Expert explains how close we are to a male contraceptive pill

Warning: This article contains discussion of mental health which some readers may find distressing.

Many have been anticipating the arrival of the male contraceptive pill for years, but how soon will it truly arrive?

Men have had it pretty easy all these years - escaping from being injected with hormones, not needing to remember to take a pill at the same time each day or having a copper coil inserted into them.

However, will 2021 be the year where the tables finally turn? When men will have more of a responsibility to prevent unwanted pregnancies?

In 2019, the male contraceptive pill passed its first round of human safety tests. However, according to the BBC, doctors at the Endocrine Society's annual meeting have said the pill may still take a decade to be made available to the general population.

The pill would be required to be taken once daily and could act as a preferred option to a vasectomy or condoms, however it won't protect against sexually transmitted diseases.

It would reportedly temporarily block new sperm cells being created by hormones, without lowering hormone levels so much that any side-effects would become an issue.

It would also relieve the pressure on women - who the responsibility has majorly fallen onto to take contraception to prevent unwanted pregnancies.

By 2019, the latest version of the male contraceptive pill had been tested by researchers at LA BioMed and University of Washington. The researchers concluded that the pill should indeed achieve its initial goals of temporarily lowering hormones.

The first phase of safety tests involved 40 men and were reported to the Endocrine 2019 meeting in New Orleans as looking 'promising'.

The study took place over 28 days and saw 10 men take a dummy 'placebo' pill, and 30 take one of the 11-beta-MNTDC, experimental male contraceptive pills.

The hormone levels required for the production of sperm dropped significantly in the men who trialled the 11-beta-MNTDC contraceptive pill, compared to those taking the placebo pill.

The side-effects of the trialled male contraceptive pill were reportedly few and mild.

Five out of the 40 men said that they had a 'mildly decreased' sex drive. Two out of 40 reported mild erectile dysfunction.

None of the 40 participants stopped taking the pill for any reason or side-effect and sexual activity was not decreased. The pill also passed all safety tests.

"Our results suggest that this pill, which combines two hormonal activities in one, will decrease sperm production while preserving libido," Professor Christina Wang and her colleagues told the BBC.

Longer trials were reported as simply being needed to check that the pill worked as effectively as it possibly could as a form of birth control.

Researchers are also looking into other methods of contraception for men, such as body gel, as well as non-hormonal options.

Speaking to UNILAD, Dr Edi-Osagie, a consultant gynaecological surgeon and head of Reproductive Medicine and Surgery Services at Central Manchester University Hospitals, noted how he thinks the development of the male pill is a 'great thing'.

"I think it just gives us another option. So that men can actually be on contraception not just women," he said. While Dr Edi-Osagie is looking forward to the male pill becoming a 'routine service available to men', will all men want to utilise it?

Dr Edi-Osagie noted how men with partners may be more likely to take on the male contraceptive pill out of what they may consider fairness, and having perhaps seen the impact certain contraceptives have had on their other half.

The responsibility has – unfairly – fallen on women for so long that men have likely gotten used to it, so will they truly want to relieve some of the pressure off of women to prevent unwanted pregnancies?

Up until now, it's often been expected for women to take the reins in using contraception with multiple contraceptive methods available ranging from pills and implants to coils.

The combined contraceptive pill for women, often just known as 'the pill', is detailed by the NHS as containing artificial versions of the female hormones, oestrogen and progesterone. The average way to take the pill is for 21 days followed by a seven-day break, which results in a period.

The pill does not protect against sexually transmitted infections and needs to be taken at the same time everyday or it could be less effective against unwanted pregnancies. There's also a potential link between the pill and depression.

I was first put on the pill when I was 16 years old due to experiencing extremely painful and heavy periods and while the pill did help ease my discomfort and regulate my periods, five years later, I'm worried that it could have had a very negative effect on my mental wellbeing.

Aged 21 I'm now terrified to come off my pill or change my type of contraception. What happens if I come off the pill and realise that I am 10x happier than I normally am?

What happens if, coming off the pill, I realise that years of depression and anxiety were exasperated by this small tablet that I was placed on aged 16 when I didn't fully understand what mental health was?

The pill for women comes with multiple risks and potential side-effects - from headaches, nausea, weight gain, increased risk of blood clots and breast cancer to mood swings.

However, contraceptives are being developed and tested for men with minimal side effects. So why have women been subjected to such contraception for so long instead of men?

While there are many forms of contraception available to women the pill is often the most popular choice, however it doesn't come without its risks.

Talking to UNILAD, Dr Edi-Osagie noted how the pill can be beneficial to help regulate periods and make them more manageable. The pill also has the benefit of being used from any age due to the 'relatively quite safe' hormones involved.

Although, Dr Edi-Osagie agreed the pill can be more complex in how it 'can impact on people psychologically'.

For some women, the benefits can outweigh the pitfalls, but Dr Edi-Osagie warned that 'it's just being mindful of that and factoring that into the plan you have for anyone to place on the pill'.

Men's sperm is what gets women pregnant so why are men not held more accountable for preventing unwanted pregnancies? Why was the pill invented for those with wombs rather than those with semen in the first place?

Talking to UNILAD, Dr Edi-Osagie agreed with how important and good it was to 'actually target men' due to how 'the level of ignorance amongst men is significantly higher than amongst women' when it comes to subjects such as sexual health and women's menstrual wellbeing.

While Dr Edi-Osagie specialises in endometriosis - a chronic and often debilitating condition that affects one in 10 women - his statement is true for many issues surrounding menstrual health, women's wellbeing and reproductive health.

In discussion of not just endometriosis, but women's menstrual health and wellbeing, Dr Edi-Osagie noted how people often do not believe, 'listen to' or take women's 'symptoms on board'. He reflected 'many women get fobbed off by their GPs and hospital doctors' which can go on for 'years and years' due to being told symptoms are just down to period pain.

Furthermore, the symptoms of conditions such as endometriosis and bad period pains are often subdued through prescribing the pill to women.

As Emma Cox of Endometriosis UK previously told UNILAD, being prescribed the contraceptive pill for period pain without any investigation as to the cause of such pain may result in longer diagnosis times and not actually getting to the bottom of what the underlying condition actually is.

The pill was a lifesaver for my own heavy periods, however I'm left wondering the extent of its effect on my mental wellbeing – whether the bouts of anxiety and depression I have faced over the past five years have been made worse by the hormones I am putting into my body on a daily basis.

Furthermore, while the pill has helped with my pain, it's not aided in providing any quicker a diagnosis as to what the root of the problem with my womb is. Dr Edi-Osagi noted: "One of the debates we've had for many years in gynaecology is whether it is acceptable to start young girls on the pill before we make a diagnosis of endometriosis. That debate is still raging up until now and like I said there's no right or wrong answer."

In relation to the impact that the pill can have on women's mental health, Dr Edi-Osagie warned people need to be 'mindful about the various psychological impacts the pill could have on some people'.

However, aged 16, I didn't really understand what mental health was, what state my own was in, and what impact the pill could therefore have. I was not given enough information about its potential effects on my mental wellbeing either – it was simply presented as an easy solution to my physical pain.

Dr Edi-Osagie explains the different types of the pill that women have available if others don't work as well in relation to their physical or mental wellbeing.

"The combined pill might have a different effect, as it contains both oestrogen and progesterone so it might have different effects to the progesterone-only pill. Pills you take orally make have different effects from contraception that you take through other roots, such as skin patches or the vaginal route," he explained.

He commented how GPs should look at 'all of those options [...] depending on the impact the pill has'.

Dr Edi-Osagie stated: "I mean contraception is very effective, we have various forms of contraception now. The only thing is most of the options are mainly to do with the woman."

Dr Edi-Osagie resolved: "With what's going on in the world now, I think it's only right that men play their part and take some of that responsibility and take some of that action to actually help provide contraception for couples."

He noted how 'a lot of work has gone into it', so men should feel reassured that they know it's safe and effective.

The only drawback Dr Edi-Osagie acknowledges so far has been how to 'provide it in a cost-effective way that is acceptable to the recipients who take it'.

Dr Edi-Osagie was not able to confirm when the highly-awaited male contraceptive pill – or any other contraceptive methods for men – will be released. But he concluded: "We're looking forward with anticipation to it being available."

All we can hope is other men will be as equally as open-minded when the pill is finally released.

If you're experiencing distressing thoughts and feelings, the Campaign Against Living Miserably (CALM) is there to support you. They're open from 5pm–midnight, 365 days a year. Their national number is 0800 58 58 58 and they also have a webchat service if you're not comfortable talking on the phone.

If you or someone you know is struggling or in crisis, help is available through Mental Health America. Call or text 988 to reach a 24-hour crisis center or you can webchat at 988lifeline.org. You can also reach the Crisis Text Line by texting MHA to 741741.