New approaches to contraception for men: do men and women
Richard A Anderson
Clinical Reproductive Science, Division of Reproduction and
Developmental Science, University of Edinburgh, UK
The development of the oral contraceptive pill enabled women for
the first time to control their fertility safely and effectively, and led to the
wide range of hormonally-based pills, injections, implants and intrauterine
devices now available. Male methods have seen no such changes, and remain
inconvenient, ineffective or irreversible. Despite this men are major users of
contraception, and condoms remain the method used by most couples at some point.
The last 20 years have seen the slow development of hormonal-based methods for
men, and there are now industry-funded studies underway. But are men interested,
and if so, in which approaches? And what might women’s views be?
Men’s attitudes and knowledge have been surveyed over many years,
and have consistently demonstrated interest in the development of new methods.
In one survey of 450 men in the UK, South Africa and China (Shanghai and Hong
Kong), the majority of men welcomed a new hormonal method even though they were
mostly happy with their existing method, and between 44 and 83% would use a male
pill. There were variations between centres however, with enthusiasm lowest in
Hong Kong, despite that being the centre where a male method, the condom, was
the main method used by respondents. A recent much larger survey (7000
participants from 9 countries) came to similar conclusions, and illustrated that
men vary in their preferences for different routes of administration. This
emphasises the need for development of a range of new male methods, just as
choice for women increases usage. Women also need to be enthusiastic about new
male methods. Few studies have addressed this, but the available data suggest
that women in a variety of cultural settings feel that the responsibility for
contraception should be shared more than at present, and a great majority
supported the development of a ‘male pill’.
These surveys give a clear and consistent message that both men
and women want to see new male methods become available.