Published in Catalogue, 2016
After a clinical trial examining the effectiveness of male hormonal contraception injections was halted this month,an inevitable turbulent media free-for-all ensued. The study, published in The Journal of Clinical Endocrinology and Metabolism, involved 320 participants and discovered that the male combined hormonal injection method was 96% effective: an undeniably promising development for hormonal contraception for men.
However, social and mainstream media alike quickly buckled under the realisation that the trial was halted by side effects including: increased heart-rate, mood swings, acne, muscle pain, and depression. A brief comparison of the side effects that women endure as a result of the combined oral contraceptive pill including: nausea, vomiting, weight changes, vaginal bleeding, DVT, pulmonary embolisms, depression, amenorrhea, and hypertension, led the majority of women across social media to react to the termination of the study with a loud, synchronised cry of “Boo-fuckin’-hoo”. Which is, to a degree, totally understandable. However, the discussion about the advent of long-term hormonal contraception for men is a deeply nuanced conversation that extends well beyond the boundaries of science and into the realm of the sociology of drugs, as well as the gendered divides in the responsibility of safe sex practice.
But the conversation has to start with the science. The persistence of clinical trials such as this in the face of side effects that have real repercussions such as mood swings and depression is not only unethical but practically difficult – the attrition rate of participants increases and it’s unlikely that you’re going to find new ones to sign the dotted line once they’ve read the fine print. While the reasons felt galling, it was 100% justifiable that the trials didn’t continue.
As a society aspiring towards complete gender equality in regards to contraception and the responsibilities of conception, perhaps we should be doing our best to encourage the perfection of the male hormonal injection before it hits the market in order to ensure that it gains widespread traction. We want men to buy into this as much as we have the Pill and – to be fair – despite the side effects, 75% of the men in this trial stated that they would continue usage of the contraception, which is great and also somewhat unsurprising considering the benefits that we’ve undeniably enjoyed for sixty odd years.
This being said, in regards to the side effects that were actually witnessed throughout the trial and how they size up to what we witness with female hormonal contraception, they were experienced in rates absolutely comparable to those experienced by women. For women taking the Pill, the incidence of depression is raised 2-3%, whilst the men observed in this study experienced a rate of depression development of 2.8%. For other forms of female contraception such as the hormonal IUD, the disparity can be more damning, such as the FDA approved Liletta, which shows a rate of depression amongst users of up to 5.4%. The point being that there are absolutely contraceptive hormonal treatments approved for commercial use post 1962 (the year that the FDA enforced more stringent approval processes following the Thalidomide tragedy and two years following FDA approval of the Pill) that show higher incidences of depression for long-term users than 2.8%.
So, let’s discuss how women have been allowed to be so historically screwed by the side effects of the Pill whilst men are comparably protected (no pun intended, please) by their contraception choices. In this recent report for Broadly, Bethy Squires examined how one of the doctors at the centre of the Puerto Rican trials of the original Pill recommended against its release based on side effects but the US pharmaceutical industry made the hormonal combination commercially available despite this evidence as “It was believed that women would tolerate side effects better than men, who demanded a better quality of life”. Furthermore, there has been next to no research since, as highlighted in a recent study detailing that in general 34% of women taking the pill are more likely to suffer from depression, while a terrifying 80% of teenagers taking a combined pill are twice as likely to be prescribed antidepressants. The total lack of prior investigation was even highlighted by the study’s concerned authors.
For women, the Pill has always unquestionably been a Costs vs. Benefits decision because ultimately, we bear the physical evidence, and burden, of conception. In fact, if you want to talk about side effects, the risk of DVT and blood clotting during pregnancy is 10 times the risk witnessed for women on the Pill and the incidence of postpartum depression symptoms has been estimated at a rate of almost 25% for new mothers. Whereas men can walk away relatively scot-free from pregnancy – excluding the legal and financial burdens. The oral contraceptive pill was nothing short of revolutionary because it liberated women from their own biology; we take control of our bodily outcomes. But in a progressing society where the issue of contraception should be equally addressed by men and women with equal sexual autonomy, the shortcomings of these synthetic hormones should no longer be only our cross to bear.