The female contraceptive pill – dispensed on the NHS for more than 50 years – is just one of many choices available to women in 2019, along with the cap, diaphragm, implants, injections, the patch, female condoms, IUD, the coil and vaginal rings. But men still have just two options: a condom or a vasectomy.
With only one of those options offering a non-permanent solution, men hardly have a surplus of choice when it comes to protecting themselves – and their partners – against unwanted parenthood.
If the arrival of the pill in the 1960s was seen as a symbol of female liberation, is this ongoing shortage of contraceptive options for men a sign of male (or indeed female) oppression by science – or of men willingly flying under the radar of innovation because it’s easier to abdicate responsibility?
Gregory Pincus, who co-invented the female contraceptive pill, first tested the same hormonal approach on men in 1957 – 62 years on, we’re still waiting.
The reasons for this delay depend on who you listen to: the difficulties of drug development; the argument that it is harder to stop millions of sperm than one egg; lack of financial investment; women not trusting men to take a pill; a lack of male enthusiasm for doing so.
Some says that it’s a case of chicken and egg: the male pill is not available so men don’t push for it so there’s less impetus to make it a reality. But a YouGov survey from September 2018 found a third (33%) of men would theoretically consider taking the pill if it was available. And the prospect of a viable hormonal contraceptive for men is less of a feminist fantasy than it once was.
In March 2019, it was announced that at least one pill, which contains hormones to stop sperm production, has passed initial human safety tests. Other trials at the University of Edinburgh (and separately at the University of Washington) are looking at a body gel containing the progestin hormone, which blocks testosterone production and reduced sperm to low or nonexistent levels when applied in early test results.
If these products took 10 years to reach the market – the likely timeline given by the scientists involved – would men be ready to take them when they were available? Would they relish the opportunity to manage their own fertility as women have done for so long or feel a sense of obligation to do so?
Chris, 26, from Leytonstone in London says he would see it as a duty to step up, if he could for his long-term partner who has taken the female pill for the entirety of their relationship. “Women often feel they have no alternative, so it would be good to carry some of the burden if it was available,” he says, while admitting that he isn’t excited at the prospect.
With women in the UK increasingly swapping hormonal contraception for other methods such as fertility tracking apps, citing the impact on their physical and mental health, is it time to ask why there isn’t demand for more choice for (and from) men. Vasectomy rates in England have fallen by 64% in 10 years, suggesting that responsibilities falls more than ever with women.
These responsibilities include the time and energy spent on visiting your GP or sexual health clinic, collecting prescriptions, undergoing potentially invasive procedures, acclimatising to side effects, feeling stress about unintended pregnancy, and moral reproach for forgetting to take a pill.
Like Chris, 23-year-old Kyle from Manchester also relies on his partner to protect them both from an unwanted pregnancy. Kyle’s girlfriend initially took the pill when they started sleeping together, but experienced side effects and later came off it. Kyle says he used condoms short term but disliked them, so his partner agreed to have a coil fitted instead. “I don’t really enjoy using condoms which leaves the responsibility on my partner,” he admits.
Things would be very different if there were a male contraceptive pill, he says – and he would take it: “I’d be happy to have another option to take more control and responsibility.” But his male friends aren’t all so enthused. “There are very mixed opinions – it seems to be a 50/50 split of men looking forward to it or willing to try and men who wouldn’t dream of going anywhere near it,” he says.
“Any dude not willing to at least consider needs a very good reason in my opinion..."”
Some of the men who spoke to HuffPost UK are currently sharing contraceptive duties with their partners and said they would actively seek out the male pill if they knew it was available, rather than feeling an obligation to do so.
“Having a male pill would be really valuable for me and my partner,” says Ben, 27, from London, whose partner does not take the pill for medical reasons. The couple use condoms, which neither of them enjoy because they get in the way of spontaneity when they are having sex. Ben is also bothered by how gendered an issue contraception has become in their relationship (though adds that he would feel differently if he were single, because of the added risk of STIs).
Single men appear to have more reservations than those who are coupled up. Tom, 31, from York, who is not in a relationship, says he would only consider taking male hormonal contraception if he got into a relationship because he would be worried about protection from STIs during one night stands.
He also raises concerns about potential side effects such as weight gain, acne or mood swings. In 2016, 20 of 320 participants dropped out of a male pill trial citing these issues. Most women will know these as commonly-accepted potential side effects of the female pill – alongside headaches, migraines, decreased libido and nausea, they’re listed on the NHS website and your GP will talk you through them when you are first prescribed the contraception.
Tom says he would want to speak to men who had taken the contraception to see if they’d experienced side effects: “I’d want to do my research first.” The latest tests, in March 2019, did not see men experiencing side effects according to a presentation of the findings at the Endocrine Society’s annual meeting.
Would other men be willing to tolerate them? “It would depend on what the side effects are and how severe.” says Chris, while acknowledging there’s a double standard. “Women have these concerns and still take the pill,” he notes.
James, 29, from Glasgow, who is in a new relationship says: ”[I think] side effects mean something works! I already have problems with weight and acne and the girlfriend has those issues so, hey, maybe it’s a bonding exercise?”
So if men are up for trying it in theory, would they remember to take it in practice? Women are sometimes blamed for halting the arrival of the male pill: a UK survey by Anglia Ruskin University, in 2011, found 70 out of 134 women would worry that their male partner would forget to take a pill each day
Chris says it’s a valid concern but he would make it work: “I’m not particularly good at remembering things. But I feel as though I should be able to step up. It only takes a daily alarm on a phone.” It might initially be a challenge, agrees Ben, but having the days listed – as on most female pill packets – would help him stick to a routine. “It would take a while of taking it regularly for me (or my girlfriend) to be able to be confident I hadn’t forgotten it,” he admits.
Meanwhile, Matt, 29, from Swindon, who is married and “heavily in favour” of the male pill, says: “I already take loads of medication so I’m unlikely to forget, or if I do I’m forgetting a load of more important drugs as well!”
He would like to see a time when society places as much expectation on men as on women to bear the burden of contraceptive responsibility. “Any dude not willing to at least consider needs a very good reason, in my opinion,” he says.
So what next? Multiple experts in the field, including John Amory, research physician at the University of Washington School of Medicine and Dr Logan Nickels at the Male Contraceptive Initiative in North Carolina have made the same joke – “the male contraceptive has been five years away for the last 40 years”. So, for now, we wait.
Some names have been changed to protect identities.