Lambasted in headlines across the nation, a research study exploring the efficacy of male hormonal contraception was halted after several participants complained of unintended side effects. Among the listed complaints were acne, pain, increased sex drive, mood disorders, and depression--common side effects associated with female hormonal birth control methods [1]. The cessation of potentially revolutionary male birth control trials over the discomforts that women are expected to manage without complaint represents a patriarchal double standard that is not only unfair, but which also threatens to perpetuate an ungrateful and potentially harmful reliance on women to be responsible for all aspects of reproductive planning.
First, it is important to address the reasons cited for cancelling the drug study. Participants predominantly reported acne as the main discomfort experienced during the trial. Fewer reported mood swings, and only one of the 320 participants reported developing severe depression after beginning the study [2]. One man completed suicide after joining the study.
While the protection of human subjects in any research trial is of paramount importance, it seems that the side effects cited as motivation for ending the study are inadequate, especially considering that comparable side effects are common among women using hormonal contraception. The chief complaint among men in the study was increased acne, frequently experienced by women who begin taking hormonal birth control. Progestin, a progesterone synthetic found in both single-hormone and combination hormonal contraceptives, can stimulate sebum production and lead to increased acne [3].
And as for the mental side effects, women experience similar changes after beginning hormonal birth control. A study published in June in the journal European Neuropsychopharmacology found a decrease in affective responsiveness among women who take oral contraceptives but were in their pill-free week compared to women who were currently taking the pill [4]. That is to say, women in their pill-free week were less able than their counterparts, who were currently taking active oral contraception, to empathize with other individuals, leading to distressed interpersonal relationships. This indicates a link between hormonal birth control cycling and mood and mental state. Coincidentally, the incidence of depression in the male contraceptive study (1 in 320 participants) is hardly statistically significant enough to warrant discontinuation, and while a diagnosis of depression is of concern, it is a multifactorial condition that cannot be adequately demonstrated to have a singular cause. Furthermore, the man who completed suicide was reported by family members to have been depressed before joining the study [5].
What implications does this have on the future of contraception? In severely setting back the development of male hormonal birth control, the discontinuation of the study reinforces it as the duty of women to take charge of family planning. Beside posing a financial burden to women, this further distances men from the discussion of reproductive planning and normalizes a culture of male dissociation from the intimacy and intricacies of sexual relationships. This can, in turn, perpetuate a power dynamic that asserts women as objects of sexual gratification, with the burden of all associated risks (including pregnancy) falling to the female partner.
There are necessary precautions in conducting human trials that cannot be compromised, no matter how pressing our motivations for greater scientific understanding. This case is no such example; it only demonstrates that some side effects should only be relegated to the feminine and that men should not be subject to ordinary discomforts in the pursuit of effective reproductive planning, an undertaking (that should be) shared by both male and female partners. In fact, the opening line of the study addresses this aspect of effective family planning, acknowledging it as a “goal men and women share” [6]. However, if men and women are to both share in the benefits of family planning, they must also both share in the burdens associated.
Author’s Note:
Men: While contraception can seem like a taboo topic, discussing it with your partner can strengthen your relationship and ease some of the emotional burden felt in procuring and using it. Offer to help pay for birth control, discuss what birth control options are available and best for you and your partner, offer support for whichever method your partner elects to use, and encourage open discussion regarding topics of sexuality and reproductive health.
For more information about family planning or birth control, there are several resources available on the web and at UVA, including:
Bedsider offers an extensive and contemporary approach to family planning, detailing various contraceptive methods, their risks and benefits, and where to get them.
Method Match allows you to select which method may be best for you given your selection criteria.
On UVA Grounds, Peer Health Educators are trained to discuss sensitive topics in a non-judgmental, open manner and offer general guidance and resources that can help make the process more comfortable and less intimidating.
References:
1. Luthra, Shefali. (2016). “What does study backlash mean for future of male birth control?” CNN, November 2, 2016. Accessed November 4, 2016. Retrieved from http://www.cnn.com/2016/11/02/health/male-birth-control-shot/index.html
2. “Male Birth Control Study Killed After Men Report Side Effects.” NPR, November 3, 2016. Accessed November 4, 2016. Retrieved from http://www.npr.org/sections/health-shots/2016/11/03/500549503/male-birth-control-study-killed-after-men-complain-about-side-effects
3. “Birth Control - In-Depth Report.” The New York Times. Accessed November 4, 2016. Retrieved from http://www.nytimes.com/health/guides/specialtopic/birth-control-and-family-planning/print.html
4. Radke, S. & Derntl, B. “Affective responsiveness is influenced by intake of oral contraceptives.” European Neuropsychopharmacology, 26:6 (1014-1019). http://dx.doi.org/10.1016/j.euroneuro.2016.03.004
5. Luhtra, Shefali.
6. Behre, H.M., Zitzmann, M., Anderson, R.A., et al. (2016). “Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men.” The Journal of Clinical Endocrinology and Metabolism, early release publication. Retrieved from http://press.endocrine.org/doi/pdf/10.1210/jc.2016-2141