The Gendered Politics of Hormonal Birth Control

I sat in my gynecologist’s patient room in a blue paper gown. “My birth control doesn’t work again,” I blurted out as she walked in. I explained to her, yet again, that I was getting multiple periods each month.

That was August, the fourth time I’ve had to have that conversation about changing medications. But, like the others, it soon stopped working. While it limited me to one cycle a month I felt physically horrible; I couldn’t keep my eyes open for more than a few hours at a time; I had eye-watering migraines; I had overbearing cramps; I gained and dropped weight drastically, sending my body image into a horrible roller coaster. So now, I am about to start my fifth birth control prescription in less than a year and a half. I am not merely changing them based on trends, either. The pills, after a few months, suddenly lose out to my natural hormones.

Why are women the ones who must endure the distressing changes that go along with hormonal birth control methods?

Male hormonal contraceptive methods have been largely unexplored in modern research. However, the latest study on male contraceptive injections proved to be about 96 percent effective. However, it was stopped prematurely –in the phase two of three– due to the drug’s unbearable side effects.

In a study sponsored by the United Nations and the Journal of Clinical Endocrinology and Metabolism, 320 healthy men in monogamous relationships, ages 18-45, were tested with the injections. The shots consisted of synthetic testosterone, similar to how female birth control pills use synthetic estrogen and progestin, to decrease the production of natural sperm. Researchers found that the sperm count in men using the injections dropped significantly, from 15 million/mL to 1 million/mL after just a 24-week period.

Negative side effects experienced by the men in the study included one case of depression, irregular heartbeat, injection site pain, muscle pain, acne and mood swings. (Hmm, sounds familiar!) Twenty men even quit the injections, citing these reasons. However, despite this, more than 75% of the participants said they would still seek this form of male contraception if it were made available.

As women, we are still fighting for the rights to our own bodies. The modern fight lives on in this country in the politics of abortion rights and access to contraception. Methods of birth control have long fallen to women to handle—diaphragms, IUDs, injections, patches, and pills are all made for women.

The FDA approved the first hormonal birth control pill in 1957 for severe menstrual disorders. In 1960 the pill was approved for contraceptive use and within five years, more than 2.3 million women were on the pill. However, it was not until 1972 that a Supreme Court case (Baird v Eisenstadt) legalized birth control for all women, regardless of their marital status (previously, only married women were granted access).

Women’s health journalist Barbara Seaman published a book in 1969 titled The Doctor’s Case Against the Pill. In it, she exposed many of the side effects of the pill, including stroke, depression, blood clots, and heart attack. This was just the beginning of the negative publicity about the pill; by the end of the 1970s, its sales had dropped 24 percent.

Today, about 50 years after Seaman’s book, the list of common side effects for birth control includes nausea, headaches, weight gain, and mood swings. And more severe side effects included blood clots, blurred vision, seizures and heart conditions.

Women have come a long way in the name of reproductive freedom; women have long fought for the right to make decisions about their own bodies. And while there is no greater pride in this history of courage, it must also be recognized as a one-sided burden to comply with an androcentric medical system.

Sparse research on male contraception suggests that there has been scientific interest. Endocrinologist Gregory Pincus, who is credited with the co-creation of the female contraceptive pill, was doing similar research on men in 1957 but it never came to fruition once the pill became a hit. In the 1970s, a non-hormonal drug known as gossypol was tested in China as a male contraceptive and seemingly worked. But the side effects were problematic, ranging from fatigue to paralysis. A Brazilian pharmaceutical company picked it up 20 years later, but the previous side effects, along with infertility, inhibited the drug from hitting the market. In 1998, the WHO recommended that all research on the drug be abandoned. Ten years later, enrollment for this latest study began.

If scientific research is not inhibiting male contraceptive methods, what is?

Science has never been closer to discovering a hormonal contraceptive for men. But on the latest attempt, the study was stopped short due to the symptoms—the very symptoms that women have endured for decades in the name of preventing unwanted pregnancy. But instead of calling men in the study “wimpy” or “weak,” maybe it is time to instead explore the gender disparity in how we politicize contraception and its side effects.

Now if you’ll excuse me, I have to go pick up my new prescription.

Further Reading:

Andy Extance, “A Brief History of Male Birth Control: Clinical Research is Promising but We Still Have A Ways To Go” Medical Daily (2016)

R.E. Fulton, “‘She Looks the Abortionist and the Bad Woman’: Sensation, Physiognomy, and Misogyny in Abortion Disclosure” Nursing Clio (2015)

Gloria Steinem, “If Men Could Menstruate” Outrageous Acts and Everyday Rebellions (1986)

V. Tanner, “Why We Must Stop Calling Menstruation A ‘Women’s Issue‘” The Establishment (2016)