New approaches to contraception for men: do men and women want them?

New approaches to contraception for men: do men and women

want them?

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.

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