy,
  • Justice/Equality,
  • Reproductive Health/Contraception

references

  1. The eleven female contraceptives are female condoms, tubal ligation, cervical cap, diaphragm, implant, injectable, IUD, patch, pill, ring, and sponge.

  2. I will only focus on heterosexual couples in the United States who use birth control to prevent pregnancy.

  3. Born RA.contraceptive technology. Nova York: Enthusiastic Media; 2004: 245.

  4. Guttmacher Institute. Summary State Guidelines: Contraceptive Insurance Coverage.http://www.guttmacher.org/statecenter/spibs/spib_ICC.pdf🇧🇷 Accessed January 18, 2012.

  5. The Affordable Care Act ensures that women receive preventive care at no additional cost. Washington, DC: Department of Health Press Office; August 1, 2011.http://www.hhs.gov/news/press/2011pres/08/20110801b.html🇧🇷 Accessed January 18, 2012.

  6. Hatter, 223.

  7. Nass SJ, Strauss JF III, eds.; Institute of Medicine.New frontiers in contraceptive research: a plan of action. Washington, DC: National Academies Press; 2004: 119.

  8. Glasier AF, Anakwe R, Everington D, et al.Would women trust their partners to take a male pill?human representative2000;15(3):646-649.
  9. Nass, Strauss, 125-126.

  10. Incubator,contraceptive technology.

  11. Hatter, Prolog.

  12. MacCorquodalePL.Gender roles and premarital contraception.J Ehe Fam.1984;46(1):57-58.
  13. Ton A. Contraceptive Users: Gender and the Political Economy of Birth Control in the 1930s In: Leavitt JW, ed.Women and Health in America: Historical Readings🇧🇷 Madison: University of Wisconsin Press; 1999: 306-326.

  14. Edward SR.Men's role in contraceptive decision-making: current knowledge and future implications.perspective of family planning.1994;26(2):77-82.
  15. Eduardo, 77.

  16. Bourke F.Boys can be given a male pill.Mercury Sunday.2006;20
  17. Bradbury j.The male contraceptive pill would be acceptable to both men and women.Lanzete.2000;355(9205):727-
  18. Glacier, 649.

  19. Martin CW, Anderson RA, Cheng L, et al.Potential implications of male hormonal contraception: cross-cultural implications for the development of new preparations.human Reproduction2000;15(3):637-645.
  20. Weston GC, Schlipalius ML, Bhuinneain MN, Vollenhoven BJ.Will Australian men use male hormonal contraceptives? A survey of a postpartum population.With J Australia.2002;176(5):208-210.
  21. Segal SJ.Under the Banyan Tree: A Population Scientist's Odyssey. Nova York: Oxford University Press; 2003: 130.

  22. Scott lContraception: Take it like a man.Echo des Nordens2003;
  23. However, it may be easier to trust available contraceptive methods to men because both condom use and removal occur in the woman's presence and vasectomy is a permanent procedure.

  24. Campo Engelstein L.Contraceptive Responsibility: Trust, Gender and Ideology[Dissertation]. East Lansing: Michigan State University; 2009

  25. Scientists at Macrae F. UK invent a 'pill' for men that can be taken hours before sex.daily mail🇧🇷 November 27, 2006.http://www.dailymail.co.uk/news/article-418791/UK-scientists-invent-male-pill-taken-hours-sex.html🇧🇷 Accessed January 20, 2012.

  26. corda, 114.

  27. US Census Bureau Children's Day: 2006 (selected indicators of child well-being).http://www.census.gov/population/www/socdemo/2006_detailedtables.html🇧🇷 Accessed January 19, 2012.

  28. US Census Bureau households and housing types.http://www.census.gov/population/www/socdemo/hh-fam.html🇧🇷 Accessed January 19, 2012.

  29. Dixon-Mueller R.Population policy and women's rights: changing reproductive choices. Nova York: Praeger Press; 1993.

  30. Correa S, Reichmann RL.Population and reproductive rights: southern feminist perspectives. Nova Jersey: Zed Books, 1994.

FAQs

Why do we need male contraceptive? ›

The ultimate availability of male contraceptives could have an important impact on decreasing global unintended pregnancy rates (currently 40% of all pregnancies) and will be a step towards reproductive justice and greater equity in family planning.

Why don't we have a male birth control pill yet? ›

Over the years, there have been many attempts to develop a male contraceptive, but in clinical trials men dropped out because of side effects. Yes, female birth control has been known to cause side effects as well, but they're usually NBD compared to pregnancy.

What are the main reasons why people use contraceptives? ›

By reducing rates of unintended pregnancies, contraception also reduces the need for unsafe abortion and reduces HIV transmissions from mothers to newborns. This can also benefit the education of girls and create opportunities for women to participate more fully in society, including paid employment.

What are the problems with male contraceptives? ›

The most commonly reported side effects associated with hormonal male contraception include weight gain, acne, slight suppression of serum high-density cholesterol, mood changes, and changes in libido.

Do men want male birth control? ›

For decades, men have only had vasectomy or condoms as contraceptive choices, and many are interested in updated options. In one survey of 1,500 U.S. men aged 18 to 44, 70% said they are very or somewhat interested in new male contraception .

Is the male pill Effective? ›

Contraceptive pill for males is 99% effective in preventing pregnancy.

Is male birth control a thing yet? ›

Currently, the only readily available male birth control options are condoms, abstinence and sterilization. Condoms help prevent many sexually transmitted infections, on top of pregnancy. However, many men want more choices to take control of their reproductive future.

Are attitudes towards the male pill the same as the female? ›

Mann-Whitney tests showed significant gender differences on attitude towards the male pill (U = 2922, p<0.0001), with females in general being more positive; and on trust in men's effective use of the male pill (U = 3440, p<0.0001), with males in general displaying more trust in themselves than females in them.

When was male birth control pill invented? ›

Researchers first began work on a male birth control pill in the 1970s. Now, nearly half a century later, the concept is, perhaps, closer to becoming a reality than ever before. Scientists at the University of Minnesota created a contraceptive pill that was proven to be 99% effective at preventing pregnancy in mice.

What are the advantages of contraceptive pills? ›

Some advantages of the pill include: it does not interrupt sex. it usually makes your bleeds regular, lighter and less painful. it reduces your risk of cancer of the ovaries, womb and colon.

What are the advantages and disadvantages of contraceptive pills? ›

They can lessen the pain of menstrual cramps, keep acne under control, and protect against certain cancers. As with all medications, they do have some potential risks and side effects. These include an increased risk of blood clots and a small increase in breast cancer risk.

Which is the best contraceptive and why? ›

Contraceptives that are more than 99% effective:

contraceptive implant (lasts up to 3 years) intrauterine system, or IUS (up to 5 years) intrauterine device, or IUD, also called the coil (up to 5 to 10 years) female sterilisation (permanent)

Is male birth control safer than female? ›

In addition to being more expensive, female methods have more serious side effects than male methods, as well, in part because various contraceptive methods for women involve hormones, while no methods for men do [6].

What percent of men would take birth control? ›

contraceptive method decreased with increasing age groups, ranging from 94.9% of men aged 15–19 to 72.4% of men aged 35–44 (Figure 2). Use of any method of contraception was highest among never-married men (89.3%), followed by formerly married (80.0%) and cohabiting (70.5%) men.

Does birth control change your interest in men? ›

Using a sample of 170 age-matched, partnered women, researchers found that the faces of men who were chosen as partners by women who were on the birth control pill had significantly less masculine faces than those of their non pill-taking contemporaries.

Is a vasectomy better than birth control? ›

The Risk of Pregnancy is Almost Zero

Vasectomy has a 0.15 percent failure rate, which is minuscule compared to the pill (nine percent), condoms (18 percent), and the withdrawal method (22 percent). Only abstinence is 100 percent effective. 99.85 percent is pretty close.

What is the best male contraceptive? ›

Currently, men have only two effective options for birth control: male condoms and vasectomy. However, condoms are single-use only and prone to failure. In contrast, vasectomy — a surgical procedure — is considered a permanent form of male sterilization.

Is contraceptive pill for males is 99% effective in preventing pregnancy? ›

Story highlights. A new birth control pill for males has been found to be 99% effective in preventing pregnancy in tests in mice. The breakthrough medication could bring balance to the contraceptive burden, with far fewer options available to men.

How long does male birth control last? ›

How long does the male birth control shot last? The male birth control shot, also known as RISUG and Vasalgel, lasts up to 10 years. It can also be reversed at any time with another injection.

Is male birth control FDA approved? ›

Many medications and substances have been studied in the past as well-intentioned male contraceptive tools. However, so far, none have won FDA approval.

What is the main difference between male and female? ›

Biological sex is often confused with gender in our society. The two sexes are differentiated as females, who have ovaries and produce eggs, and males, who have testes and produce sperm. In mammals, females typically have XX chromosomes and males typically have XY chromosomes.

What determines the difference between male and female? ›

The phenotypic differences between males and females are determined, initially, by genes on the sex chromosomes. Sex chromosome-linked genes can be expressed in both germ-line and somatic cells and could influence an individual's phenotype, including disease susceptibility, at many levels.

Why are there differences between males and females? ›

Generally, females have two X chromosomes in their pair, while males have one X and one Y chromosome. A gene on the Y chromosome is responsible for the cascade of developmental events that cause bodies and brains to take on male characteristics.

How long have they been trying to make male birth control? ›

Efforts to develop male contraceptives have existed since at least the 1970s (not long after the pill for women became widely available), when researchers started clinical trials for hormonal birth control methods for men.

What is the male pill 2022? ›

The new contraceptive method is a non-hormonal pill with the active compound of the drug being YCT529. This compound blocks RAR-a proteins which are crucial in cell growth, sperm formation and embryonic growth. By blocking this protein the role of vitamin A in sperm development is inhibited, leading to sterility.

What are the side effects of the male birth control pill 2022? ›

As for side effects, some participants report weight gain, changes in libido, acne, or mood swings." Those, she points out, are "very similar to those that some women experience using female hormonal contraceptives."

What are the three advantages of contraceptive methods? ›

Contraception allows them to put off having children until their bodies are fully able to support a pregnancy. It can also prevent pregnancy for older people who face pregnancy-related risks. Contraceptive use reduces the need for abortion by preventing unwanted pregnancies.

Can birth control make your boobs bigger? ›

When taking these pills, the level of hormones in your body increase. At these increased levels, these hormones can generate changes in your body, such as a temporary increase in breast size or weight gain. In addition to these changes, some women experience more severe side effects from birth control pills.

What are the pros and cons of different types of birth control? ›

Which Method is Right for You?
MethodEffectivenessCons
Birth Control Implant99%More expensive than other methods
IUD (Intrauterine Device)99%More expensive, may cause irregular/heavy periods
Vasectomy99%May not be reversible, more expensive
Tubal Ligation99%May not be reversible, more expensive
8 more rows

Is the pill the best contraceptive? ›

The pill has the potential to be 99% effective at preventing pregnancy if you take it without fail — meaning you don't forget to take the pill for even a day or two. However, taking the pill perfectly can be difficult, which is why nine out of 100 women who use the pill will have an unintended pregnancy every year.

Is the pill a good contraceptive? ›

Perfect use: more than 99% effective.

Fewer than 1 in 100 women will get pregnant in a year when using the combined pill correctly.

Is the pill an effective contraceptive? ›

If you use it perfectly, the pill is 99% effective. But people aren't perfect and it's easy to forget or miss pills — so in reality the pill is about 93% effective. That means about 7 out of 100 pill users get pregnant each year.

Which contraceptive pill is most used? ›

The most commonly prescribed pill is the combined hormonal pill with estrogen and progesterone. Progesterone is the hormone that prevents pregnancy, and the estrogen component controls menstrual bleeding.

What is the safest form of contraception Why? ›

Abstinence is the only birth control that is 100% effective. It means you never have sexual intercourse. It's also the only way to protect yourself from STDs.

What is an ideal contraceptive essay? ›

An ideal contraceptive should be the one that should not interfere with the normal sexual drive of the couple. It should not affect the libido in any way. It should be easy to usee. An ideal contraceptive should be highly effective and discrete. It should be non-reactive and do not harm the body in any way.

What type of birth control is made for only males? ›

NES/T (Nestorone®/Testosterone) is the first birth control product designed for males that has progressed past the initial steps in the clinical trial process, which consists of several phases and subphases defined by the U.S. Food and Drug Administration (FDA).

What is the contraceptive for men? ›

Currently, the only male birth control options are condoms and vasectomy. Men can also use behaviors, such as outercourse, to reduce the risk of pregnancy. No male birth control pill is currently available.

Who is responsible for contraception in a relationship? ›

It is BOTH partners' responsibility to ensure that you have safer sex, and use contraception to prevent both unplanned pregnancy and sexually transmitted infections (STIs).

What is meant by male contraceptive? ›

Traditional methods of male contraception have long included periodic abstinence, non-vaginal ejaculation, condoms, and vasectomy, the latter two representing physical methods to prevent sperm from reaching the site of fertilization.

What is the most common male contraceptive? ›

Condoms and spermicides are two common birth control options for males, while a vasectomy provides a permanent option.

How does contraception affect marriage? ›

Ever-use of contraceptive methods was associated with two times the odds of divorce and four times for cohabitation compared to those women who never-used those methods.

Should a couple use contraceptives? ›

Couples who do have sex need to use birth control properly and consistently to prevent pregnancy. For example, the birth control pill can be effective in preventing pregnancy. But if pills are skipped, it isn't an effective method. Condoms can be an effective form of birth control too.

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