Male contraception, why does the pill not pass?

Could contraception finally become a man’s story? While research has stalled and few solutions hit the market, male contraception is on everyone’s lips. Will men swallow the pill?

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Whereas a woman is potentially fertile a few days a month during her cycles, a man is fertile every day. As long as a man is healthy, his fertility is (almost) assured. In such a context, it would seem logical that men also have a role to play in contraception. That instead of controlling temporary fertility, we should perhaps be concerned with constant. But it is clear that the pill does not go away in men.

Stunning research

“The men’s pill does not exist yet, but I confidently believe that we will have it in a few years”. This is what Dr. Robert Schoysman said in front of RTBF cameras in 1978. More than forty years later, it is still not our dear pill. So what happened?

Because despite the enormous advances in science, currently, the only officially recognized and available male contraceptive method is the use of condoms. And despite some pushes and news, the situation is not changing that much. Yes, there are alternatives or other possible solutions, but none seem to find favor with the WHO. The latter therefore remain very often marginalized or little followed, with a real lack of knowledge on the part of the medical profession, which does not particularly encourage men to take an active part in the field of contraception.

“We are behind on the social phenomenon”confides Dr. Cédric Pé, general practitioner and family planning doctor in Brussels, to our colleagues at RTBF. “In any case, the doctors, and the facilities that deal with contraception, are behind on this request for male contraception. It is difficult to absorb the demand and we are not trained enough for it.”

Change briefs

Because despite the lack of a lasting solution, men seem to be increasingly interested in contraception. Dr. Daniel Murillo, gynecologist of the CHU Saint-Pierre in Brussels and trained in andrology underlines this: “It is young people between 20 and 30 who are truly interested in male contraception” He explains “There is in them a questioning of the sharing of the contraceptive load in the couple”.

Because men didn’t particularly wait for science to try to shift the lines. It is with a brief that they also try to control their fertility. The principle? A short “warm-up”! This underwear like no other raises the wearer’s testicles, thus slightly raising their temperature which allows semen production to stop. It should be worn 15 hours a day, 7 days a week and its effects are completely reversible.

However, health workers are temperate. While it is true that this technique appears to be proven and appears to be really effective, it is not yet recognized as an official method of contraception.

Also, this practice doesn’t start overnight. The affected man must first undergo a spermogram to check the sperm count. He then has to wear the heated briefs for three months, every day, so that his sperm count is no longer sufficient to be fertile. After this period, he must redo an analysis to verify that he is indeed sterile. And it is only once this result is confirmed that the slip can be used as a contraceptive.

If the method can make you smile, it is still recommended by specialists. “It’s a completely self-contained method, it’s not hormonal, it’s without third party intervention, you just have to wear it from sunrise to sunset, 7 days a week. It may sound restrictive but I think we get used to it. I think it’s a good alternative you can get quite easily “, cincludes Daniel Murillo.

The weight of tradition

However, it seems appropriate to point out that the method is not without shadows. If it seems effective, nothing has been observed in the long term yet. The risk of complications (testicular cancer or other) is also not entirely remote.

In 2022, contraception therefore remains a story of women. And the contraceptive burden weighs more on the latter. Right in our approach to sex education for young people. “Young women are informed about contraception and the risks of pregnancy and young men about sexually transmitted infections (STIs)”deplores Erwan Taverne, co-founder of the Garcon Association (Action and Research Group for Contraception) and advocate of the “heated briefs” method.

And as Daniel Murillo explains, the lack of choice in male contraception is also historic: ” there are several brakes. First, there was the feminist movement in the 1960s, women’s empowerment and fertility control. Studies on female contraception have been conducted. The first pill was marketed at that time. And at the same time there were also male derivations but which were oriented towards permanent contraception, therefore vasectomy. Other avenues have been explored but have not reached the full development of the product placed on the market, in particular due to the lack of interest on the part of pharmaceutical companies who do not see any obvious commercial interest in it “.

This is perhaps, ultimately, the biggest obstacle to male contraception. The pharmaceutical industry and its commercial interest which, despite the vehemence of feminist groups and the desire of some men to take an active part in contraception, does not seem ready to evolve …

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