Male Contraceptives 08

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--AnneVR 8 janvier 2009 à 11:18 (MET) --MelodyF 13 janvier 2009 à 15:21 (MET) --ThomasT 20 janvier 2009 à 15:49 (MET)

Introduction : What is contraception?

Contraception or birth control is the term used for the prevention of pregnancy.

There are many kinds of contraceptives, the male and female ones. They are both very efficient but work in different ways. We're going to explain the male ones.

Contraception (birth control) prevents pregnancy by interfering with the normal process of ovulation, fertilization, and implantation. There are different kinds of birth control that act at different points in the process.

What are the different contraceptives for men and how do they work?

There are many contraceptives for men but the most used are the following ones. We didn't consider sterilization and especially vasectomy in it, because this chapter is studied by another group.
Each one has its own particular uses and we must consider them all to understand when and how they can be used and if they are really efficient.

The condom

A condom is a device most commonly used during sexual intercourse. It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner. Condoms are used to prevent pregnancy and transmission of sexually transmitted diseases (STDs—such as gonorrhea, syphilis, and HIV).

In the modern age, condoms are most often made from latex. As a method of contraception, male condoms have the advantage of being inexpensive, easy to use, having few side-effects, and of offering protection against sexually transmitted diseases.

Condoms have been used for at least 400 years. Since the nineteenth century, they have been one of the most popular method of contraception in the world. While widely accepted in modern times, condoms have generated some controversy.

Condoms are widely recommended for the prevention of sexually transmitted diseases (STDs). They have been shown to be effective in reducing infection rates in both men and women. While not perfect, the condom is effective at reducing the transmission of HIV, genital herpes, genital warts, syphilis, chlamydia, gonorrhea, and other diseases.

Some condoms contain also spermicide which guarantees a better efficiency. We'll develop this in the spermicide's section.


  • Causes of failure:

Condoms may slip off the penis after ejaculation, break due to improper application or physical damage (such as tears caused when opening the package), or break or slip due to latex degradation (typically from usage past the expiration date, improper storage, or exposure to oils). The rate of breakage is between 0.4% and 2.3%, while the rate of slippage is between 0.6% and 1.3%. Even if no breakage or slippage is observed, 1–2% of women will test positive for semen residue after intercourse with a condom. "Double bagging," using two condoms at once, also increases the risk of condom failure.

Different modes of condom failure result in different levels of semen exposure. If a failure occurs during application, the damaged condom may be disposed of and a new condom applied before intercourse begins - such failures generally pose no risk to the user. One study found that semen exposure from a broken condom was about half that of unprotected intercourse; semen exposure from a slipped condom was about one-fifth that of unprotected intercourse.

Advantages

  • Cheap
  • Easy to use
  • Prevent pregnancy with an efficiency of 90% to 99%
  • Protect from STD's

Disadvantages

  • Some men are allergic to latex
  • Some couples find it uncomfortable
  • One must always have one with him

The male pill

Scientists are currently working to develop a male contraceptive pill that will allow men to control their fertility, in much the same way that the female contraceptive pill allows women to.

  • How will it work?

The male contraceptive pill is likely to work by blocking sperm production, using a combination of the sex hormones progestogen and testosterone. It is likely to become available as either a single pill or a longer-acting implant.
The major challenge for the male pill compared to the female one is that it has to inhibit millions of sperm cells instead of only one ovum. It's thus very difficult to have a pill that is 100% effective in every man, all of the time.
On an other, more moral side, we also could ask ourselves if it would work for men, simply because :

  • Some men think it has always been the women who took the pill and could ask them selves why now they should take it themselves
  • Men are not as involved as women in pregnancy, as it's not them who will have to cary the baby. Even if they care about what will happen for the woman (some don't!), they're still not 100% concerned.
  • It is also a question of trust. If the woman took the pill before the sexual act, she knows that she is safe. While if the man tells her he's taken it, he could always be lying, and escape the problems later on.
  • And men, as it's not as problematic for them if the woman gets pregnant, could easily forget to take the pill everyday. They would really need a good reason to take it everyday, to have this endurance and strength of mind.

So in conclusion, we could say that first it has to be proved that this new pill works a 100%. Then it should be tested on a large number of men during a long period of time to see if it really works. This pill is more based on the question "would men WANT to take the pill" ? --AnneVR 31 janvier 2009 à 14:05 (MET)

The non-hormonal pill

This new pill contains chemicals that prevent ejaculation and could be in tablet-form. Men could take one daily, just like the female pill, or have one a few hours before sex as a one-off contraceptive. The tablet would prevent a man from being able to impregnate a woman. Sexual satisfaction is not affected and the absence of hormones means that a man's fertility should return to normal within hours of stopping the treatment.


Doctors' quotes:

"The non-hormonal male pill could be taken when and as needed."

"If the man was taking the pill over a period of several months and decided to come off it, we would expect his fertility to return just as quickly as if he had taken it on a one-off basis."

However, side-effects including dizziness and drowsiness mean these medicines could not be marketed as contraceptives. London researchers tried creating tablets that do the same thing but without the side-effects. Already tested in the lab, we hope that it will shortly be on the market within the next five years. Its strength lays in its ability to prevent pregnancy without using hormones which could cause side-effects such as hot flushes and moodiness.


Why people aren't excited by the male pill?

Ethical considerations in the development of a male birth control pill: First of all, it is new and unknown, people has to get used to it before it gets usual. The common perception is that few women would actually believe a man who said he was on the Pill.
How could we make it more common: "If you give the consumer the peace of mind that their fertility will be restored and that their hormones are not going to be affected, they may feel that it is safer to use this contraceptive,"

But actually, for the male partner, the consideration of the risks and benefits of the contraceptive will be very different from a woman's, by the simple fact that men don't get pregnant. All potential harm that come from a male contraceptive would count against the ethical use of it, since there is no impact on a man's health (physiological perspective) for impregnating someone. This is part of the reason why it is possible for men to be fathers without knowing or accepting that they are fathers and even choose to take care of the mother and the child. The analogous situation wouldn't happen with a mother. The mother could have to bear heavy consequences if the man does not regularly take the pill, or lies about taking it, and then after making the mistake she will have to accept the situation alone if the partner chooses not to be present as a father It is also more likely not to be trusted by women as they are not relying on their man having to remember to take his pill every day for it to work.

A men is also scared of having a child but only psychologically, not in the same way as a women. men are not as implicated in pregnancy as women, because it's not them who are going to get pregnant. They can care or not, it's their choice. so why would they use it if they are not even sure that it won't affect their sexual life?

The answer is simple, they will hesitate a lot, and most of them will never accept to take the pill maybe with the years things will change but it will surely take time. --LovisaS 31 janvier 2009 à 14:42 (MET)

The spermicide

Even if the spermicide is put into the vagina we consider this way of contraception as a male one, because it kills the male gametes.

The spermicide alone : A foam, cream, jelly, film, or suppository, or tablet containing nonoxynol-9. It is actually killing or slow the spermatozoa down making them not able to move well. Depending on product, it is inserted between five and 90 minutes before intercourse. It is usually left in place at least six to eight hours after.

Spermicide is inserted vaginally. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods. Usually, spermicides are combined with contraceptive barrier methods such as diaphragms, condoms, cervical caps, and sponges.

Spermicides are unscented, clear, unflavored, non-staining, and lubricative.

Spermicides containing nonoxynol-9 are available in many forms, such as jelly (gel), films, and foams. Contraceptive Technology states that spermicides have a failure rate of 18% per year when used correctly and consistently, and 29% under typical use.

Nonoxynol-9 has a number of possible side effects. These include irritation, itching, or burning of the sex organs (either partner), and in women, urinary tract infections, yeast infection, and bacterial vaginosis. These side effects are uncommon; one study found that only 3-5% of women who try spermicides discontinue use due to side effects.

What is the most efficient?

There is no doubt, the condom is really the most efficient male contraceptive. Indeed, comparing it to the male pill we can see that the pill doesn't protect for STD's and the pill also causes a lot of ethical problems. The spermicide isn't better. Indeed, it doesn't protect from STD's either and have much more failures than a condom. So the condom is the best male contraceptive.

References

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