Male Contraceptives

Introduction

Research studies focused on hormones and human sexuality facilitated the development of contraceptives for women beginning just over five decades ago in the late 1950s. Considering the diminutive history of the inclusion of female reproductive system in medicine, it is unsurprising that the initialphysiological contraceptive development focused entirely on women. Since the second war of the world, researchers have developed at least thirteen new female contraceptives. This stands in strident contrast to the development of male contraceptives. In the past century, researchers have not developed any new methods for men, with the exception ofthe enhancement of existing ones, namely sterilization and condoms, both which date back to the 19^th century (Nieschlag, & Behre, 2013).

Researchers focused on human sexuality first introduced rubber condoms around 1860, whereas male sterilization (also known as a vasectomy) dates back to the late 1890s. In the early years of the second half of the 20^th century, scientists developed better-quality condoms, and in last decade of the same century they introduced polyurethanecondoms. As such, the revolution regarding contraceptives has remained principallylimited to female methods (Kogan, & Wald, 2014). Nonetheless, recent research advances on male contraception show that we could potentially have new methods of contraception for men widely available in the near future. This paper examines the history and development of contraceptives for men, the pros, and cons of male contraceptives, the male contraceptive method that would be most appropriate, and who, between the man and the woman, should pay for them. The paper also highlights some of the reasons why a man would use male contraceptives or not.

The History and Development of Contraceptives for Men

Because of the innovation in methods of contraception for women – including the intrauterine devices (IUDs), hormonal methods such as Norplant, and hormonal contraceptive pills–female methods have come to prevail as family planning practices. Oral contraceptives for women, female sterilization, and IUDs account for the majority of methods of contraception currently in use. As such, there exists a wide gender gap in contraceptives that call for the need to develop male contraceptives. Feminists first challenged the gender disproportionateness in contraceptives in the decade between 1960 and 1970 (Kogan, & Wald, 2014). In the case of hormonal contraceptives, particularly the pill, the request to come up with new contraceptives for men stemmed from outside the research community. More specifically, in this instance, social pressure came from Asian governments, most notably India and China, and feminists in the Western countries (Extance, 2016).

Feministscalled formen to share the responsibility and hazards of health that come with the use of contraceptives, while governmental agencies pushed for the inclusion of the “overlooked50 percent of family planning” as the object for the development of male contraceptives (Extance, 2016). In the decades between 1970 and 1990, questions regarding the male pillappeared regularly in newspaper headlines, especially during the time when reports about the grave health risks of using the female pill surfaced (Kogan, & Wald, 2014). According to Extance (2016), even though research in the reproduction of men and the development of different methods for male contraception has increased owing to these pressures, the male pill and other new male contraceptive techniques are yet to appear on the market. Accordingly, for the past four decades or so, the term “male pill” has become engrained in our language.

The very fact that the male pill has become entrenched in our language since the 1970s shows an atypicalpattern in the prevailing technological culture. Contrary to other technological developments where drive-in processes change with technology diffusion, nowadays, the notion of a male contraceptive pill has become deeply engrained in our culture, despite the fact that the technology itself is yet to come into existence. As such, the concept of an oral contraceptive for men functions as an inexplicable symbol of our culture. Those who have no information regarding the methods of contraception presently available might tend to hold the belief that both men and women can opt to use oral contraceptives. However, in real sense, the term “male pill” is a symbol of a potential technology that nonetheless appears to be difficult to make a reality (DCYB, 2017).

Over the past few years, journalists have reported advances in research focused on new male contraceptives, echoing “the male pill” phrase and accordingly promulgating the notion that it is on the verge of becoming a practicable method of male contraception. Headlines from newspapers, magazines, and websites –“The Race for the Male Birth Control Pill,” “A Pill for Men – Five years Away,” and “We’re One Step Closer to Hormonal Birth Control for Men” – exemplify this point (UW, 2014; Kissling, 2010; Almendrala, 2016). One can find similar promises in research texts in which scientists proclaim that new methods of contraceptives for men will be available for use within half a decade or ten years.The 1970s scientists pointed out that the year 1984 was the most probableperiod when new methods of male contraceptives would come into existence, while in the two decades before the beginning of the 21^st century researchers mentioned the dawn of the new millennium as the likely date (Hamlin, 2015). Nevertheless,little by little, scientists have come to show a reluctance in predictingthe arrival of new methods of male contraception to evadeconstantly disappointing potential users.

According to Flood, Gardner, Pease, and Pringle (2011), the delay in new male contraceptive development can be explained by making reference to technical and biological constraints. Scientists and journalists in the biomedical field encourage us to assume that techniques to intervene in new contraceptives for men have not thrived because, by nature, the reproductive system of the male is more impervious to intervention in comparison to that of the female. However, biological explanations are insufficient to enable us to understand the slow pace of new male contraceptive development. Despite the fact thatthe development of contraceptive drugs usually covers a period of about 15 years, the hormonal male contraceptive development has taken more than four decades. Most importantly, the technical feasibility of male hormonal contraceptives had already been demonstrated as early as the late 1970s (Extance, 2016). As such, the delay in new male contraceptives development can be explained more by social and cultural processes than by technical constraints.

First, we can understand the holdup in the development of new options for male contraceptives in the social context of the specific infrastructures in which this technological innovation can take place. Until the late 1990s, pharmaceutical firms had shown hardly any interest in male contraceptive R&D because of liability issues associated with safety concerns, stringent drug regulatory requirements, and a reluctant market. Second, the slow pace of male contraceptive development can be attributed to cultural constraints. Ever since scientists articulated the notionof a male contraceptive pill, journalists, clinicians, pharmaceutical entrepreneurs, and feminists have voiced concerns regarding whether both sexes would accept a new method of male contraception if it were available. The preponderance of contemporary contraceptive methods for women has taught men to entrust contraception responsibilities largely to the female partner (Extance, & Reddick, 2016). Consequently, the use of contraceptives has come to be precluded from the superseding masculinity.

Male Contraceptive Methods

At present, there are only two techniques of male contraception that are in existence and demonstrate a high rate of success: sterilization and condoms. Male sterilization is a radical contraceptive method; some would argue that it is not used to prevent pregnancy but instead reflects the desire to never have children. The male condom has been used over the past years to prevent pregnancy and the transmission of STDs, including HIV/AIDS. The new male methods closest to practical implementation are reversible hormonal techniques. Such methods include oral contraceptives, implants, and injectable androgens, which stand out as promising options for men. These reversible hormonal methods would most likely interfere with the maturity of the sperm.

According to Sammarco (2016), there exists evidence demonstrating that hormonal contraceptive methods for men have a 90-95 percent efficacy rate. Research also shows that both men and women are receptive to the idea of a male hormonal contraceptive method, particularly the oral contraceptive option (Kolb, 2011). Strides toward developing new non-hormonal male contraceptives have also been made recently. The potential non-hormonal male contraceptives include products that target sperm mortality. Despite the considerable progress that clinical research has made on male contraception, no new product is currently available, although scientists say that there is a likelihood for new male contraceptive methods to be seen in the near future (Sammarco, 2016).

The Pros and Cons of Male Contraceptives

Male condoms have long been used for contraception because of they are relatively inexpensive, wholly reversible method that men can control at the time of intercourse. Another advantage of male condoms is that they provide some barrier protection against the transmission of STIs. The main disadvantages of condoms as a method of male contraception include interruption of foreplay for application, decreased sensation, and the possibility of breakage or slippage during intercourse (Sammarco, 2016). Another method of male contraception that has long been in use is sterilization (vasectomy), which has its pros reflected in the fact that it does not affect male sexual functioning, including ejaculation, erectile function, semen volume, or sexual pleasure. Moreover, male sterilization has the advantages of being a highly effective permanent male contraception method and it offers quick recovery and few long-term adverse effects. The main cons associated with sterilization are expensiveness, lack of provision of protection from STIs, and irreversibility (Elist, 2015).

There also exists the possibility of having new male contraceptive methods, such as oral contraceptives for men, implants, and injectable androgens. The main advantage of these new methods would be the provision of a reversible techniquethat men could control themselves as an alternative to vasectomy, which is irreversible (Sammarco, 2016). Moreover, the new methods would provide alternatives for couples who are unable to use certain female contraception methods, such as IUDs. An additional potential advantage of the new male contraception methods relates to the shared responsibility between men and women for the contraception cost and the need for regular visits to reproductive health physicians. Nonetheless, the new techniques would be disadvantageous in the sense that they would not safeguard against the transmission of STIs and would take a considerably long time to wear off, particularly in the case of hormonal medication. Another potential disadvantage, especially for the approaches that would interfere with the maturity of the sperm, is that the methods could result in a low sperm count (Better Health Channel, 2016).

The Male Contraceptive Method That Would Be Most Appropriate

According to Better Health Channel (2016), before choosing a particular contraceptive method to use, it is important to know its effectiveness in preventing pregnancy, its safety and ease of use, how much it costs, and the potential side-effects associated with its use. Given that the new contraceptive methods for men are yet to appear on the market, the cost factor cannot help determine which among the methods would be the most appropriate. Nonetheless, other factors highlighted by Better Health Channel (2016) can apply. Recent laboratory tests indicate that among the potential male contraceptive methods likely to be available in the near future such as injectable androgens, oral contraception would have the least side effects on men (Scutti, 2016). Moreover, given their high potential to inhibit sperm maturity, male oral contraceptives would be highly effective in preventing pregnancy (Sammarco, 2016). It would be easy and unproblematic to use the oral contraceptive method because it would require one to simply take the medication through the mouth and swallow it. In this regard, the male contraception method that would be most appropriate is the oral contraceptive or the male pill.

Who, Between the Man and the Woman, Should Pay for contraception?

The fact that most of the contraceptive methods available are for women has led to a predominantconception that women are the ones who should pay for contraceptives. Nonetheless, when a couple makes use of a contraceptive method, the aim is not to benefit the woman alone, but the man as well. Both would have made the choice to use contraceptives because of their mutual interest not to have babies. Fairness, decency, and concern for greater equality and mutuality point out to the premise that a man and his female partner should share the cost of purchasing contraceptives. Irrespective of the method of contraception that a couple chooses to use, whether the method is for men or women, both the man and his significant other should contribute toward the payment of contraception (Williamson, 2015).

Reasons Why A Man Would Use Male Contraceptives or Not

There are various reasons as to why a man would use male contraceptives or not. More specifically, a man would make use of male contraceptives because he has become aware of his responsibility in matters of contraception and fatherhood. A man is responsible for the process of procreation and for the children he procreates and as such, to avoid the burden that comes with fatherhood responsibility, he would use male contraceptives to prevent a pregnancy. Also, a man would use male contraception, particularly condoms, to sidestep contracting STIs and to avoid imposing an STD upon his female partner (Stacey, 2015).

Nonetheless, there are instances where a man would not use male contraceptives because of various reasons. More precisely, a male would refuse to use contraceptives for men, such as a condom or a male pill, because this does not fit into his macho male perspective. Moreover, a man would decline contraception for fear of losing control during a medical genital approach, such as a vasectomy, which is somehow comparable to castration. Accordingly, the fear of loss of sexual desire and the perceived resultant weakness would lead a man to refuse contraception. Indolence, particularly in instances where the man sees that his significant other has started using contraception, can also lead the man not to use male contraception. Additionally, cultural taboos, such as those that dictate that family planning is the woman’s responsibility, can cause a man to refuse using male contraceptives.

Conclusion

Innovation in methods of contraception for women – including the intrauterine devices (IUDs), hormonal methods such as Norplant, and hormonal contraceptive pill –  have led to female methods being predominant as family planning practices. Oral contraceptives for women, female sterilization, and IUDs account for the majority of methods of contraception currently in use. As such, there exists a wide gender gap in contraceptives that call for the need to develop male contraceptives. Recent research on male contraception indicates that we could potentially have new male contraceptive methods widely available in the near future to supplement the existing methods of condoms and vasectomy. Such methods include male hormonal contraceptives such as the male pill, implants, and injectable androgens, as well as non-hormonal contraceptives that comprise of products that target sperm mortality.

Both the existing and potential methods of contraception for men offer benefits and drawbacks. The advantages and disadvantages of the methods largely manifest in their ability to offer protection against the transmission of STIs, their effectiveness in preventing pregnancy, their safety and ease of use, how much they cost, and the potential side-effects associated with their use. Among the potential male contraceptive methods likely to be available in the near future, the one that would be most appropriate is the oral contraceptive or the male pill, particularly because of the numerous benefits associated with it. There are various reasons that explain why a man would opt for the male pill or any other contraceptive method for men, including the avoidance of the burden that comes with fatherhood responsibility, and to sidestep contracting STIs or avoid imposing an STD upon the female partner. In a similar manner, various reasons exist as to why a man would not use male contraceptives, including fear, indolence, and cultural taboos. If a couple decides to use contraception, whether the method of contraception is for men or women, both the male partner and his significant other should contribute toward the purchase of the contraceptive.

References

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