What about male contraception? – The post

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A few days ago the French newspaper Libération published on the front page a appeal signed by some men to ask the government and scientific laboratories to carry on the topic and research on male contraception. The appeal states that it is “an important issue for gender equality in terms of sexual health”, which would, among other things, have to do with the right, even for men, to take control of their reproductive life or at least with the sharing of a responsibility.

The appeal, accompanied by an online petition and a campaign with the hashtag #ContraceptonsNous, was published on the front page of Libération with the title “Stop Giving Your Pill Gilded.” You are addressing the government and, in particular, the Minister of Health François Braun and the Minister for Equality Isabelle Rome. The text explains that contraception affects both men and women, but that today, in France, birth control is still entirely the responsibility of women, “to the point that male contraception seems to be a real taboo”.

It is said that alternatives to female contraception have been under consideration for decades, but that such studies and trials are still in their infancy, due to resistance from the political world and the pharmaceutical industry. But there is also a cultural and information problem.

The arrival of a contraceptive pill for men (which, speaking of the cultural problem, comes from the Italian newspapers often called “Pill”) remains an unfulfilled promise, says the appeal, with the consequence that “many heterosexual men continue to rely on their partners.”

Last spring a report on male contraception was to be presented to the French National Assembly which, it is always said in the appeal, should have contained indications and proposals on free access to condoms for men up to 25 years (today in France they are reimbursable up to 60 percent of just two brands of condoms). But this report has not yet been presented.

The text concludes with an invitation to the government and the ministers concerned to implement in France “a true policy of male contraception. Gender equality will only be real in terms of sexual health when men do their part ”.

Research on male hormonal contraceptives began around the same time that research on the women’s pill began, ie in the late 1950s. But in 2022, the only means of male contraception available in France (and beyond) are vasectomy (which is a surgical procedure with reversibility problems) and condoms (which theoretically have a high efficacy, but lower than that of others. methods: effectiveness which in practice is lower due to some errors in use).

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The lack of interest in the development of male contraception is due to various reasons. AIDS, explains Libération citing Jeanne Perrin, professor of developmental biology and reproductive medicine at the Hospital of Marseille, in the 1980s he actually helped to stop all research on male contraception that did not protect against sexually transmitted diseases. That historical moment, alone, however, is not sufficient as an explanation: “The unwillingness of men, accustomed to relying on women, should not be overlooked,” said Perrin.

In short, a series of stereotypes related to sexuality, bodies and social roles associated with women and men remain rooted, which in turn have many consequences on scientific research. In the calculation of the risk-benefit ratio, for example, while for women the side effects of hormonal dosages are considered as a discomfort to be endured but inevitable to avoid an unwanted pregnancy, in men, explained Mireille Le Guen, expert in evolution in use of contraceptives, the cost-benefit balance is always calculated “in relation to the fact of being in good health” and the balance will therefore always and definitively be negative. In short, pregnancy would be essentially a female issue and therefore there would be no reason for men to face the possible side effects of a male contraceptive.

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However, there are also other elements that led to the early termination of clinical trials: «As soon as it was seen that it could have effects on libido, we began to say that this method was not sufficiently suitable for men and we stopped. This question has been asked less for women “and this is because the idea that” male sexuality has more to do with a physiological aspect, with a drive, while female sexuality it would depend more on the psychological question“.

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These stereotypes have in fact led to the absence of significant data production on male contraception, to the lack of funding for studies and trials, and to a lack of general information on the existing possibilities: in fact, as we have seen, condoms and vasectomies. Among other things, in France, vasectomy, which was legalized only in 2001, is used by less than 1 percent of men compared to 21 percent of men in the United Kingdom, also because it is still associated with the fear of losing one’s manhood. .

Libérationin another article, list the different methods of male contraception. Many of these have never been validated: they are therefore methods whose efficacy or safety has not been guaranteed. Part of these methods is based on heat. To produce sperm, the testicles must have a lower temperature than the rest of the body, between 34 and 35 degrees. Increasing the temperature of the testicles would therefore lead to a slowdown in spermatogenesis, that is, the formation of sexual cells capable of fertilizing. The increase in the temperature of the testicles can be obtained by using for many consecutive hours a special underwear, which raises the testicles towards the groin or which warms them through a thermoregulator, or by using a special silicone ring.

Finally, there are several methods under study: hormone injections, a non-hormonal pill, a hormone gel that blocks sperm formation and is currently being tested in the United States, or a blocking gel that if injected into the vas deferens of the male genital system – those in which sperm passes to go from the testicles to the penis – prevents sperm from adding to the seminal fluid produced by the prostate and seminal vesicles.

A prototype of this gel was developed in India and is called Risug (which stands for Reversible Inhibition of Sperm Under Guidance): it was also the first and only male contraceptive to reach phase 3 of the clinical trial, i.e. the penultimate, but it has not yet been definitively approved. In the United States, inspired by Risug, Vasalgel is being tested.

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