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contraception
April 2, 2012 | by  | in Features |
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On the Pill

The search for a male contraceptive

“What qualifies me to be an expert on women’s reproductive health?” asks a sombre, besuited Leland Palmer in a parody posted on FunnyOrDie.com. “I’m a 59-year-old man.”

The video is a nod to the fact that access to hormonal birth control—a debate that raged in the United States over half a century ago—has always been as much about politics as it has about health. It’s no less contentious an issue in 2012: election year.

In February, the Republican Party attempted to overturn President Obama’s new law, introduced as part of healthcare reforms, that requires most employers or insurers to cover the cost of contraceptives. Republicans argued that this requirement violates the First Amendment’s guarantee of religious freedom by forcing employers to pay for employees’ contraception, even if their faith forbade its use. A narrow majority of Senate Democrats voted against the amendment, arguing that hormonal birth control is prescribed to women for health- related purposes unrelated to preventing pregnancy.

Of greater concern was that the “Blunt amendment”, named for Senator Roy Blunt of Missouri, would place control of women’s reproductive health decisions in the hands of their employers. But, as the FunnyOrDie.com parody wryly references, so far in the debate, such decisions have been weighed in on by everyone but women themselves.

Commenting on the debate in the same month, Foster Friess—the single largest donor to Republican presidential candidate Rick Santorum’s political action committee—said, without a trace of self- awareness or humour, that “in [his] day”, “gals” held aspirin between their knees in lieu of contraception, “and it wasn’t that costly”. Conservative broadcaster Rush Limbaugh later referred to Freiss’s comment when he called law student Sandra Fluke, who was denied the right to speak on an all- male panel on the religious implications of the issue, a “slut” and a “prostitute” on air.

However, the Republican Party’s bid to encumber women’s access to birth control has gone beyond straightforward name- calling. A couple of weeks ago, former presidential candidate Rick Perry supported the passing of a law in Texas that barred Planned Parenthood from receiving funding under the state’s healthcare programme. This prompted a slew of posts on his official Facebook page (that were promptly removed) along the lines of: “Hey, Rick, when I menstruate there is sometimes coagulated purple gel in my Mooncup. I’m not 100% sure what it is, so I figured I’d ask an expert on women’s health.”

It’s easy to see the source of inspiration for the FunnyOrDie.com video. What the controversy over contraceptives in the United States has highlighted is the inequality and intrinsic difference that exists between what can be crudely generalised as ‘male’ and ‘female’ dialogues within the debate. As male Republican politicians campaign for legislation that will impact on thousands, if not hundreds of thousands, of women’s decision-making in regards to their reproductive health, women alone know how it feels like to take charge of their own fertility—and the risks of not doing so.

As Kyle Munkittrick put it in a guest blog for Discover magazine (http:// is.gd/tR2Qtc), “women are constantly bombarded with reminders that they can make babies [and]… that it can happen accidentally. Consider this: no matter what the situation, men are only required to think about safe sex right before or as it’s happening, but never in the interim… a woman is constantly being asked if she’s pregnant, might be pregnant, or is planning on getting pregnant. She… is probably on or considering some form of birth control based on the possibility that she might have sex in the future.

“…The enormous problem here is that while girls are forced to contemplate STDs and pregnancy early, boys are largely unconcerned until they have sex for the first time. In many cases, it will be the girl who asks about a condom or says “I’m on the pill, it’s OK” or something else responsible.”

As a 21-year-old, sexually active (though, in the interests of full disclosure, ‘active’ implies a frequency that I cannot live up to), I can attest to Munkittrick’s argument. I have been expected, just as a matter of course, to have the matter of my fertility under control by taking a hormonal contraceptive every day—most of which pass by without any opportunity for me to risk pregnancy (unless the urban legends about public toilets are true). This requires a certain level of effort on my part: making and attending the appointment at Student Health, picking up the prescription, and taking it as directed. The implicit statement seems to be that—as much as any woman can count on her sexual partner to support her in the case of an accidental pregnancy—women’s fertility is a women’s issue, even though it takes an egg and a sperm to make a fetus.

As Munkittrick points out, despite the debate over it in the political sphere, contraception is a single-sex issue, and this has created a basic inequality in men and women’s attitudes towards sexual health and responsibility. At the moment, the current choices for men looking to take control of their fertility are condoms— already irreplaceable for protection from diseases such as herpes and chlamydia— and vasectomies. (Resulting in about 30 pregnancies per 100 women per year, withdrawal is not a legitimate option. Come on.) The latter is too drastic a step for the majority of men below the age of 40, while condoms have a high rate of failure compared to hormonal contraception.

Conversely, there are 11 female-only contraceptive methods, many of which are readily available at Student Health and Family Planning. The development of a non-barrier birth control for men, typified by the image of a ‘male pill’, would go some way towards addressing this imbalance. “A male pill would dramatically alter some consciousnesses. Both sexes would be having discussions about preventing pregnancy as well as preventing diseases in sex-ed,” argued Munkittrick. “The burden of responsibility would be equalised early on.”

The benefits of male birth control are obvious, but developing and marketing a new contraceptive is difficult. “It’s just around the corner” has become something of a catchphrase in regards to the development of a temporary, reversible contraceptive for men. The key stumbling block seems to be the rate of gamete production in the male reproductive system. Women release one egg a month, and so hormonal contraceptives need only interrupt that single event in order to be effective. Some reports suggest that men produced as many as 1,000 sperm every second, and stemming that flow poses more of a problem.

More of a problem, yes, but not an insurmountable one. Options include hormonal pills and injections inspired by marijuana’s link to impotence, and a similar, but more easily reversible procedure to a vasectomy known as ‘Reversible Inhibition of Sperm Under Guidance’. Most encouragingly, researchers at the University of North Carolina recently concluded (with the help of an $100,000 grant from the Bill & Melinda Gates Foundation) that dosing the testes with ultrasound is a “promising candidate” in providing men with up to six months of reliable, low-cost, non-hormonal contraception.

However, further study as to whether there would be cumulative damage from repeated doses of ultrasound is necessary before the treatment can be considered a marketable reality. “The last thing we want is a lingering damage to sperm,” commented Dr Allan Pacey, a senior lecturer at the University of Sheffield, to BBC News. One 20-year-old male I spoke to—who was otherwise enthusiastic about the idea—expressed concern at the potential of “lingering damage”, admitting that he would take steps to preserve his sperm before trialling any male-only contraceptive.

Though the development of and widespread access to a male-only contraceptive seems like it would liberate, it would likely only be of benefit to people in long-term, committed relationships, as it would not replace the protection against sexually-transmitted diseases provided by a condom. Moreover, some women are understandably reluctant to trust their sexual partner with matters of fertility that are of such great consequence to them themselves; though no studies have been carried out on the matter, anecdotal evidence points to some reluctance amongst women to have men take care of contraception.

Somewhat ironically, this argument perpetuates the inequality and mistrust that made birth control one of the defining social issues of this primary in the first place. It implies that, though men have the authority to delegate responsibility for preventing against pregnancy and disease to women, they cannot be trusted with the task themselves. Of course, women have much more at stake. “I, for one, would love to let my body take a break after eight years of hormonal birth control and let my partner take a turn,” wrote one female commentator on Munkittrick’s article.

“[But] would I really be willing to trust that the other person is being responsible and taking the pill every day?… At the end of the day, it’s my body that’s going to have a baby growing inside it, and all that entails… It’s going to take an enormous cultural shift before getting pregnant after a one-night stand affects both partners equally.”

Reluctance to adopt male-only birth control will likely discourage pharmaceutical companies from funding its development, which is a shame. The debate isn’t just about safe sex and contraception; it’s also about attitudes to safe sex and contraception. Though

the “enormous cultural shift” necessary to make male contraception an accepted alternative is often spoken of as being a disincentive to progress, its ultimate upshot would be improved responsibility, awareness, and understanding of birth control across the board. To put it bluntly, more equality in matters of fertility would change society’s understanding of sex, reproduction and relationships for the better—as much as it might be a bitter pill to swallow for the Republican Party.

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About the Author ()

Elle started out at Salient reviewing music. In 2010, she wrote features and Animal of The Week, which an informal poll revealed to be 40% of Victoria students' favourite part of the magazine. Alongside Uther Dean, she was co-editor for 2011. In 2012, she is chief features writer.

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