Finally, the ‘male Pill’ is here. So what DOES it do to your sex life? Hot flushes. Mood swings. And an extra half a stone — for him! After a year testing a revolutionary hormonal contraceptive for men, one brave couple lift the covers
- Ed, 32, is one of more than 100 men trialing the drug Nesterone/Testosterone
- Spotted advert for medical trial of male hormonal contraceptive near Edinburgh
- His partner Fiona, 30, experienced a freak side-effect from contraceptive coil
- Ed reveals male contraceptive side effects include hot flushes and weight gain
Fraught with worry, paramedic Ed was rushing alongside a trolley through hospital corridors when a poster on the wall caught his eye.
Volunteers wanted, the A4 sheet declared. Researchers were looking for recruits to test what would be the first male hormonal contraceptive on the market. And the medical trial was set to start near his home in Edinburgh. Had he seen the poster just a day earlier, he wouldn’t have given it a second glance. But the reason he was in hospital on that summer day in 2019 made the notice seem more like fate.
Because Ed, now 32, wasn’t on the ward for work. Instead, he was watching over his beloved partner of eight years, struck down with sepsis — a life-threatening condition that came about after surgery to treat a freak side-effect of her contraceptive coil.
Proofreader Fiona, now 30, had been using the copper coil or IUD (intrauterine device) — a hormone-free contraceptive that sits inside the womb — for more than six years without any concerns when she went to the doctor complaining of what she believed to be period pain.
Ed, 32, who has been in a relationship with Fiona, 30, (pictured) for eight years, reveals the symptoms he experienced while trialing a drug called Nesterone/Testosterone for 18 months
In fact, a 7 cm (3 in) abscess had developed in her pelvis near her fallopian tube. Similar to toxic shock syndrome, the infection could be linked to her coil, doctors told her. However, emergency surgery to remove both the abscess and the coil had resulted in sepsis, and her being rushed to intensive care. A traumatised Ed spent a fortnight at the bedside of his barely lucid girlfriend — more than enough time to concentrate his mind on who would take the lead on contraception in the future.
Doctors advised that the coil was now too risky and, while Fiona had tried hormonal birth control in her teens and early 20s, she found the Pill brought on bouts of depression and tearfulness. So without these options, what could they do?
They could just have used condoms or other barrier protection. But, keen to maintain a spontaneous sex life, Ed saw little reason not to do what women have done since the 1960s. A long-term hormonal contraceptive he would take seemed to be a logical solution.
‘I thought, why shouldn’t I be taking responsibility if I can?’ says Ed. Clearly, he is devoted to Fiona. When he met her on a dating site in 2013, the site’s algorithm had them down as a 99 per cent match — while also noting the couple were ‘significantly less romantic than average’.
But while buying bunches of flowers might not be his style, Ed believes taking on something as crucial as birth control was the ultimate romantic gesture.
When Fiona was safely back at their home from hospital, they discussed it. Ed found she was keen for him to ‘take his turn’ and felt liberated by him offering to take over the burden of contraception. ‘I really do think a lot of guys don’t realise the daily commitment of managing birth control,’ says Ed. ‘But there’s no good reason why they shouldn’t have the option of doing so.’
Ed is one of more than 100 men trialling a drug called Nesterone/Testosterone, tipped to become the first male hormonal contraceptive on the market.
It works by using a progestin — a synthetic hormone also used in female contraceptives — together with a synthetic testosterone to switch off a man’s natural testosterone production, thereby preventing sperm being made in the testes.
Ed decided to do the medical trial of the male hormonal contraceptive, after Fiona (pictured right) was safely back at their home from hospital
The synthetic testosterone also ensures the man’s libido and overall physical health is maintained. The result: no sperm in his semen but, researchers say, few other discernible effects.
Just as with the female Pill, the trial so far indicates it is reversible. Within a few months of halting the drug, volunteers’ sperm production returns to normal, just as a woman’s ovulation resumes after stopping the Pill.
The male ‘Pill’, however, turns out to be a gel, which Ed has to apply daily.
Every morning around the same time, after showering, he applies the gel across his shoulder blades and chest, waits a minute for the residue to dry as the hormones are absorbed through his skin and into his bloodstream, and ‘that’s it, I wash my hands, put on my shirt and go about my day’.
Sounds simple. So why has it taken so long for a male alternative to the Pill to arrive?
Dr John Reynolds-Wright, a clinical research fellow working on the Edinburgh trial, says: ‘Efforts to create a male contraceptive in the same vein as the Pill were first made in the 1950s, but it’s trickier to make a male contraceptive than a female one, partly because if you give testosterone in a tablet form, it breaks down very quickly.
‘You’d have to give it six times a day to get an effective dose.
‘In addition, in women a hormonal contraceptive works to prevent ovulation. Ovulation only happens once a month, whereas men are producing millions of sperm daily. So you’ve got to have a drug that does more “work” to get the same effect and protect people from pregnancy.
Dr John Reynolds-Wright who is a clinical research fellow working on the Edinburgh trial, said it’s trickier to make a male contraceptive than a female one (file image)
‘A sperm count of less than one million sperm per millilitre of semen is considered effectively a contraceptive. There’s less than 1 per cent chance of pregnancy at that concentration — although lots of men on Nesterone end up with a sperm count of zero.’ One million sperm may sound a lot, but a healthy man will have more than 15 million per millilitre.
Some men perceive taking a male ‘Pill’ as somehow unmasculine. So how does it feel to be ‘firing blanks’, as Ed himsef describes it? He reports his masculinity remains intact.
As for matters in the bedroom? No ‘tangible changes’, reports Ed. Fiona agrees: ‘Our sex life is exactly the same.’
There is one difference: Ed has to shower religiously before sex because if the gel were to rub off on Fiona’s skin she could absorb too much testosterone and her own hormone balance would be affected.
As for side-effects, Ed adds: ‘I do occasionally get hot flushes and night sweats. And I’ve gained 3-4 kg [around 7 lb].’ The hot flushes are attributed to his hormonal balance being slightly disrupted, just as women experience in midlife. Ed says: ‘I don’t mind having the odd hot flush if that’s the price for an absolutely easy, carefree sex life.’
As for any emotional fragility, Ed has taken to his ‘mood changes’ like a duck to water. ‘Anything hormonal is going to affect different individuals differently,’ he says. ‘But something like the gel should still be an option for men.’
I wouldn’t trust my younger self with this…
by SIMON MILLS
As a sexually clueless but inquisitive teenager and a recklessly priapic 20-something, contraception was a big subject.
Condoms were the cheap and readily available solution. Yet they seemed like clumsy passion killers. Much easier and safer to make sure the girl was ‘on the Pill’ before you ‘did it’, right?
Yep, that’s how useless, self-centred and irresponsible boys like me tended to be.
Simon Mills (pictured) admits when he was younger, he couldn’t have been trusted to rub a gel into his shoulders daily
As I remember it, as far back as the 1970s, scientists have claimed the male ‘Pill’ was on the way. One version saw it administered as an injection directly into the penis (where it blocks sperm from leaving the testicles) — only to be dismissed by males because, well, what man wants to do that?
But now an effective, wince-free-application male contraceptive ‘Pill’ is here, administered as gel, and applied as a part of the daily male hygiene routine. Yet I can’t help but remember that as a young man I rarely bathed.
Once, during an idyllic summer spent sleeping mostly rough in the South of France, I realised I hadn’t showered or bathed properly (ie not in the sea or via a quayside tap) for almost three months. Which meant the most effective contraceptive was probably the honk coming from my underarms. And unless it was a quick spray of Ralgex before rugby, I certainly didn’t do anything namby-pamby with gels or unguents.
Could I have been trusted to rub a gel into my shoulder every day? Even with the promise of sex at the end of it? Hmm.
To 20-something me, the idea of doing something, anything, regularly, as part of a routine, was a non-starter.
But, of course, things are very different now. A quick look at the buff, preening, tight-trousered narcissists across Instagram supports the prediction that the global men’s grooming market will be worth a massive £57 billion by 2025.
The upside of this boom in male vanity is that my two daughters, now in their 20s, would, I imagine, have no hesitation in trusting a man to gel himself up in the name of what used to be called ‘family planning’.
Me? As a 57-year-old man who is no longer in his sexual prime, but scruffed and power-showered, I could probably just about be trusted to use it too. If only the bedroom action I was ready for these days didn’t mostly involve a hot water bottle and television remote control.
Friends and family have been supportive. Several of Ed’s mates have ‘indicated they would be up for using the gel if they weren’t actively trying for children’. Ed and Fiona don’t plan to start trying for a family for several years.
So is the gel something you would trust a less mature man to use properly? Would a woman in a short-term relationship feel confident leaving the responsibility up to a casual partner?
‘I think it would have been deeply optimistic for the teenage me to think he needed to use a contraceptive every day,’ says Ed.
Fiona adds: ‘I suspect, if I were younger, I would want to be on birth control as well. When I was in my early 20s, I was on the weekly patch because I found it easier to remember than a pill. So if doing something daily was going to be tough for me to remember, it would have been much nicer for me to know both of us were doing it.’
Their participation in the 18-month trial concludes in a few months — and they will no longer have access to the gel, so it will probably fall to Fiona to take some form of hormonal contraception.
‘I’m devastated,’ she says. ‘It’s been wonderful to have this time using something that works for us both. I have mood swings in the first few months of using hormonal contraception, so I am not looking forward to it. Aside from the coil, which is simply too dangerous for me to use again, the gel is the best contraceptive we’ve had. It would be my first choice if we could keep using it. It’s a shame to have to go back to second or third best after a really nice year where I haven’t had to worry at all.’
Ed adds: ‘There could be some troubles ahead. I’ll have to be tactful because suggesting any arguments are down to the Pill will probably make things a lot worse.’
Experts hope the male ‘Pill’ might be on the market within the next five to ten years. Then, say Ed and Fiona, other couples can try the carefree contraception that has been such a lifeline for them.
WOULD YOU RELY ON YOUR MAN TO TAKE IT?
Janet Street-Porter says:
There’s a simple reason men cannot be trusted with birth control.
It’s not because they are liars, forgetful, or duplicitous. Women can be all those things too. The simple reason a contraceptive gel or pill for men will never be commercially viable is because ever since the advent of the Pill in 1961, women have been in charge of their own destiny.
Once you’ve tasted that freedom, why hand it back? The Pill switched power from one sex to another. It marked an historic moment for women, giving us control over our bodies and lives.
Janet Street-Porter (pictured) said men are good at many things, but she wouldn’t trust them with her fertility
Before the Pill was readily available, my generation had to rely on condoms — rely on men who would agree to use them, trust men not to remove them at the last minute. Men had the power in lovemaking and women who didn’t want to run the risk of an unwanted pregnancy had to be on their guard.
I know from bittersweet experience, having had two frightening abortions while still a teenager, that trusting men (or the impulses of a headstrong young girl — me! — who thought she’d be lucky and not get pregnant) is not always the best policy.
Are women prepared to hand the job of birth control over to men? It doesn’t look that way. In a survey by Anglia Ruskin University in 2011, over half the women said they would worry men would forget to take the Pill or use a gel if it was available.
After those two teenage mistakes, I religiously took my contraceptive pills right up to my 40s. I chose not to have children — along the way I cared for a stepson (who sadly died from cancer) — and focused on my career as a TV executive, then a presenter and national newspaper editor. All demanding jobs with long hours.
The Pill gave me the freedom to craft my life and make decisions all by myself. It removed a huge amount of worry and anxiety. Was my decision not to have kids callous and self-centred? I made it clear to the men in my life I was using contraception and didn’t want babies.
The Pill gave me the life I chose and I don’t regret any of it. Men are good at so many things. But I wouldn’t trust them with my fertility.
Linda Kelsey says:
Eugynon 30. A name that still has the power to make me shudder. It was what was handed out to me, aged 17, when I went to the on-campus health centre my second week up at university in 1969.
No questions asked, no information given, an automatic prescription to keep me safe from pregnancy. I wasn’t warned about the headaches. Or the weight gain. Or breasts so sore I could hardly let a boy near me, certainly not near enough to make me pregnant. By the end of my first term I’d gained 10 lb and a stash of anti-fungals for regular bouts of thrush.
Linda Kelsey (pictured) questions being in a relationship with someone who you can’t trust to slather on some gel as part of his morning routine
Contraception and I always had something of a dysfunctional relationship. If The Pill and I didn’t get on, and I experimented with several different ones down the years, neither did I feel happy with anything else.
The cap was messy and smelt weird. The coil gave me shooting pains in my pelvis, and had to be removed.
One grand contraceptive fail led to an unwanted pregnancy and an abortion I feel sad about even to this day.
Gosh, I’d have been thrilled if there had been a fail-safe male contraceptive around at the time — in the form of a pill, a patch or a gel. And while I wouldn’t have risked leaving contraception entirely up to a man in a casual relationship — unless it was something like a condom — I could see, once I’d become part of a couple, I would have loved to hand over some responsibility.
Yes, it’s a matter of trust, but if you can’t trust someone you’re living with in a long-term relationship, then what on earth are you doing with them in the first place? And if you think he’s too daft to remember to slather on some gel as part of his morning routine, I suggest you may have chosen someone not bright enough for you.
The one thing I don’t miss, now that I’m post-menopausal, is having to carry the burden of contraception. Women have a lot of physical stuff to put up with that men don’t. Periods. Pregnancy. Childbirth. Raging hormones and, when it comes to menopause, the list can be endless. So share the pain, I say.
I really don’t think massaging in a bit of gel — so long as its effects on sperm production are reversible — is a lot to ask of a loving partner.
If I were young again, I’d even be prepared to rub it in for him.
The study at Saint Mary’s Hospital, part of Manchester University NHS Foundation Trust, and the University of Edinburgh is recruiting men between 18 and 50 in a stable relationship with a woman aged between 18 and 34. Call 0161 276 3296 (Manchester) or 0131 242 2669 (Edinburgh).
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