Meet the researcher behind that infamous male birth control study
Dr. Richard Anderson addresses the controversy and explains why he wants “safe and effective birth control for all”.
In late 2016, The Journal of Clinical Endocrinology and Metabolism published a landmark study on male birth control. The trial of hormonal injections initially seemed promising. It achieved a 96% success rate at preventing pregnancy in the male participants’ partners and was sponsored by the World Health Organization. But the side effect of mood disorders was so significant that an external safety review committee recommended the study be cut short. The trial’s disappointing end inspired a wave of harsh criticism. PBS Newshour asked, “Did gender bias kill hormonal birth control for men?” while Cosmopolitan’s headline simply stated, “WOMAN UP”.
Healthcare professionals, too, had questions about the research, and the study’s co-author Dr. Richard Anderson took to Figure 1 to answer them. Dr. Anderson is a professor of Clinical Reproductive Science at the University of Edinburgh and a Consultant in Reproductive Medicine at the Royal Infirmary of Edinburgh.
Dr. Anderson’s Figure 1 on 1 can be read in its entirety on Figure 1. Here are some highlights.
On the mood disorders that ended the trial
Several healthcare professionals asked Dr. Anderson for his thoughts on the severity of the mood disorders that the male participants experienced. He replied, “the great majority of mood changes were very minor and didn’t cause the men to want to leave the trial. In a trial all side effects are recorded, so you pick up a lot of things that may or may not be important.”
On side effects of female birth control
One medical student said, “This study has incited claims on my campus about preferential treatment for men in clinical studies.” Dr. Anderson replied, “I don’t think there is any basis for differential treatment. But yes the so-called ‘minor side effects’ of female contraception are very prevalent, and it is unlikely that any male method would be completely side effect-free in all men.”
“There is no such thing as a free lunch and that applies to contraception, too.”
When a medical student presented the idea that scientists have “conveniently forgotten to pursue decreasing side effects for women for decades”, Dr. Anderson replied, “You are just wrong that reducing side effects for women has not been a major aspect of the development of new methods of contraception. Just look at the changes in the COCP [combined oral contraceptive pill] over the years.” He added, “We want safe and effective contraception for all.”
On why 96% is not as high as it sounds
“One thing worth remembering is that efficacy rates are generally significantly better in trials (closely supervised, perfect use) compared to the ‘real world’ normal use situation,” Dr. Anderson noted.
On the politicization of birth control for women
A social worker student said, “Birth control and contraception for women has been largely surrounded with politics and restrictions. As a male, working with male contraception, do you think males will experience the same obstacles? For example, not getting easy access, insurance coverage, workplace interference, etc?”
Dr. Anderson replied, “These are important issues. I would hope that if male methods become as varied and widely used as female ones, these gender-specific issues will become less important.”
On the possibilities of non-hormonal male contraceptives
A pharmacist asked, “Do you think it would be viable if you could somehow immobilize the tail of sperm with hormonal or chemical treatment in an effort to stop the sperm from being able to swim?”
Dr. Anderson said this was a “great approach. There is a lot of work going into non-hormonal methods, targeting sperm maturation and function. There are a lot of good leads, but it’s a big jump from these lab studies to clinical trials and many approaches don’t make it.”
On his “wish list” for male contraceptives
“[B]uilding in health benefits (e.g. to the prostate) is certainly in the ‘wish list’, analogous to the wide range of non-contraceptive benefits of female contraception. At present the concept is that a 5alpha reductase [enzyme] component would do that. The other key issue is in relation to cardiovascular disease. At present there is a lot of debate as to whether giving men testosterone replacement increases or reduces that risk. Whether the man has pre-existing CV [cardiovascular] disease is likely to be crucial there.”
