It Takes Two to Tango

by Navya Baranwal '20

Women have been rushing to get the birth control pill ever since it was approved by the FDA in 1960 [1]. While it has been in use for decades, men resort to more typical methods of contraception such as condoms or withdrawal. There’s also vasectomy, in which the tubes that carry sperm are blocked, but let’s be real: a permanent procedure like this prevents males from being fertile ever again, and so is extremely rare [2]. Meanwhile, a woman’s options for contraceptive measure include birth control pills, female condoms, the patch, the ring, the shield, film, implant, sponge, diaphragm, and the list goes on. According to the Center for Disease Control, 16.0% of women aged 15-44 are currently on the birth pill. The birth control pill has fairly drastic consequences, forcing us to ask this question: why is it that women have to take such brute measures to prevent pregnancy, but men can get away with putting on some latex covering?  There’s no doubt that men truly need to take a more active role in contraceptive measures. 

---

Men produce millions of sperm every day - however, women have a finite amount of eggs, which are regulated by monthly cycles (or ovulation, which is the release of an egg).  The birth control pill prevents pregnancy by stopping the ovulatory cycle, making fertilization impossible. This is done through the pill’s release of two female hormones - estrogen and progestin - which make the uterine lining hostile for a fertilized egg and thicken the cervical mucus to hinder a sperm’s journey [3]. While this combination pill is more effective, some side effects can include extreme nausea or breast tenderness, inducing some to opt for the progestin-only pill [4].


Although scientists have yet to find an effective biological birth control method for men, there has been ongoing research to develop a male birth control pill. The Parsemus Foundation has been developing Vasalgel, a non-hormonal male contraceptive, which will potentially be released between 2018 and 2020 [5]. Vasalgel is a polymer that blocks sperm; however, as of now, it is not a purely reversible method, and is thus simply an alternative to the vasectomy. There have been animal studies conducted on rabbits in which a second injection of sodium bicarbonate (baking soda) flushes out the Vasalgel, but more studies must be conducted to see if reversibility is truly an option.


There was some hope for a “safe and effective reversible method for male contraception” when the World Health Organization employed a trial to test a two-hormone injection intended to lower sperm count [6]. The study focused on healthy men aged between 18 and 45 years old, and of the 226 female partners, only four got pregnant. Things were looking good in the realms of safe sex until 20 men in the study complained of the side effects that included acne, increased libido, weight gain, and mood swings.

---

Various reactions to the results of the male birth control study

​In comparison to the side effects of women’s birth control pill (nausea, breast tenderness, headaches, weight gain, mood changes) these side effects seem almost negligible. The potential for a male contraceptive pill has been zapped away because men can’t handle what 10.6 million women on the pill in the United States go through every single day [7]. This dilemma delves into the deeper issue of who bares the heavier burdens in an unwanted pregnancy. Sadly, it is women who have to go through the risks of getting pregnant. Since the study showed that the male birth control injection was effective (despite its side effects), it is only a matter of time until the value of such an injection and the fact that some side effects should be sacrificed for pregnancy-prevention are realized. Let's give it another shot (literally!) because the prospect of a male birth pill would truly lighten some of the load off of women. After all, it takes two to tango.

Sources:
[1] http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/
[2] https://www.plannedparenthood.org/learn/birth-control
[3]  http://goaskalice.columbia.edu/answered-questions/how-do-birth-control-pills-work
[4]  https://bedsider.org/features/89-which-birth-control-pill-is-right-for-me
[5] https://www.parsemusfoundation.org/projects/vasalgel/   
​[6] http://press.endocrine.org/doi/10.1210/jc.2016-2141
[7]  http://www.cdc.gov/nchs/data/nhsr/nhsr060.pdf