The idea of male contraception has been around for 60 years. Gregory Pincus, the co-inventor of the female contraceptive pill, tested the same hormonal approach on men in 1957, and various hormonal and non-hormonal methods have been explored since. Based on side effects and other research complications, there are still only two reliable, non-hormonal contraceptives on the market for men today: condoms and vasectomy.
FHI 360 | Distinguished Scientist and Director, Contraceptive Technology Innovation
As contraceptive product developers, we should support development of contraceptive options that rapidly and reliably eliminate bleeding to offer women a liberating choice.
This piece was originally published by the CTI Exchange blog, Exchanges.
Menarche—the onset of menstruation—is a rite of passage for young girls everywhere. In many cultures, this milestone of womanhood comes with celebrations steeped in tradition. But following the ritual comes the reality of having to manage this aspect of being female for 40 or more years.
Worldwide, women refer to menstruation in various ways, reflecting their many attitudes toward it. Where I grew up in northeastern Pennsylvania, my family and friends called it the “curse” (in my opinion, for good reason). And, as much as many women dread “Aunt Flo’s” monthly visit, they have come to rely on their “friend” as a confirmation they are not pregnant. Others see it as affirmation of womanhood or view it as a natural and necessary means of cleansing to remove accumulated blood.
Injectable contraceptives are used by more than 50 million women globally. In much of sub-Saharan Africa, they are the most commonly used family planning method. The most popular version, Depo-Provera (depot-medroxyprogesterone acetate, or DMPA), is administered intramuscularly (IM) or subcutaneously (SC) every three months. The SC form is marketed globally as Sayana® or Sayana® Press.
Injectable contraceptives appeal to many women because of their relatively long duration of action (one to three months depending on formulation), high effectiveness (>94%), and ease and discreet nature of administration.
After being embedded in reproductive health work for 15+ years, I’ve found myself intrigued by the novelty of male contraception. I accepted a position on the Board of Male Contraception Initiative (MCI) two years ago, and then stepped in during a leadership gap as Interim Executive Director at the end of 2017.
The time has come for innovation in the contraception space. Don’t get me wrong—I love the Pill and LARCs, but they all rely on interrupting female hormonal cycles. And think about it: There has been little to no innovation in contraception since the ‘50s, and it’s 2018.
After the Pill hit the market and sparked a virtual revolution in women’s lives, researchers invented new ways to deliver hormones, including injectables, implants, patches, and hormonal IUDs. Women now have an array of hormonal contraceptive choices with the ensuing side effects. Because this method of action—the interruption of the menstrual cycle using hormones—is so effective, there has been little research on non-hormonal contraception with fewer side effects for either men or women to date.
Use of contraceptive implants has increased dramatically over the past several years. This trend is especially evident in several Family Planning 2020 (FP2020) focus countries, where the addition of implants is increasing the diversity of the long-acting contraceptive method mix. This is all good news.
Contraceptive implants are attractive because they are more than 99% effective at preventing pregnancy for three to five years, depending on product type. Once inserted, they are “forgettable,” with women only having to think about them when the period of effectiveness is about to expire. What these women cannot forget is that these implants require removal by a trained professional. While the procedure itself is relatively easy, finding a trained provider or making arrangements to get to the implant removal clinic can present challenges—especially in low-resource settings.
IntraHealth International | Media and Communications Specialist
mSakhi is transforming maternal and child health care in Uttarakhand. Photo: Vijay Kutty for IntraHealth International.
This post originally appeared on IntraHealth's blog, VITAL.
One of the smaller states in India, Uttarakhand lies in the Himalayan foothills with international borders touching Nepal and China. It’s a land of mighty rivers, forests, hills, and mountains. Rich in natural resources, it boasts a variety of flora and fauna, including medicinal plants, tigers, and elephants.
Women should be able to find and use a contraceptive method of their choice, and self-injection with DMPA may be an appealing option for those who want to manage their own reproductive health. Photo: PATH/Will Boase
Recent evidence on self-injection of a new injectable contraceptive called subcutaneous DMPA (DMPA-SC) is providing one possible answer to an age-old question in family planning: How do we address barriers that make it difficult for women to keep using contraception consistently?
According to three recent studies, women who self-inject with DMPA-SC in their own homes or communities may continue using injectable contraception longer than those who receive injections from providers. In many Family Planning 2020 (FP2020) countries, injectable contraception is already popular, but often requires women to return to clinics every three months for injections. This can pose a significant barrier to consistent contraceptive use, especially for women who live in rural and remote areas. These new findings on self-injection should be very good news for women who like injectable contraception—if the global FP field has the courage to put this option for pregnancy prevention directly in women’s hands.
Health advocates have a long history of increasing access to lifesaving products, especially for women and children, by affecting policy change. But what happens when, once adopted, the national policy doesn’t translate into increased product access throughout the country? Policy change alone is not always sufficient to achieve improved access to health products. However, advocates have an important tool at their disposal to complement policy change: market advocacy.