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            17 / 08 / 16

            Why aren’t we more excited about new forms of male contraception?

            • Efforts to avoid pregnancy have existed since ancient times, from Chinese cocktails made of lead and mercury to plants the Greeks drove extinct, such was their appetite for their supposed contraceptive powers.

              Men have used condoms for centuries, but it wasn’t until 1960, when the US Food and Drug Administration approved the birth control pill, developed by Planned Parenthood founder Margaret Sagner, that women finally had control when it came to having sex and avoiding pregnancy. With IUDs, patches, and a variety of other options currently on the market, women now have more choices of birth control than ever before.

              Male birth control options, however, are still limited. Other than condoms, which many believe diminish sexual pleasure, and vasectomies, which involve minor, reversible surgery, men have few alternative forms of contraception.

              A male birth control pill was in development in the US in the 1990s, but the project was abandoned due to minor headaches and other side effects. A new form of male birth control may reach the market in just a few years.

              Reversible Inhibition of Sperm Under Guidance (RISUG) was first developed in India in the 1970s. It is a small amount of gel injected into a man’s vas deferens, a tube that helps connect the testicles to the ejaculatory ducts, which prevents sperm from being released during sex. The gel is effective for about 10 years, but can also be reversed at any point with a small incision. RISUG was abandoned in India due to a lack of research volunteers, but was patented in other countries such as the US, which is currently in the process of developing Vasalgel, a product similar to RISUG. Vasalgel is expected to be available in the US by 2018. The Paramus Foundation provides more up to date information on the product on their website.

              Why has it taken RISUG so long to reach the market, and why isn't their more excitement about it? To really understand this question, it's important to look at traditional notions of masculinity and virility.

              The word virility now means a “characteristic of a man; marked by manly force,” but it’s been associated with sexual potency since the 1500s. Undergoing a procedure that denies a man the ability to impregnate a woman may contradict deep social codes of masculinity.

              To better understand attitudes, we asked 60 men and women from around the world to talk about male contraception and masculinity. Although responses to alternative forms of contraception were mostly positive, there was still significant resistance based on beliefs that people “wouldn’t feel comfortable taking a shot that makes sperm ineffective,” and the fact that “beyond condoms, [birth control] has always been a ‘woman’s thing’.” Only one male respondent said he would be willing to receive a RISUG injection.

              Yet with more males taking on roles historically thought of as female, becoming school teachers or cooking and cleaning at home, the idea of men being responsible for birth control could also become more accepted over time. In a recent study of over 9,000 males from around the world, more than 60 per cent said they would be willing to use some kind of new male contraceptive.

              There has also been support for Vasalgel and new male contraceptives from females, who could be spared the expense, inconvenience and adverse side effects of birth control pills. On the other hand, in our survey women said they trusted men with condoms because they could see them, and weren't sure men would be as honest or diligent about birth control if they were in charge because “the stakes are not as high for them”.

              If, despite concerns, it does take off, RISUG or Vasalgel may not be good news for condom and contraceptive pill manufacturers. Males may see Vasalgel, which is estimated to cost $1,000, as an alternative to condoms, though the latter still has the advantage of being able to prevent STDs. Couples may decide that a male partner receiving Vasalgel is less harmful than a female partner taking hormonal contraception, though marketers of birth control pills could still appeal to a woman’s desire to control her own reproductive system, and espouse the pills’ added benefits of relieving period-related pains such as headaches and cramps and helping clear up acne.

              Ultimately, it would be smart of these companies – and any others looking to compete in the contraceptives market – to keep track of potentially game-changing cultural shifts in masculinity.

              Health through the Culture Lens is a weekly series exploring important cultural currents in health and pharma

              • Article by Paul Irizarry