Birth control for men: Is there gender inequality in health research?
Various forms of birth control — including the pill, injections and implants — have been widely available for women since the 1960s. However, as of yet, there hasn’t been a viable option for men using similar methods.
A study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism in October reported a high success rate during a clinical trial of an injectable contraceptive for men. However, after three years, the study stopped enrolling new participants due to what they called serious side effects, such as depression and mood disorders reported by those involved in the study.
However, over the years, depression has been linked with the birth control pill as well as injectable birth control methods for women such as Depro Provera.
And in October, a study suggested that women who used hormonal contraception had a 40 per cent chance of developing depression after six months of use.
Yet these birth control methods continue to be on the market. Is there a difference between how the medical community handles research between the sexes?
“I think there’s inequality throughout medicine; gender inequality throughout health,” said Cristabelle Sethna, associate professor at the University of Ottawa’s Insitute of Feminist and Gender Studies.
“I don’t think it’s specifically about birth control; I think it’s about medicine in general.”
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Even with the associated risks of depression using horomonal birth control, it doesn’t seem as though any of the options are coming off the market any time soon.
The difference, said Doug Colvard, Contraception Research and Development’s (CONRAD) deputy director for programs at Eastern Virginia Medical School, which co-sponsored the study, may lie with various research monitoring agencies. Some may have tighter restrictions and lower tolerances.
In the case of this study, Colvard said the research team was initially given the go-ahead to continue the study, even after reports of depression. However, when the World Health Organization (WHO) examined the data, they felt it was unwise to continue.
“So, I wouldn’t go to say the different standard is being applied to men and women,” he said.
“In late March 2011, a different review group with the WHO … when they looked at the data, they had a different interpretation about … what the side effects were, and recommended that the potential adverse effects to participants going forward wouldn’t be outweighed by the better data what would be obtained if the study was continued,” said Colvard.
However, there’s been ongoing debate in gender inequality within the medical community.
In 1994, the U.S. National Institutes of Health implemented guidelines for the study and evaluation of gender differences in clinical trials. However, the problem didn’t seem to subside. Even in 2005, a report found that eight out of 10 prescription drugs were pulled off the market because of health issues experienced by women.
A 2014 study reported that differences in gender was still ongoing throughout research, in particular when it comes to cardiovascular disease. And, though depression is 70 per cent more likely to occur in women, their study found that “fewer than 45 per cent of animal studies on anxiety and depression use female lab animals…”
Ensuring that equal amounts of research are done on females and males is important as various factors cause women to metabolize drugs differently. So, while drug trials may be successful in treating a particular health concern in men, it may not be the case for women.
Continuing the research
Though Colvard admits having to halt the study was “very disappointing,” he said there could be other means of delivering hormones to men when it came to birth control, such as a transdermal gel that might be better than a single big injection. So there is still promise for a male hormonal contraceptive.
Sethna said that while she believes the medical community approaches studies differently when it comes to the sexes, she hopes research continues in the development of a male hormonal contraceptive.
“I don’t want this unfortunate side effect to stop research on really effective male contraception,” she said.
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