Contraceptives: The male pill is almost here—Will men take it?
YCT-529 is the only non-hormonal contraceptive pill for men. A study revealed a 99 per cent its effectiveness rate. If approved for use, it would be the first male oral contraceptive.
What you need to know:
- Despite scientific progress, social attitudes and misinformation may hinder widespread acceptance of male contraceptive methods.
- Male contraception promises equality in family planning, but uptake depends on trust, culture, and overcoming long-held fears.
The burden of contraception has always been borne by women. A 2021 article titled Male contraception: What do women think? by C. Richard and others indicates that the main reasons for the inertia in developing a male pill are “lack of industry involvement, doubts concerning the need for a male contraceptive method (and) physiological characteristics of spermatogenesis”.
While women have a wide array of contraceptive methods, men are limited to the condom, vasectomy, abstinence and withdrawal. Richard et al highlights an additional method called Thermal Male Contraception, which requires men to wear special underwear that increases testicular temperature by two degrees centigrade to reduce fertility. To be effective, the underwear has to be worn for at least 15 hours a day, a tedium that makes the method dead (and buried) on arrival.
But a recent study shows significant advances towards development and approval of a male oral contraceptive (pill). Anarticle by Mary Wangari (Daily Nation, April 30) reveals a 99 per cent effectiveness rate of the pill YCT-529. If approved for use in humans, it would be the first male oral contraceptive.
Developing the male pill appears to be buoyed by consistent findings that men would be willing to use such contraception and women would welcome it. A 2012 study in France established 61 per cent approval by men, with 91 per cent affirming that contraception should be a shared responsibility.
Another study in Australia established that 75.4 per cent of male respondents were affirmative. The more recent study by Richard et al established that 69.7 per cent of women “were in favour of letting men deal with contraception” although this reduced to 46.7 per cent when given additional information about existing male contraceptives and those under development.
The necessity of the male pill arises from the shortcomings of the other methods. The condom, discovered in 1839 by American scientist Charles Goodyear, reduces sexual sensation and is easy to sabotage through power dynamics in relationships. A study, What About Methods for Men? A Qualitative Analysis of Attitudes Toward Male Contraception in Burkina Faso and Uganda by Alice F. Cartwright and others, records “perceptions that condoms reduce sexual pleasure or indicate infidelity, and men’s concerns that vasectomy will affect them physiologically or signify to others that they have lost their ‘masculinity’”.
Although vasectomy is now reversible, this does not guarantee conception, which renders the same a mere gamble for rebounding fertility. Moreover, it commands low levels of use, at only 0.1 per cent in Sub-Saharan Africa, according to Cartwright et al. Withdrawal has a high failure rate because it relies on rationality and control, which are easier said than done. Abstinence requires a high level of discipline and is antithetical to marriage.
Cartwrightet al highlights reasons for support of male methods among both men and women in Uganda and Burkina Faso. First, male contraception would enable men to share with women the burden of managing fertility. Simply put, it takes two to tango (even to tangle). Respondents in Uganda added that it would provide a backup where the woman could not tolerate a specific method.
Second, male contraception would deter extramarital pregnancies. This would divest women of care for children from the husbands’ philandering in communities where custom requires such offspring to be taken to their biological fathers. Three, the pill would widen the choices for men, hence overcome the shortcomings of existing methods. Four, men would “make their own contraceptive choices” without being constrained by the fertility desires of their partners.
A number of reasons were registered against male contraception. One was the feeling that new methods are superfluous given reluctance by many men to use what is available. Two was the fear of side effects on libido, performance and fertility.
Third was the convention that women have been the primary targets of contraceptives. Introducing a male pill would thus be merely exploratory and could even spread the negative side effects to men. Fourth was that the pill would be futile in polygamous marriages where there are “differing fertility desires of multiple wives”.
Getting YCT-529 out would be a remarkable development. Yet it would be the easier part. The more challenging one would be to get it widely accepted and used. Another would be to diversify the male contraceptive methods to address attitudinal concerns as well as physiological toleration levels.
Fears of the likely side effects may be allayed by the fact that the pill is non-hormonal (does not affect libido as it leaves testosterone levels intact) and findings that fertility rebounds within 6-15 weeks of stopping use. Whether these would be adequate arguments in reality will only be determined once the pill is out.
The writer is a lecturer in Gender and Development Studies at South Eastern Kenya ([email protected]).
