Hi there,
It’s International Women’s Day!
This week I’m talking about contraception. Preventing pregnancy is important to women and men, but the responsibility is placed primarily on women. This needs to change.
Current contraception methods are not good enough
The most common birth control method used by women in Europe and the USA is the hormonal contraceptive pill. It first became available in the 1960s and hasn’t changed much since, despite side effects being prevalent.
Last year, there was an outcry about the blood clotting risk associated with the AstraZeneca Covid vaccine. The risk of blood clotting from the AZ vaccine is 1 in 200,000, while the risk from the birth control pill is about 1 in 3000. This is significantly higher than the vaccine but is silently deemed an acceptable risk for women around the world who take the pill every day.
Non-hormonal contraceptive options are limited, and not much better. One of my good friends described the copper coil as a Victorian-era torture chamber. Yet we continue to shoulder the burden of contraception.
Women suffering is a price that society is willing to pay.
Male contraception is limited
Currently, the only options for male birth control are condoms and vasectomy.
Male hormonal contraceptive pills, gels, and injections have been developed. They involve using testosterone and progestogen to decrease sperm production. Surveys conducted internationally show that 44-83% of men would welcome the opportunity to use these methods. However, none of them have been commercialised.
The answer as to why is unsurprising: money.
There isn’t much financial incentive for pharmaceutical companies to develop male birth control (or to develop better birth control options for women). They can make more money from other types of drugs. And as a society, we haven’t shouted about the need for alternative methods. Instead, we’ve quietly normalised the concept that women will tolerate pain.
New technology can help
New contraception methods are being created (such as digital contraception), though they still primarily place the responsibility on women rather than men.
Here are a few interesting non-hormonal approaches to male birth control being developed:
Coso uses ultrasound to temporarily reduce sperm count. A few studies have been conducted on ultrasound contraception in animals, but further research needs to be done in humans to better understand contraceptive efficacy and reversibility. This approach is promising because it’s a quick and non-invasive treatment that can be done at home, and has the potential to be effective for several months.
Contraline has created a hydrogel that is injected into the vas deferens (the tubes that transport sperm) to block the flow of sperm. It’s minimally invasive (certainly less invasive than the IUD currently available to women) and should be effective for about a year.
These solutions are not yet commercially available, but it’s promising that funding is going towards balancing the responsibility for contraception.
I’m trying out some new sections for the newsletter - let me know what you think!
Question of the week
New technologies and increased public attention does give me hope for future progress when it comes to contraception, and women’s issues more generally. But I can’t help but feel frustrated that these issues still exist in modern society. Sometimes I wonder if things will ever change.
This feeling reminds me of a Chinese proverb:
The best time to plant a tree was 20 years ago. The second best time is now.
The current state of the world can feel disheartening. At both the individual and societal scale, trying to change things might feel like a lost cause, too late, or pointless. But it’s not.
It’s time to start planting.
So with that, my question for you is: What seed can you plant today?
Link of the week
Companies everywhere are virtue signalling by making the obligatory International Women’s Day post today, but many of them aren’t making any real changes. This is a bot that retweets these posts with the company’s gender pay gap. Genius.
That’s all for now. Have a wonderful week!
I don't think it's true that commercialisation is the issue. The surveys pretty clearly show men are interested and would pay for it - even given the side effects.
Take for example the 2016 study - it was discontinued because of concerns by the safety committee, however 75% of the men were actually keen to continue the trial. This is despite the fact that the side effects were much much higher than they are on the pill. Source: https://www.vox.com/2016/11/2/13494126/male-birth-control-study
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Of course what the coverage doesn't mention is the side effects which the participants were most likely very happy about. Increased libido, increased muscle mass, reduced bodyfat, etc. The hormonal approaches all boil down to *literally* taking steroids - with all of the pros and cons of doing that.
Both the 1970s study (200mg/wk) and the 2016 study (1000mg/mnth) are well above a hormone replacement regime (about 100-150mg/wk).