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.