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Pill-osophy: Redefining Birth Control for Men

Pill-osophy: Redefining Birth Control for Men


Men and their sperm are a little bit like AK-47 guns—always full of sperm, ready to fire with alarming enthusiasm. Every single ejaculate consists of hundreds of millions of sperm, so they have the potential to make someone pregnant at any given hour of any given day. Whereas women ovulate only once a month, and it takes a special full moon night with cosmic rays filtering in from Jupiter to make them pregnant (in case you didn’t realize, I am joking ). Then why are most birth control options aimed at women, with condoms and vasectomies being the only options for men?

Why is the responsibility of contraception not shared? Why can’t we develop birth control options for men? Feeling frustrated with these fuckall limited options is natural, there should be more money funnelled into male birth control. There should be more options. Not just because the sole duty of contraception should not lie with uterus owners, but also because penis owners deserve choices too. It doesn’t help that a lot of penis owners refuse to share the burden of contraception. If men desire long-term contraception, they can always get a vasectomy, but fears about post-surgery pain (and some myths about losing masculinity after surgery) stops them there too. Although birth control is largely in the hands of women—so men cannot interfere or subjugate women in their reproductive choices, as some of them tend to do—it is truly unfair that the whole burden of planning, purchasing, and dealing with the consequences lies on the woman. And it is also truly unfair that the men do not get a say. But why is it so difficult to make a male birth control pill? How do we empower men with contraceptive choices, and how do we hold them responsible for sharing contraceptive duties? Why haven’t we been able to make a male birth control pill for so long?

Understanding how pregnancy works.
Every month, several eggs mature in the ovaries; out of these eggs one becomes the biggest and strongest. This one egg is released at some point during the month in the process we call ovulation, while the rest of the eggs die. This egg stays alive for about 24 hours, during which it must be fertilized. If that doesn’t happen, then within 14 days of releasing the egg, you get a period, and your body starts recruiting and developing a fresh new lot of eggs for the next month. Now on the other side, about 200 million sperm are

released in every ejaculate, no matter what time of the month the ejaculation happens. (Remember, sperm is prepared fresh every day; testicles make around 1500 sperm every second . And ovaries are born with all the eggs they will ever have; you only have about half a million remaining by the time you hit puberty.) So, while a woman can only get pregnant for a few days in a month, men can go around impregnating hundreds of people every single day. In theory, I mean, it’s pretty hard to have sex with hundreds of people every day. You’d need some weirdo to calculate how many people you can realistically have sex with in one day to figure out how many you can impregnate.

Don’t worry, team Peppy is that weirdo, and we calculated. In a 24-hour day, there are about 14 hours available to have sex. We accounted for 8 hours of sleep, and 2 hours of grooming, eating, and preparing for sex. Now the average duration of penetrative sex is about 2–7 minutes, so if we were to take a rough number of 5 minutes per penetrative sexual intercourse, plus at least 30 minutes of refractory period between the sex episodes, one can ejaculate every 35 minutes. That works out to: 14 × 60 = 840 minutes, so in the 840 minutes available per day for ejaculation; 840/35 = 24, one can jizz about 24 times. Obviously, we are not counting for the logistics involved in this such as setting up the vaginas to ejaculate into, the wooing and the foreplay, and the dilutionn of semen which would happen with so many back-to-back jizzaculations.

Why male birth control is difficult
Penis owners can make about 24 people pregnant daily, which is 720 every month! Whereas uterus owners only have this magic pregnancy window for barely 3–5 days in a month. So, wouldn’t it be more effective to target the millions of sperm? Well, yes of course! But is it easier? Umm . . . NO. And that’s where the problem with male birth control lies. There are just so frikkin many sperm made all the frikkin time, that it is very hard to stop those little slippery swimmers. It’s not because of a lack of people wanting to do that. It’s because it’s so hard! You’d still be quite fertile and produce millions of sperm even if your sperm count fell by 90 per cent! It is much easier to stop one egg being released every month than it is to stop hundreds of millions of sperm being produced every single day.

Now, birth control pills for women work in a very clever (and ironic) way—by mimicking a 

pregnancy. Once your body becomes pregnant, it will not release more eggs out into the wild for making Baby No. 2 while already pregnant, right? Instead, it will release some hormones that prevent the new egg from being released. Birth control pills contain these same hormones (that your body releases after ovulation) which make sure you don’t immediately release more eggs. Now you start taking birth control pills at the beginning of your cycle, before ovulation has occurred. But from the very beginning of the cycle, these birth control pills maintain the hormonal bank balance that you would naturally have after ovulation. This makes your body think that ovulation has already happened, and your ovaries do not release more eggs. This is how ‘anovulation’ from birth control pills works, by mimicking a pregnancy.

If that was difficult to understand, think of it like this. Think of going to a restaurant and ordering food. Now, if you’ve ordered a massive chocolate cake to begin with, you won’t go back and order a giant pizza na ? (Okay fine, I know some of you will. No judgement. Just play along for my story, okay?). Instead, after eating the giant chocolate cake—think of this as ovulation—your body will release satisfaction chemicals inside you that make you feel full. This way you will not order the giant pizza. Now imagine there is a magical pill called NoMoreFood (think of this as birth control pills). NoMoreFood Pill contains the same chemicals your body naturally releases after eating cake (ovulation), which make sure you don’t immediately order a new pizza (release new eggs). Now, you would take the NoMoreFood pill outside the restaurant, before you eat the cake. This way, from the very start of your restaurant visit, the NoMoreFood pill will maintain the satisfaction you would otherwise have after eating the cake. This makes your body think you are already full (have already ovulated), and you don’t order the cake (anovulation), even though you never ate the cake to begin with. This is how birth control pills work.

Contrast this with sperm, which are produced fresh inside the testicles. At the start of puberty, your body makes a delicious testosterone milkshake, which is essential for the formation of these sperm. And once you start producing them, you never really stop. It’s a 24/7 kinda situation. The only way to stop them would be to either completely shut down the testosterone milkshake production, or to block the road these sperm use to exit the body. We’ve actually already used that second option, since that’s how a vasectomy works. Some scientists are also working on making a plug that you could inject inside the vas deferens, i.e., the tube that connects the testicles to the penis and helps transport sperm out, that could be dissolved with an injection if someone wanted to be fertile again. They’re still going through trials for this as of 2022, so it may be a while before we see it in the market, if at all.

The problem with using the first option is that testosterone is a little bit essential for daily living. (As are estrogen and progesterone, but with birth control pills, we provide these hormones continuously, in amounts that our bodies naturally produce anyway during a part of our cycle. We don’t stop them entirely. It’s like giving you the same food every single day versus stopping food altogether.) Testosterone is essential for muscle and bone strength, among many other things. Stopping testosterone is not really an effective answer unless we could specifically stop testosterone locally only in the testicles. Luckily, for us, there is a group of doctors and scientists that are working on a drug that works locally on the testicles to reduce testosterone, and therefore sperm production. It’s still in the works though.

So it’s not that we aren’t working on making alternative contraception options for men. We’re working, and we’re working very hard. Male contraception (other than condoms and surgery) is simply not at a stage where it can be considered safe and healthy by doctors and scientists. And I am not saying that there is no discrimination in medicine; there really is, and we are working on it, and will need to work on it for a very long time before it becomes even close to a level playing field. I’m saying that it’s hard, and it will take some time for us to make a safe alternative that works as well. It’s kinda like this: say you were to hear a really annoying tune on the TV. Would it not be easier to temporarily turn that TV off? Or would it make more sense to throw the whole TV out of the window to stop the song? Except it’s not one TV, but 15 million of them.

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