Beyond X & Y

Beyond X & Y: Men Seem to be on Board with Taking the Pill

"The goal is to de-gender reproductive health," said the lead author on an acceptability trial for a male oral contraceptive

November 2, 2020
The letters "se" and "xy" moving toward each other horizontally, pressing together, and then separating as "s" and "x" move upward and "e" and "y" move downward out of frame
Gender and sex beyond X & Y. [Credit: Niko McCarty | CC BY-NC-ND 2.0]

On Oct. 26, Amy Coney Barrett was confirmed to the Supreme Court. Her pro-life stance is well-documented, and her appointment brings the state of legal abortion in the United States into question. While issues of birth control and pregnancy have historically been considered the responsibility solely of those who get pregnant, it’s crucial to recognize that men have a role in it too.

Every so often a study will come out testing a male contraceptive pill, gel or injection. (I still remember when the injection study was released and most of my cis male friends were horrified and I am so certain they don’t know the first thing about IUD insertion.) But how do we know that once we have safe, effective birth control that works for all reproductive systems, how do we know there will be willing takers?

Rather than safety or efficacy, a small trial gauged acceptability and ease of adopting the routine among volunteer participants. If men in this country are willing to adopt a daily birth control regimen, it could ease the risk of unintended pregnancy.

“It really doesn’t matter if we make the most perfect male contraceptive if men aren’t ready to use it,” said Dr. Brian Nguyen. Dr. Nguyen’s on the obstetrics and gynecology faculty at the University of Southern California and the study’s lead author.

But if the findings hold in a larger study, they could suggest a cultural shift for the better in reproductive health and responsibility. “There has to be some degree of balance to alleviate the burden from women,” Nguyen said. “The goal is to de-gender reproductive issues.”

Here’s an overview of the study, which determined acceptability by asking, for example, how displeasing or difficult participants found the new daily pill:

 

  • Results based on participant responses to a survey:
      • 80% of participants reported satisfaction
      • 77% would recommend it
      • 54% said they would use the pill as their primary contraceptive were it available
  • Details
      • Randomized double-blind trial
      • Lasted 28 days
      • 57 healthy men* took a once-daily capsule
        • 39 received the contraceptive dimethandrolone undecanoate (DMAU)
        • The rest got a sugar pill; this was to note potential side effects from DMAU (all participants were advised not to use this pill as birth control with their partners)
          • In fact, more people who took DMAU responded favorably to taking an oral contraceptive than those who got the placebo
  • Limitations
    • Limited sample size/diversity
    • Brief duration
    • Self-selection may have come into play
      • Logan Nickels, research director at the Male Contraceptive Initiative: “It’s dealing with a population that’s not so big to begin with: people in clinical trials for male contraceptives.”

 

Nguyen suggested other potential benefits for men taking this drug, too, such as increased muscle mass and libido. A daily pill could also encourage more holistic sexual healthcare habits in men, such as regular STI testing. 

A male contraceptive could hit the market in 10 or 20 years, Nguyen estimates. “But the speed all depends on how much we can get the word out in ways that will increase cultural awareness and acceptance of the concept,” he adds. Male contraceptives could help improve the world for everyone, but only if men embrace them.

 

*”men” here refers to cis men, since some men don’t have penises and some people with penises aren’t men. As we know, reproductive organs and gender aren’t cut and dry.

About the Author

Elana Spivack is a freelance science writer in the New York City area and contributor to Scienceline. When not on deadline (or sheltering for a pandemic), she enjoys salsa dancing, bike riding and befriending bodega cats.

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