Could contraception also become a question for men? This question, relayed by feminist associations, must be on the menu of the government’s sexual and reproductive health strategy, presented this Wednesday, December 1, which should encourage it.
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Today, male contraception is very rare. According to a WHO study conducted in 2019, among women in a stable relationship, the three most common methods in this case are the use of a condom (18%), withdrawal (5%) and vasectomy ( 2%). “Suffice to say that male contraception is very under-represented and that the methods used are not without flaw,” said Dr. Jeanne Perrin, responsible for training in male contraception at the French-speaking society of andrology.
The first two methods are not completely effective in terms of birth control, less so than female contraception. As for vasectomy, a surgical operation which consists in cutting the channels which transport sperm, it is a definitive method which has only been authorized in France since 2001. “Until then, it was seen as mutilation because we do not can’t really go back. It is the equivalent of a tubal ligation in women, ”explains the doctor. If it has quadrupled since 2001, according to the French Society of Urology, the recourse rate has now reached 1%.
Other solutions however exist, but have not been developed. First of all, male hormonal contraception is technically possible. “The WHO validated a protocol in the 1990s”, explains Jeanne Perrin, consisting in injecting a derivative of testosterone into the man once a week. This restrictive method has not been deployed, in particular because the therapeutic indication is not the contraceptive goal. Doctors who choose to prescribe this drug therefore do so “off-label” (marketing authorization), under their own responsibility. “It is certain that, like the first generation pill in its day, this drug has certain side effects. New, safer versions are being studied, particularly in the form of a gel. “
Another avenue, thermal contraception, sometimes referred to as “heated briefs”. “It is a device whose ability to block spermatogenesis has been demonstrated. It is patented by the Toulouse hospital ”, assures Jeanne Perrin. However, no commercialization is possible, for lack of a phase 4 study. At an estimated cost of 1 million euros, this has never interested laboratories. The few models sold on the Internet are not necessarily reliable.
“Things could change, however, in the years to come, anticipates the doctor. Mentalities are changing very quickly on these subjects and men are now more open on the issue. However, the day there is a market, laboratories will invest in research. “