Men want to use a contraceptive pill—so why won’t we give it to them?

Polling shows over a third of men would want to take it, and research trials are looking positive. It's time to have an honest conversation about the male pill

January 14, 2019
The pill transformed contraception. When will there be a male equivalent? Photo: Prospect composite
The pill transformed contraception. When will there be a male equivalent? Photo: Prospect composite

The pill transformed contraception. When will there be a male equivalent? Photo: Prospect composite

The Pill has been a constant part of the lives of millions of British women for more than half a century. The female hormonal contraceptive pill was introduced on the NHS in 1961—for married women. In 1967, the pill became available to all. It is now taken by 33 per cent of British sexually active women. Its popularity is a reflection of female sexual liberation in Britain from 1960s onwards. But it is nonetheless propagated on sexism.

Every hormonal contraception targeted at women comes with side effects and risks. At best, users risk suffering from headaches, tender breasts, weight gain, acne, pain, and continuous or irregular bleeding. At worst, they must weigh up the associated risks of blood clots, breast cancer, cervical cancer and liver cancer. It takes 10 years after taking the pill for these risks to go back to normal.

Other forms of contraception come with painful procedures or surgery. The price of liberation has been high and painful, and it is not until recently that we have begun the conversation about redistributing the burden of these risks.

Clinical trials for the introduction of a male contraceptive pill or gel have been underway for a while. The most promising drug, dimethandroline undecanoate (DMAU), safely combines an androgen, such as testosterone, with progestin, reducing production of sperm. It works similarly to the combined pill, with few side effects. 

Scientists involved have said that DMAU is 'unprecedented' and a major step forward. Longer-term studies are underway to ensure its safety, with introduction potentially being possible in 5 years.

Some prior trials have been stopped because users experienced dangerous side effects including liver inflammation; others, however, considered headaches, weight gain, and acne too intolerable to continue pursuing a drug. All side effects, of course, have always been part of the deal for women taking the pill.

But in fact, the biggest obstacle to male contraception has simply been a lack of funding. Funders are not interested because they believe consumers are not interested. Large pharmaceutical companies have simply not invested in the research.

And amongst potential consumers, there remains a stubborn argument that may hinder interest and market demand: trust. After all, the biggest risk is borne by the person who can get pregnant, which in the majority of couples is a woman. Should they trust their partners to take it?

It is a conversation that occurs a surprising amount amongst female friends. A common response was reiterated recently by a friend: “I wouldn’t trust men I sleep with … They don’t necessarily have to live with the consequences. It’s hard to see them being as committed as I am.” (This friend uses an implant; they suffered from nine months of severe symptoms, but persisted regardless.)

Yet whilst the male pill may be seen currently as too high-risk for some women, this simply should not be the reason for cutting off debate. If we change the conversation there, and the pill receives demand, as it goes through the process of mainstreaming men and women may see it as a potential alternative. Not only will this reduce many women’s burden, but it may also change the perception of men as innately reckless, careless and immune from consequence.

Young male sexual health campaigner Alex Cheney, who is a “champion” for young people’s sexual health charity Brook, tells me: “I believe over time it would make men take more responsibility over their reproductive health.”

Any delays to initial take up, he anticipates, “will be due to an ingrained societal view that it is a woman’s responsibility”. Would he personally take it? “I’d personally feel very comfortable taking it. It’s the responsibility of all partners involved.”

Attitudes like these are represented in a YouGov poll released last week: 33 per cent of men say they would take it—the exact same proportion of British women who take the pill. Even more encouragingly, the figure rises to 40 per cent among 25-49-year-olds. There is a growing potential demand that reflects an increased sense of fairness: 8 in 10 Britons believe men and women should share responsibility for contraception.

Perceptions of what “should” happen aside, however, perceptions of reality remain unequal. And this is where a push for change ought to happen.

An interesting and—for women—unsurprising finding of the same YouGov survey illustrates this well. 70 per cent of women believe women, in reality, take more responsibility for contraception—and only 40 per cent of men agree. The objective truth is that women are and have been taking the biggest burden.

As one male friend in his 20s told me: “I’d take it. My partner has had to deal with side effects and procedures, and we’ve talked about it, and the conversation has made me want to share the burden.”

“I think that conversation should happen to for all men, with long-term partners or single. They should carry the responsibilities and consequences of contraception every bit as women. It takes having that conversation with someone.”

The YouGov poll presents an opportunity for this conversation. The status quo is a product of sex inequalities and sexism. Public campaigners, the pharmaceutical industry and consumers must take hold of this moment to change an intrinsic and damaging element of the patriarchy—for women and for men.