I was wrong about male contraceptives

Some of our most interesting debates with M. are sparked at 6 am, I’m not quite sure what’s the reason behind it but today’s debate was particularly interesting because I ended up admitting quite fast (less than 2 hours) that my arguments and perceptions behind male contraceptives were wrong, no sugar coating, it was just a classic biased and misleading argument and I want to open part of this debate to you so you can also join and include your own arguments and understand a bit better why aren’t men contraceptives fully developed yet. This was also possible thanks to the support of Mar Muñoz, my go-to expert in drug development, debates on pharmaceutical community and reliable research sources.

Today’s picture is a pumpkin soup because pumpkin season in the hood and I can’t wait to start having cozy soups for this grey and depressing weather, can we just be in April again?

The situation started because I shared on my Instagram this 3 images about contraception, for me the entire argument was quite reasonable, clear and I supported the idea. My initial thoughts on this matter were:

1. It is true that we should focus on the most fertile side of the situation, if a women can get pregnant only once every 9 months then it doesn’t make sense that they are the one’s that should take pills every day, for their entire lives with those terrible side effects. If a man can impregnate so many more women in the same period of time, then the problem is in that side.
2. Ugg science, why are you so obsessed with controlling female bodies instead of create options for men so we can have an equal reproductive situation.
3. The society shouldn’t put that responsibility fully on women, it is unfair and sexist and is just another way of violence against women. Why should we be the only side taking care of the responsibility and side effects when man can just use a condom with zero side effects. Unfair and BS.

At this point you may agree with me in some points and they sound completely reasonable, I know, but I will try to dissect the entire situation a bit further to try to be less wrong and maybe get closer to a conclusion on the topic. Please keep in mind this is a personal experience and the debate still open for new perspectives and I’m looking forward to hear from you and your arguments. The more the merrier.

Why aren’t male contraceptives ready yet?

Spoiler: it is too complicated to develop but they are trying a lot.

One of my first steps was to go and check sources about why male contraceptives are not ready yet and I realised I was a complete ignorant on the topic, in this 5 minute video the topic is very well explained and includes the sources in the description box, in this sources (1, 2 and 3) provided my Mar, they gather what does the scientific community knows about male contraceptives so far and what are the options they have explored, but long story short, the community have tried several methods from hormonal, biological to barrer, but the hormonal path for a pill is very difficult to achieve!!!!!!! I’m clearly not an expert and this is why this is the first post featuring a professional on the matter, thanks again Mar <3.

There’s a new compound (DMA) that can trick the body to reduce the testosterone level focused in the testes and stop the sperm production and it could be available with a single pill a day. in 2018-2019 it seem promising and you can find the study results here. Nevertheless a drug-study can take more than 10 years before it’s available for consumers, between research, development, trials for efficiency and safety, regulation approval, creation and distribution. So it will take more time to be available even if they already discovered the magic compound. What I understood about this study is:

1. Lower the count of sperm using synthetic hormones is not very efficient because the dosis must be very high and there are a lot of side effects including liver problems. (and some other side effects that are currently present in female contraceptives, but anyway they complain about it, I got it, we all would rather not to have any side effects but women can’t afford that luxury yet)
2. The body eliminate this synthetic testosterone very fast so they have to take pills twice a day.
3. Even if the treatment is safe (in terms of side effects), it should be convenient and easy enough for men to take it, otherwise is useless if they create a pill but men don’t take it.

I also found that the hormonal male contraceptive development has been, in fact, in the eye of the scientific community at least since 1957, while for women the magic compound (hormones in progesteron) was discovered in 1951, the pills became publicly available in the 1960s (see, kind of 10 years for the entire process). With this fact, I get to soften a bit my discomfort with the obsession on science and society controlling the female body trough contraceptions because I don’t think it is true that they are not focusing on the male contraceptives, in fact they are checking other options as well such as pills, injections or gel to clog the sperm tubes and it’s a real work-in-progress that I didn’t know about but it didn’t mean it wasn’t happening.

Why is the scientific community so obsessed with women?

Spoiler: it is not, finding a birth control option from an event that happens once a month with a single egg is significantly easier to solve than finding an option for millions of sperms a day. Also they are researching male contraceptives since 1957 (and for women since 1951)

On the other hand, I was wondering why all the research and development has been focused on women and why this pill has been available since the 1960s (including the terrible side effects and poor performance of a lot of this pills) but there’s nothing even close for men. The next step here was to keep reading about the issue and the debate on the pharmaceutical field and this get me to include very interesting points that I didn’t knew yesterday. The situation is not lack of interest from the scientific community (they’ve been doing the work since the 50s), it is a multimillion dollar business idea (so there is funding for the I+D) and there is not lack of interest from men to take it either (so they have potential customers ready for the magic product).

The most reasonable explanation I have found for the situation is because from an objective/scientific/drug-development point of view it is way easier to stop one egg a month than stop millions of sperm a day and the first practical and safe solution came from developing hormonal and barrier contraceptives for women, merely from a practical point of view and not as a political statement. (I still haven’t fully set my mind on this, I thinks there’s some kind of political statement of this as well, but this doesn’t change the fact that is an easier problem to solve and this is why the female contraceptive happened first)

The egg release happens with a spike of estrogen (hormone), this usually happens once a month in a healthy woman, so the daily pills avoid that spike by keeping a continuous flow of the hormone and therefore no egg - no baby. This process has been researched and addressed from decades now and we can say is mainly solved, there are plenty of available options in the market and birth control is included in the health system schemes. So again, this kind of ruin the argument that we should focus on the male side of the procreation because is the fertile side, the problem is a bit more complex that this but still, please keep working on those male contraceptives.

Why is the responsibility fully on women? why do we have to deal with those horrible side effects?

Spoiler: I agree that it is unfair but I’m also glad that millions of women around the globe can have even more autonomy on their own bodies thanks to the pill, is not perfect but can you imagine if only men could have the pill?

This is the hardest question for me, I agree that is unfair that women are exposed to risky side effects while looking for autonomy on their own bodies and the ability to plan their lives with or without kids as a decision and not something fortuitous, but the good old days were not good at all and I’m glad that female contraceptives are available right now, let me state some examples on this:

• Nowadays the side effects are clearly documented and tested so we have a lot of information available before making any decision, in the past a lot of this side effects were not known and a lot of women suffer from unintended and horrible side effects (such as blood clots, hearth attacks, liver cancer) but contraceptives now are safer than ever, this doesn’t mean they are all good and there’s no room for improvement but you know, it was way worse. Hopefully they will keep improving over time.
• Nowadays birth control is part of most health system schemes, it is broadly available and the costs and barriers of access are reducing over time, previously they were illegal, unaccepted by some religions and openly rejected by some societies but now they are more accesible than ever and they will keep gaining acceptance as part of human rights agreements around the world.

Now, on the political side of the situation it became even more complex, some people agree with the idea that birth control is a way to provide freedom to women, to regain some control over their bodies and to start to change their role in societies from mere breeders to active individuals with desire of fulfilling lives where having babies may be or not part of the plan but they should have the decision about this. I agree with this statement and this is why I support the access to female contraceptives even with the side effects and the discomfort of the daily reminder. The way I see it, is way better to have a work-in-progress solution that none at all.

Another interesting point I’m still not sure how to solve in my head, is the the social dynamics around condoms and how if they have zero side effects and they prevent diseases, there’s still a lot of people against the use of it, maybe because of ignorance, maybe because is a power move, maybe because they are entitled, maybe because of lack of access or education, I honestly don’t know and if you are against the use of condoms I would like to hear from you so I can get to understand better the entire situation and your position on this.

Final thoughts

And finally to discuss about the questions I shared on social media, I appreciate the time people took to vote and talk to me about the topic, and after the long considerations and discussions, I don’t have a solid argument to support the statements so my answer for them is “no”:

“The reason why the contraceptives are focused on women is because of male chauvinism or sexism” no, because even when I feel/know part of the male chauvinism and sexist problem is related to reproduction and autonomy, female contraceptives support that autonomy we are looking for, and even when the path hasn’t been perfect and a lot of women had suffered horrible side effects, I’m thankful that the contraceptives are in fact developed, accesible and available to so many women around the globe. There’s still work to do to guarantee education and access to them worldwide.

“The argument that men are significantly more fertile than women is a valid reason to focus on development male contraceptive” no, after learning about how hard it is to develop hormonal male contraceptives and putting in perspective the two sides of the procreation process, I understand that is not lack of interest, money or a power move (completely). I understand a bit better that is a different and more complex problem to solve and this is a very solid reason why it was developed first for women and why is already available and widely used. This doesn’t mean I’m okay with the responsibility distribution. I would like to see hormonal contraceptives for men in the near future, please keep working on it.

This was such an interesting journey and I’m looking forward to hear from you all, to hear about your own perspectives, opinions, what am I missing on this situation?, and I hope after this thoughts you could have a better understanding of the hormonal male contraceptive situation and why I’m so glad the pills exist (even with the side effects and unbalanced power situation). Hopefully this topic can spark an interesting conversation with your partner(s), friends, parents, or someone in social media (but don’t forget about this). Thanks for being here and don’t forget you can now subscribe to the email list in the form below to receive the posts in your inbox with notes from the editor. And special thanks to Mar for joining the cause and spread the word.

See you next time.

Annie