Opinion | Why the male birth control pill remains a dream

Via Peters
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Susanna Schrobsdorff writes the “It’s Not Just You” newsletter at Substack.com.

Women didn’t exactly rush into the streets to celebrate the news last month that an improved contraceptive pill for men is in the works. We’ve been waiting for men to help solve this problem for decades, so please forgive our skepticism. First, we laughed at the idea of men taking any kind of medication that causes temporary infertility. And then we cried because we remembered that men will never be good at birth control until they can get pregnant.

Certainly, there has never been a better time for people with testes to step up and take some responsibility for contraception. According to a recent U.N. report, half of all pregnancies on our overcrowded planet are unintended. A male contraceptive could, if approved, reduce abortions and child poverty. And in the United States, a pill for men should have more relevance now that access to abortion is being rapidly curtailed in many states.

The new male contraceptive works by targeting a specific protein important for cell growth, including sperm formation. Inhibiting this protein dramatically reduces sperm counts, and reportedly it is 99 percent effective. And while the compound has only been tested on mice, there are no observable side effects so far. Four to six weeks after the mice stopped receiving the compound; they were able to father pups again. Human trials are planned for this fall.

Until that occurs, we have time to tackle a foundational issue or two. Let’s start with the big one: What exactly could entice the average guy to take a daily pill that does something mysterious to his sperm?

Why there’s still no new birth control for men

This might be the world’s greatest advertising challenge. “Temporary sterility” will never be an easy sell to an audience that is accustomed to being served up all kinds of marketing hustles for trucks, beverages and screen time that play to their masculinity. The only way you’d get guys to take that contraceptive pill, a male friend remarked, is if it also gives them an erection.

The belated emergence of an oral contraceptive for men is further evidence of a pernicious double standard in reproductive health care. Men, as medical researchers put it, have a very “low threshold” for side effects. Earlier versions of the male pill, for example, worked by reducing a man’s testosterone but came with side effects that included reduced libido, weight gain and depression.

People who take female oral contraceptives have been putting up with the same kinds of symptoms for decades, plus an elevated risk of severe health issues, including blood clots and some cancers. As you may recall, the female pill works by mimicking pregnancy in the body, stopping ovulation and/or implantation of an embryo. So, yes, to keep from getting pregnant, women take hormones that make them feel pregnant. Often, for years.

It’s hard to imagine men opting for an equivalent biochemical commitment in exchange for birth control. But let’s say this new non-hormonal pill for guys makes it to market, and men are willing to try it. Can we really expect them to take a pill every day? If he forgets his pill pack on vacation, you’re rolling the dice. Even habitual use of condoms is a challenge for most guys: a 2016 study of 51 males found that men were “less likely” to wear a condom when they judged a potential partner to be attractive or in good health. Until they can suffer the consequences of an unintended pregnancy, men aren’t likely to reliably take responsibility for birth control.

Still, all is not lost. German scientist Rebecca Weiss won the James Dyson Award last fall for inventing an “ultrasound-based, reversible and hormone-free” form of male contraception. Users simply put their testicles into a custom-fitted device filled with heated water before intercourse and ultrasound temporarily stops the sperms’ motility so they can’t fertilize an egg.

That might be even more awkward than some female birth control devices we won’t mention. But surely the folks who design space rockets can give this contraption a super-manly astronaut vibe.

Until then, contraception equality is just a dream — a dream in which men are not the only ones who can turn to a sexual partner at the critical moment and say: “We’re good, right?”

https://www.washingtonpost.com/opinions/2022/04/21/xx/

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