Our most recent MCI fellow Stephany Strahle sat down with us to discuss her interest in male contraception and motivation in her work. This blog post shares highlights from that conversation
Four years ago, I bought a 1936 copy of the Medical History of Contraception by Norman Edwin Himes. I wanted to learn more about the seemingly ancient and sometimes outlandish contraceptive methods used worldwide. Nowadays, other than the occasional mention of the fun fact that some societies used elephant dung as an effective contraceptive method, I rarely open up or think about the book. The book entered my life, however, as I was experiencing my own bouts of debilitating side effects from contraceptive use. To know that despite the immense technological advancements behind contraceptive methods, they still produced unwanted side effects for many users, who were most often people with uteruses throughout its history, left an unsettling feeling.
Humans have been seeking contraceptives for centuries. This seemingly ubiquitous and historical desire for options that address our individual reproductive health needs is an ever-evolving public health concern. Adding modern male contraceptives to the mix spurs us to think differently about family planning systemically.
At the start of my summer fellowship with the Male Contraceptive Initiative, I had hardly a clue of the inner workings of contraceptive development – let alone for male contraceptives. In my time with MCI, I focused on exploring the policy and regulatory side of the field. Historically, male contraceptives have received little attention in these spheres, but as research advances, the need for tangible discussions and partnership-building becomes increasingly apparent. In the United States, Congressional members are uniquely positioned to advocate the need for the Food and Drug Administration (FDA) to establish timely guidance for conducting large-scale clinical trials and contraceptive approval based on the robust science emerging from the male contraceptive research community. As MCI looks to engage with policymakers on this issue, part of my work consisted of fielding which Congressional members could serve as strong policy proponents for male contraceptive development.
The second part of my work centered on understanding the current metrics used to determine male contraceptive efficacy and how that applies to designing the regulatory guidance the industry needs. Through sperm count analysis, male contraceptives have demonstrated effectiveness at a sperm count of <1 million/mL, a threshold the male contraceptive research community has long utilized. For later phases of development, however, large clinical trials only allow for couples to participate, which quickly becomes costly and lengthy and places both female and male participants at risk of unintended pregnancy. Shifting the standard to incorporate the demonstrated sufficiency of using sperm count analyses to reach that threshold of <1 million/mL is ideal for allowing greater participation from single sperm producers, reducing costs, and facilitating more efficient trials.
Learning about these aspects of male contraceptive development gave me a new lens to view contraceptives and reproductive health generally. I think this is an exciting frontier to usher in science-driven policy solutions to contraceptive access both nationally and globally. Adding more options for male contraceptives that are reversible and non-hormonal requires establishing regulatory guidance based on the mounting evidence from the male contraceptive research community and garnering support from policymakers across the nation for increased contraceptive access and innovation. For individuals and organizations at the forefront of male contraceptive advocacy, strategically building those bridges between science and policy can help bring modern methods to the general public and really put “reproductive freedom for all” into practice.
Want to lend your voice to the conversation? Reach out to us and share your thoughts today!