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The pill and gender equality

There is not so much a taboo surrounding male contraception as a discussion deficit. With almost every woman using some form of contraception at one point in their life, the emergence of an effective male contraceptive should come as no surprise. Yet with (sometimes) unreliable condoms and (almost always) permanent vasectomies as the current alternatives, men and those who produce sperm are frequently left out of the contraception conversation. It’s time for the other half of baby makers to step up and share responsibility.

NES/T is making that possible. The University of Edinburgh and Manchester University NHS Foundation Trust are part of a study led by St Mary’s Hospital in the UK, bringing male contraception into closer reach. A daily gel applied to the upper arms and shoulders is a hormone-based treatment to supress the production of sperm. First trialled in the 1970s; researchers have been testing a male equivalent to the pill for decades. The science, however, is far more complicated since the hormones needed to supress sperm production can have severe implications.

Today more than 100 million women are on the pill, bringing side effects like weight gain, mood swings and decreased libido, that women and those who can carry children are constantly having to navigate. With 45% of pregnancies and one third of births in England currently unplanned, this development in the contraception space is important. But are we ready?

A third of sexually active men in the UK say they would consider using contraception. Yet the fact remains that those who produce sperm will never, in fact, be the one carrying the child for nine months. Would you trust a sexual partner to be responsible enough given the ultimate weight lies with you?

The pill was a historical achievement for gender equality. Contraception gave women, and those who can carry children, a freedom which revolutionised their sexual experience. It also gave them control over their bodies and their futures, the ability to postpone childbirth in favour of pursing higher education and employment. Yet with this comes the all too common side effects and heightened burden of preventing an unplanned conception. So, it seems we have come full circle: men and sperm producers can share this responsibility.

In previous trials the male participants complained of mood swings, acne and sore muscles, leading some to be discontinued. Yet, the stated side effects are just three among those commonly experienced with female contraception. This led many to note an apparent double standard: a different tolerance for side effects depending on gender. However, NES/T gel is a combination of progesterone, to reduce sperm production, and then added testosterone, to recompensate for the drop of testosterone this causes. Men on this recent trial have claimed minimal side effects, with some enjoying higher sex drives.

According to Dr Cheryl Fitzgerald, a consultant in reproductive medicine at the Manchester University NHS Foundation Trust, we are still over 10 years away from male contraception being widely available. But starting the conversation is imperative. Removing the social barriers and eliminating the emasculating stigma is vital in making space for and accepting an alternative.

While welcome, the availability of an effective male contraception does not necessarily equate to its widespread usage. Sterilisation rates, comparably, are ten times more common worldwide than vasectomy rates, despite the higher associated costs and potential complications, and reduced efficacy.

Scientists have been working on an alternative contraception for almost half a century – it’s an immense achievement. More than anything, the emergence of NES/T brings flexibility. It reinforces two important truths: both partners are responsible for conceiving, and thus the duty to prevent it. And secondly, men and those who carry sperm, should take a more active role in understanding reproductive health as well as the trials and tribulations that come with contraception in general.

Image: reproductive healthcare via unsplash