“The Pill” for Men and Accountability in Pregnancy Prevention

With the advent of the birth control pill in the 1960s, women’s sexual freedoms expanded as they could now engage in sexual relationships without the fear of becoming pregnant. Since this groundbreaking medication hit the market, however, questions of shared responsibility in contraceptive use have risen. With a man’s only contraceptive option being the sometimes-unreliable condom or the irreversible vasectomy, continued interest in lifting the one-sided burden of pregnancy prevention has resulted in researching a male birth control pill. Unfortunately, fifty years after this research began, a male Pill has yet to reach the consumer.

Part of the reason research into a male birth control pill has been slow could be due to the attitudes American society has about the shared responsibility (or lack thereof) of preventing pregnancy. Because women often shoulder more responsibility when they become pregnant, it is likely that even if a male birth control pill were to hit the market, women may not trust their partner to remember to take the pill and keep them from becoming pregnant.

The advent of the Pill was about giving women agency and power over their reproductive system. The Pill did more than just prevent pregnancy; it emancipated women from a life of motherhood and child-rearing that, even in marriage, became primarily their responsibility. In other words, the Pill gave women a sense of security and control over making decisions about their lives. So why would they give up this power to their partner who hasn’t had to deal with (and never will have to deal with) the consequences of unplanned pregnancy in the same way? Additionally, while many of the critiques of the Pill revolved around giving women a license to promiscuity and permission to break their unspoken virginal vow, men are not held to the same sexual standard and therefore do not have the same moral hurdle to overcome.

Despite the concerns presented by women, polls show that men are interested in developing a male birth control pill. Several new male contraceptive options have been undergoing research since the 1970s. A new hormonal male contraceptive pill formulated with a mix of testosterone and progestin was tested on 30 healthy men for 28 consecutive days. Although the study only assessed safety and hormone responses in study participants, initial blood tests suggest it could be effective at suppressing sperm and testosterone production enough to prevent pregnancy. Another birth control method in development is RISUG (“reversible vasectomy”), a one-time injection into the vas deferens to stop sperm motility which can be reversed with a second injection. Other options include plant-based pills, “dry orgasm” pills aimed at restricting sperm from becoming semen, and hormonal topical gels.

But as with any drug, side effects are common. Another male birth control pill in development, Dimethandrolone undecanoate (DMAU)—a once-daily pill aimed at decreasing production of sperm and testosterone and two types of male hormones—received reports from study participants of acne, headaches, mild erectile dysfunction, decreased libido, fatigue, and mild weight gain. These reports are not unusual, however, given that many women suffer these side effects (and more) from their birth control.

Overall, despite the concerns from women that men will not take the responsibility of pregnancy prevention seriously and concerns from men and researchers that the male pill is safe and has minimal side effects, there remains a continued interest in developing a male birth control pill, implying a shift in attitudes about the shared accountability of contraception.