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Where’s the hormone-free contraception for women?

Scientists are developing a male pill with no side effects, but it would be an outrage if this luxury wasn’t granted to all of us.

By Sarah Dawood

Since the creation of the oral contraceptive pill in 1950, the onus for avoiding unwanted pregnancy has been placed on women. Although clinical research into an equivalent for men has taken place, male contraception has yet to materialise.

In February, however, it was revealed that scientists have made a breakthrough in the creation of a male pill. So far it has only been tested on mice, but these experiments show that it could be effective. Unlike female contraceptive pills, it is non-hormonal, so it would probably have little to no side effects and could be taken as and when needed, rather than every day.

The new drug works by temporarily immobilising sperm, targeting and inhibiting a protein – soluble adenylyl cyclase (sAC) – that controls sperm’s ability to move or “swim”. In tests, the mice’s sperm were paralysed for three hours and effects wore off fully after 24 hours. If this is proven successful in humans, in theory, men could simply take a pill an hour before sex. They could take it whenever they choose and suffer little discomfort.

[See also: The great birth control debate]

Of course, there are downsides; planning one’s sexual schedule, like an exercise or meal regime, might not be entirely palatable. And while the scientific prowess involved in this discovery is admirable, women everywhere would be forgiven for asking: why has a drug like this not been investigated before? The female oral contraceptive pill has been around for over 70 years. Multiple formulations have been invented, all entailing a potentially horrendous mix of side effects, from acne, hair loss and lack of libido, to weight gain, nausea and abdominal cramps. Why are the options for women so dire?

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True, alternatives to hormonal contraception do exist. There are condoms and femidoms, but neither rank highly when it comes to enabling spontaneity and enjoyment. Then there are dubious, fringe forms of contraception such as fertility tracking apps, the accuracy of which has been called into question. The only mainstream form of non-hormonal contraception is the copper intrauterine device (IUD), which can require surgery to remove, can cause heavier, longer and more painful periods, and can result in fertility taking up to 12 months to return after removal.

One newer advancement is the gel Phexxi, which offers a similar temporary female solution to the proposed male pill and is inserted like a tampon. But women have reported everything from burning and itching to infections after using it, while the application method means that contraceptive effectiveness could only be 86 per cent, according to one study.

What this latest scientific breakthrough highlights is the glaring gender inequality in contraceptive clinical research. For decades, women have put up with often serious discomfort. Many are left wondering: why would scientists choose to focus on a side-effect-free pill for men, when not a single one exists for women?

We should not diminish this attempt to level the playing field between men and women, but if there is a renewed focus on creating contraceptive methods that offer greater lifestyle flexibility and fewer caveats, this needs to be pursued for everyone. It is difficult to believe that creating a side-effect-free, spontaneous female pill is scientifically impossible. Pharmaceutical companies and scientists have an obligation to invest in clinical trials that result in contraception for women that is not only effective, but also does not cause them misery.

This article was originally published on 20 February 2022.

[See also: Contraception is a human right, not a tool for population control]

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