Collab Column | It’s about time you got on the pill, fellas!

By Sarah Liez and Harsh Hiwase

Collab columns consist of multiple columnists offering their own takes and experiences on a topic. In this issue, we’ll discuss the debate on male birth control.

Men should take birth control too, and this is why // Sarah Liez, Senior Staff Columnist

Nearly every person I know with a uterus knows the struggle of taking birth control. Do I take it and mess with my hormones? Will people judge me for being sexually active and not using a  contraceptive other than a condom? What will happen if I miss a pill or have health complications? What about if my partner refuses to use a condom? These are just a few of the questions that individuals who use birth control, myself included, consider when debating how to regulate their ability to get pregnant.

Personally, I chose not to take birth control until my second year of college. Despite being sexually active for several years, I didn’t want to experience the negative side effects that my friends told me about — migraines, increased bleeding or even launching my hormones into chaos. Even when I eventually decided to get an intrauterine device — or an IUD — I suffered through 15 minutes of intense contractions caused by dilation from insertion, a week of cramping and three months of continuous bleeding followed by three more months of on-and-off bleeding. I was one of the lucky ones — some of my friends vomited or even passed out from the pain.

I am a firm believer that those with the ability to get pregnant should not be the sole proprietors of medical contraceptives, such as long-acting reversible contraceptives or LARCs — and prescription medications. Not only is it simply unfair to place all of these expectations and negative impacts on these individuals — typically women — alone, but it is morally and logically unsound as well.

Let me pose a scenario — a man and a woman each sleep with nine different partners each day over a span of nine months. Within that time frame, the woman can only get pregnant once, whereas the man could potentially impregnate each and every woman he sleeps with. Thus, one man could impregnate as many as 2,430 women in the time it takes for one woman to carry out a single pregnancy. So tell me, then, who should really be on medical birth control?

If men were on contraceptives in addition to women, unintended pregnancies — which account for roughly 40% of all pregnancies — would be greatly reduced. As of right now, men only have two viable contraception options: condoms and vasectomy. The first is only 98% effective with perfect use, and the latter is intended for permanence

Despite decades of research proving that there may be viable options for male-intended LARCs or medications, these contraceptives have not left the trial phase because most people who cannot give birth simply do not feel responsibility for preventing pregnancy. Since they are not the ones primarily impacted by pregnancy, they can evade the need to take medical contraceptives, such as oral prescriptions and LARCs.

Men should share the responsibility, at minimum, by joining women in committing to medical contraception. If nearly all sexually active individuals with the ability to birth a child are expected to regulate their ability to give birth, then men — who have an equal role in fermenting an egg cell — should be too.

Men want to take birth control pills. Here’s why we can’t // Harsh Hiwase, Senior Staff Columnist

In 2003, The Pitt News editorial board estimated that male birth control pills would soon be available on the market. Almost 20 years later, we’re still waiting. 

Every few years we see a revolutionary idea spring up in the field of male contraception, but nothing commercial comes of it. In 2014, the Swiss company Bimek SLV devised a mechanical duct valve with a switch to restrict sperm flow. The idea went viral in 2016, but fizzled out almost immediately after. The company said it wasn’t able to gather enough financial capital to continue with the clinical trial and approval process. 

People with uteruses have to bear the burden of contraception disproportionately because there are more products available for them — and this is unfair. People with uteruses have to put in more emotional and physical work to actively prevent pregnancies than people without, and they also deal with the long list of persistent psychological and physically painful side effects while on hormonal contraception that males are exempt from. Would people without a uterus do the same if given the chance?

I believe that men would pull their weight in the burden of contraception if given the chance. Surveys suggest that up to 71% of men would use a male hormonal contraceptive. Men currently only have two reliable options — condoms or vasectomies. One is temporary and leaves room for error when not used correctly, the other is more permanent and can be difficult to reverse. Men need something in between. 

Temporary contraceptive methods are in the works. The Contraceptive Development Program in Maryland is developing a hormonal method that has proven to have sufficient contraceptive effects without major side effects. Private firms such as COSO and Vasalgel are developing non-hormonal methods like an ultrasound-based “jacuzzi” and an injectable plug that blocks the duct where sperm travels through.

Despite so many products and discoveries in the pipeline, I worry that they’ll fizzle out just like Bimek SLV, and it isn’t because of low demand. The root of the problem is Big Pharma’s unethical sales strategies which ensure that people continue to buy their products. 

Big Pharma companies have consistently been criticized for prioritizing revenue ahead of patient welfare by differentiating their products instead of innovating new ones. A common strategy is product hopping, where drug companies market reformulations of their best-selling medications that are nearing the end of their monopolistic life so consumers don’t use cheaper, generic medications. 

On average, pharmaceutical companies only spend 18% of their revenue on research and development of new medications. Funding the development of an alternative drug may reduce the short term profits of Big Pharma companies so they aren’t incentivized to do it.

Small biotech companies like Bimek SLV, COSO and Vasalgel are revolutionizing male contraception. However, they need funding to continue developing their inventions. In order for their products to go through clinical trials, certification and finally development, they have to partner up with Big Pharma companies — which may not happen because it threatens their profit margins.

We need to move on from arguments about whether there is a true demand for male contraception or whether males are ready to handle the responsibilities associated with being on contraception. The only way forward now is to bring to light unethical practices by big pharma and hold them accountable for undermining innovation. I can’t say for sure how long it will take to finally have a commercial product for male birth control, but I can say with certainty who is stopping us from getting there.