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
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).
Thanks for the comment! Agree that it's not the only issue. I think the data isn't entirely clear on the safety side of things. Some studies have reported a very low incidence of side effects, e.g. one on injected testosterone undecanoate and another on testosterone gel showed minimal adverse events - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419257
Very interesting point about the positive nature of some of the side effects, I suppose it's still considered an unsafe % even though they might be welcome!
I think another reason male birth control hasn't been developed (not to do with commercialisation) is because it's a slightly strange use case. I can't think of any other medication where the purpose of you taking it is for someone else body rather than your own. Not sure if I'd entirely trust someone to be adherent to something I would have to bear the consequences of.
For TRT the main concern with gels tends to be the transfer risk rather than the direct side effects. Essentially it's very easy to be accidentally applying the gel to a romantic partner - who could potentially have side effects from it.
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Intuitively I quite like the non-hormonal options of blocking the vas deferens. I haven't followed the research on it though.
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The use case is an interesting point. Any contraception which is done outside the act has to rely on trust, including female oral contraceptives, IUD, etc. Obviously the consequences are uneven, but unexpectedly becoming a father isn't typically consequence free.
I imagine two main use cases:
1) Belt and braces. Sexually active, unpartnered males who use it as an additional precaution ('she might not be on the pill, I'm definitely on XYZ'). Although it likely increases their risk-appetite for unprotected sex with casual partners.
2) Pill alternative. Partnered males using it as the sole contraceptive in a relationship.
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Contra my own point - it's pretty well known that steroids (even at TRT levels) function as a male contraceptive and they are very readily available. But I haven't ever heard of anyone intentionally using them for that purpose (as opposed to being jacked).
This was another interesting study which also involved injection into the vas deferens, but I think the mechanism involves killing the sperm cells rather than the physical blockade - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798614/
Totally agree there is a life consequence for both men and women, I meant more because the physical consequence of pregnancy only impacts women it feels like an unusual use case for a medication. The 'belt and braces' situation is interesting - I wonder what the uptake of that would be like (looking at the surveys it's not entirely clear whether the men were single or partnered).
I actually didn't know that about steroids! That could be an interesting selling point: get hench and prevent pregnancy
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
-----
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).
Thanks for the comment! Agree that it's not the only issue. I think the data isn't entirely clear on the safety side of things. Some studies have reported a very low incidence of side effects, e.g. one on injected testosterone undecanoate and another on testosterone gel showed minimal adverse events - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419257
Very interesting point about the positive nature of some of the side effects, I suppose it's still considered an unsafe % even though they might be welcome!
I think another reason male birth control hasn't been developed (not to do with commercialisation) is because it's a slightly strange use case. I can't think of any other medication where the purpose of you taking it is for someone else body rather than your own. Not sure if I'd entirely trust someone to be adherent to something I would have to bear the consequences of.
For TRT the main concern with gels tends to be the transfer risk rather than the direct side effects. Essentially it's very easy to be accidentally applying the gel to a romantic partner - who could potentially have side effects from it.
----
Intuitively I quite like the non-hormonal options of blocking the vas deferens. I haven't followed the research on it though.
----
The use case is an interesting point. Any contraception which is done outside the act has to rely on trust, including female oral contraceptives, IUD, etc. Obviously the consequences are uneven, but unexpectedly becoming a father isn't typically consequence free.
I imagine two main use cases:
1) Belt and braces. Sexually active, unpartnered males who use it as an additional precaution ('she might not be on the pill, I'm definitely on XYZ'). Although it likely increases their risk-appetite for unprotected sex with casual partners.
2) Pill alternative. Partnered males using it as the sole contraceptive in a relationship.
----
Contra my own point - it's pretty well known that steroids (even at TRT levels) function as a male contraceptive and they are very readily available. But I haven't ever heard of anyone intentionally using them for that purpose (as opposed to being jacked).
Good point about the transfer risk of the gel!
This was another interesting study which also involved injection into the vas deferens, but I think the mechanism involves killing the sperm cells rather than the physical blockade - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798614/
Totally agree there is a life consequence for both men and women, I meant more because the physical consequence of pregnancy only impacts women it feels like an unusual use case for a medication. The 'belt and braces' situation is interesting - I wonder what the uptake of that would be like (looking at the surveys it's not entirely clear whether the men were single or partnered).
I actually didn't know that about steroids! That could be an interesting selling point: get hench and prevent pregnancy