Photo Credit: Tishina Okegbe
Post written by guest blogger Kathryn Carpenter, MPH, Advocacy Strategist, Male Contraceptive Initiative
The field of male contraception
New methods of male contraception are needed that allow men to contracept reversibly, and on a long-term basis. Men currently have access to condoms and vasectomy, but neither are long-lasting and reversible; additionally, condoms have a typical-use failure rate of 15%, and also have adherence and acceptability limitations. Because of reversibility limitations on vasectomies, they must be considered permanent, limiting their use to men whose families are complete. Many different new methods are under development, including those that inhibit sperm production and/or impact sperm function. They include non-hormonal and hormonal drugs, which can be delivered as gels, pills, and injectables, or other methods like vas-occlusion: a gel in the vas deferens that screens out sperm.
Research from the Male Contraceptive Initiative shows that men and women are willing to use new methods of male contraception. In fact, a recent consumer research study shows a potential US market of 19 million men, and that there is a preference for reversible and non-hormonal methods. Another study shows overall acceptance of hormonal male contraceptive by men in 9 countries is above 55%. It’s clear that men are interested in new methods, but beyond the obvious benefit of allowing men reproductive agency, there are also other benefits that we might expect. This blog explores the benefits that male contraception options may provide for men, women, and some sexual and gender minority populations.
How male contraception benefits men
Because reversible male contraception is still under development, one can’t precisely describe the benefits it will provide beyond pregnancy prevention; however, some real possibilities include:
Higher satisfaction in relationships
By creating a new paradigm where both partners in a heterosexual relationship can contracept using reversible methods, it’s possible that satisfaction within relationships will increase. Allowing men to actively participate in the contraception process removes the burden solely from the female partner and may improve gender and relationship dynamics.
Better health, education, and economical outcomes for men and their children
Family planning use has benefits that permeate all aspects of an individual’s social, economic, and physical life. By creating more male contraceptive options, impact could spread beyond men as individuals to familial and societal levels. For example, increasing men’s ability to plan for their children could increase men’s involvement in child-raising, thus, improving the health and familial support of those children.
Lowered risk of transmission of sexually transmitted diseases
Because some methods under development could potentially work through preventing the transmission of ejaculatory fluids while still allowing orgasm, there is speculation that this mechanism could slow or stop the spread of diseases that spread through bodily fluids.
Increased sexual pleasure
Some methods under development have the “side benefit” of increasing sexual satisfaction by improving feel during intercourse. Though no known drug-based male contraceptives are expected to have these benefits, next generation barrier methods like the hydrogel condom may. Additionally, new male contraceptives would allow couples to contracept in ways beyond condoms or the withdrawal method.
How male contraception benefits women
While many women benefit from female contraception beyond pregnancy prevention, many also struggle to find the right option for them. By providing more options for couples to contracept, male contraception positively impacts women too.
Reduced mortality and morbidity
Contraception helps men and women plan pregnancies, which has positive implications for maternal health behaviors, and can lead to better birth outcomes and child health. This can also help women avoid pregnancy and birth-related morbidity and mortality, including complications from unintended pregnancies or unsafe abortions.
Shared burden of responsibility
A broader range of male methods could create more responsibility for men to prevent pregnancy, ultimately creating an atmosphere of shared responsibility. In addition to improving gender outcomes, this shared responsibility takes stress off women and could improve relationship dynamics by making pregnancy prevention a dual responsibility.
Increased health equity
Women often disproportionately carry the burden of unintended pregnancy and its impact. Having more male contraceptive options could help prevent more unintended pregnancies for more women, helping create more health equity between low- and high-resource women.
How male contraception benefits transgender people and people of other genders
Transgender, non-binary, and gender-fluid people use contraception too and need options that work for their bodies and lives. And existing contraceptive options may not serve these needs. A broader range of male contraceptives could help these populations by expanding the method mix to serve a wider spectrum of individuals.
For example, transgender men may be at risk for unintended pregnancy and may have more limited birth control options because of medical therapy use, such as hormonal therapy. Non-hormonal contraception specifically may be useful for these populations. Additionally, because a transgender man may have difficulty finding suitable options to prevent pregnancy, if he has a cisgender male partner, more forms of male contraception offer options for the couple to use, and thus in that way, fill an unmet need in the contraceptive landscape. Ultimately, with an enhanced offering of male contraceptive options, there may be a reduction in health disparities experienced by sexual and gender minorities.
Though new reversible and non-hormonal male contraceptive methods are several years away, we can imagine the potential public health, economic, societal, and familial benefits for men, women, sexual and gender minority populations, and their future children. It stands to reason that the introduction of more methods for four billion men currently without reversible, long-acting contraception will undoubtedly fill unmet contraception need, but it will also have reverberations into other areas of life.