It’s a conversation that most women will be familiar with. The tales of weight gain, of moods swings, of unexpected pregnancies. Periods that never start again. Periods that never stop. Birth control gone bad is a topic that ties inexorably in with discourse on sex—and the results are not always good.
News broke last week that a male contraceptive compound has been successfully tested, giving hope that a so-called ‘male pill’ without side effects could soon be a reality. The drug, known as EP055 targets a protein on the surface of the sperm, limiting their ability to move. Crucially, and unlike most pharmacological contraceptive choices available for women, EP055 does not rely on hormones. This research comes in the wake of a halted 2016 roll out of a hormone-based male contraceptive that was pulled due to side-effects, including mood disorders, muscle pain, acne, and decreased libido.
For women everywhere the news of a male contraceptive will be encouraging, but marred with reminders of how significantly birth control options are currently lacking. Safe and reversible options for male contraception are not expected to be on the market anytime soon, and current trials bring into focus a lack of comparable concerns with the side-effects of oral contraceptives aimed at women.
Although statistics are few and far between, at last reliable count, over three quarters of women aged 16-49 in the UK were using some form of contraception. How many of them were happy with their prescription is a more shrouded matter.
Most of us know a horror story and will nod knowingly when the topic comes up.
“My friend was diagnosed with depression within weeks of changing pills,” you might say, “as soon as she switched back she was fine.”
As anecdotal as most of this evidence may be, the warning labels on packs of pills and the NHS’s guidance tell a worrying tale. When nausea, blood clots, and cervical cancer are listed as side-effects of the contraceptive of choice for many women, then there are crucial questions to be asked.
For me, this issue is personal. At the age of 24 I became the statistic that doctors tell you not to worry about. The estimated 12 women in every 10,000 who get a blood clot on the pill per year. That figure sounded small sat in my local GP’s office as he wrote out my first prescription. As I was injected with blood thinners and told how dangerously close to death I had come on a Friday night in A&E it seemed colossal.
Research into male contraceptive methods finally seems to be making progress, and the importance of every medicine being thoroughly tested and deemed safe before release cannot be understated. The disparity, however, between what side effects that are seen as par for the course for women, and side effects that stop trials in their tracks for men is glaring and uncomfortable.
The contraception controversy barely scratches the surface of a world where women’s health is regularly overlooked. In spite of notable exceptions where men are similarly in second place—mental health and the underfunding of prostate cancer research jump to mind—the global disparity between male and female health options and outcomes in favour of the XY chromosome is evident.
The reasons for this are as numerous as they are complex. Although much has been done to improve gender equity in clinical medicine, research remains heavily male dominated. In 2016 it was estimated that only 28.4% of the world’s scientists employed in research and development were female. In addition, the vast majority of clinical trials are still carried out on men—creatures with vastly different anatomies to their female counterparts. More women currently die annually from cardiovascular disease than from all cancers combined. Why? Because most of what we know about the symptoms of heart attacks is based on research conducted on men, causing misdiagnosis to be 50% higher in female sufferers.
More telling are the examples that play into age-old narratives of female health. It takes, on average, seven to eight years to be diagnosed with endometriosis, a condition that up to 10% of women experience, often because women are reportedly not trusted to accurately describe their symptoms. One study showed that women are inadequately treated for pain, in some cases being given sedatives rather than pain medication (one cannot help be reminded of centuries old stories of women confined to asylums for hysteria). Numerous women are now suing the NHS after vaginal mesh, used to treat incontinence or prolapse after childbirth, caused pain, infection, and in one case death. In this instance the Medicines and Healthcare Products Regulatory Agency argued that the benefits outweighed the risks, despite the many women whose lives were destroyed by this procedure ardently arguing otherwise. The difference between this and the attitude to the side effects of the male contraceptive pill are significant.
The image of emotive women unable to effectively evaluate their own pain levels is one narrative that is difficult to break. The great contraceptive debate plays into another—a longheld and constraining perception of female sexuality. The impact of a constant influx of hormones on our body fits neatly into a wider discourse on sex where women are second-class citizens—where our libido, happiness, and sexual pleasure are secondary to those of our male counterparts. As long as female sexuality and health are devalued, as long as side-effects like a loss of libido and vaginal dryness are shrugged off, solutions for an improved method of protecting our sexual health continue to be a distant dream.
For me, traumatised after a major and terrifying health event which culminated in a kindly junior doctor chasing me down the corridor to tell me not to move my arm for risk of inciting an immediate and devastating heart attack, I found answers to my questions sorely lacking. Doctors who shrugged and told me that no contraceptive method is foolproof only left me wondering why solutions have not yet been found for a problem that medicine seems to want to ignore.
It’s time to take women seriously in all arenas of health. When a woman reports to A&E we have to trust that they know their bodies and can reliably report their symptoms. We have to take side-effects seriously, whether they impact us physically, emotionally, or socially. We have to demand more from contraceptive choices and advice—and if better isn’t an option then we need to be asking why. The news of a successful male contraceptive is a step in the right direction. Let’s hope it’s the first of many towards ensuring a healthier future for women.