November 17, 2015

It’s Time To Give Men More Birth Control Choices

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For all of recorded history, the contraceptive of choice for men—short of sterilization, withdrawal or abstinence—has been the condom.

logo_ColumnHow ubiquitous are condoms? The federal government says 18 billion condoms will be used worldwide this year alone. They’re sold in latex, lambskin (good for pregnancy prevention, not good for prevention of STDs or HIV), and ribbed with something called “tattoo-inspired textures.”

The choices are dizzying, but only within an extremely small field that involves placing an expandable sheath over an erect penis. Not a single new form of male contraceptives has been introduced on the market in this century—or the last.

Hard to imagine, isn’t it? By comparison, the female contraceptive market has increased significantly in the last five decades. Though the oral contraceptive pill remains the most popular choice, a sexually active woman can also choose from intrauterine devices, sponges, diaphragms, contraceptive patches, sub-dermal contraceptive implants, non-surgical permanent contraceptive devices, and even a female condom, which is marketed as the only female-initiated barrier method that  prevents pregnancy and the spread of STD and HIV.

But even with the wide choice of contraceptive technologies for women, according to the Guttmacher Institute, nearly half of all U.S. pregnancies are unintended. (The institute also said that in 2010, the most recent year for which numbers are available, slightly more than the national average—51 percent—of Connecticut pregnancies were unintended.)

So if men had more control over their reproductive destinies, could the number of unintended pregnancies be lowered?

A Guttmacher study says that unintended pregnancies cost taxpayers $21 billion—with a “b”—a year. (An unintended pregnancy is any pregnancy that comes at the wrong time, or a pregnancy that isn’t desired.) Unintended pregnancies have both public and private costs. The Census Bureau says that in 2010, the average monthly child support was $430. From that same report, 85 percent of child support providers are men.

Condoms go back to the Egyptians, though whether they were used as contraceptive devices or decorations is a popular academic discussion. Used properly, condoms are 98 percent effective in preventing pregnancy—but a significant number of users don’t them properly, which drops the effectiveness rate significantly. (The effectiveness of any non-permanent method of birth control is hampered by incorrect use.)

Yearly, 18 billion condoms are used worldwide.

iStock Photo.

Yearly, 18 billion condoms are used worldwide.

A global 2012 survey of 9,000 men from nine countries showed that men say they are far more willing to use contraceptives than expected—and this is even in countries where men aren’t culturally outspoken about birth control. That reflects a huge societal shift in attitudes. A recent study from the Demographic and Health Surveys, a program of the United States Agency for International Development, looked at 18 countries and found more than half of the men surveyed believed contraception was their responsibility as much as that of their female partner’s. And as the age of first-time fathers increases, U.S. men show more willingness to consider themselves as responsible for birth control as their female partners.

In the past few years, organizations such as the North Carolina-based nonprofit, Male Contraceptive Initiative are seeking to educate the public, and push for more research money. Some methods are in the works but they’re not available yet, mostly because funding isn’t there for research. Those methods include (but aren’t limited to) a polymer gel that blocks sperm, and a so-called “clean sheets” pill that blocks the ejaculation of sperm.

But without the proper funding, these methods remain theoretical, and men are left with shockingly few choices.

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