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  • Emma Louise Alvarez

A Woman’s Breakthrough in Male Contraception

© Illustration by INJECTION - Matthew Rawlinson

Why is there such a lack of male contraceptive options? Rebecca Weiss has the answer.

The maths should be simple. 12 contraceptive options for women, 2 widely available contraceptive options for men. 1 pregnancy in 9 months, versus up to a potential of 2430 pregnancies that can be caused in the same 9 months. Why doesn’t it add up?

Contraceptive options for women range from a hormone based birth control pill, to IUDs and implants that last between 3 - 10 years, but men really only have two options: condoms or a permanent vasectomy.

Rebecca Weiss is changing that. She is a German design graduate and has won a James Dyson Award for her breakthrough in male contraception.

© Digital image by COSO

The contraceptive device is named COSO and is designed for at-home use, where it also includes an app that would be able to track sperm count. The working principle is that it uses ultrasound waves to temporarily modify spermatogenesis - it is designed to be a safe and reversible contraceptive option, where, according to its hypothetical concept, it is effective two weeks after its first application.

Weiss discusses the inspiration behind COSO and explains that it links back to her being diagnosed with a cancer precursor cervix due to contraception with the pill. She also knew that this problem was not unique to her, and sought a more accessible and user-friendly male contraception option.

It is in the use of this keyword, “user-friendly,” that Weiss explains why she thinks other male contraceptive options have failed.

According to Weiss, the research approaches to contraception for men have not caught on for a variety of reasons. The male contraceptive pill study failed due to its severe side effects. Other approaches like the Vasalgel, which blocks the vas deferens by injections or the surgical Sperm-switch-valve as an implant as well as the contraceptive pants, where the testicles slip into the abdomen couldn’t succeed. Where, according to her research, they all failed due to a lack of user-friendliness.

COSO provides a comfortable, safe, and reversible alternative. The small device is easy to operate: first it is filled with water, and after it is turned on the temperature of the water is raised until “operating temperature,” it is ready to be used by the user. The user would sit in a comfortable upright position, where the testicles would be dipped in the bowl-like device for only a few minutes.

© Digital image by COSO

But why is it only now that more advancements are being made towards new (male) contraception options? It is because (finally) attitudes towards contraception and responsibility are changing.

In an article posted in 2018, the provocative headline reads: “Men cause 100% of unwanted pregnancies.” The author, Gabrielle Blair, goes on to explain that “pregnancies happen when men have an orgasm. Unwanted pregnancies happen when men orgasm irresponsibly.” While Blair acknowledges that there are extenuating circumstances that fall outside of this, she still cites the problematic nature of men dissociating sex from pregnancy as being the culprit. And while Blair also discusses the adverse reactions to the condom and the vasectomy as contraceptive methods, new studies show that men’s attitudes towards contraception are changing.

A study from 2019, where this is the largest survey in the United States to survey sexually active men ages 18-44, shows that men are twice as likely to choose a non-hormonal method to a hormonal contraceptive, supporting Weis’s hypothesis. Another key finding cited that “85% of participants want to prevent their partner from getting pregnant and 60% of those men cite taking responsibility for birth control as the key reason for wanting a new male method” of contraception.

Weis’s new method of contraception is more than just a breakthrough in male contraception options: it fosters support for the subtle but growing cultural shifts towards gender equality. If more men are willing to take responsibility for contraception and join the conversation on how to improve the options that are out there, it shifts the very conversations we are currently having around gender and responsibility.

Another more recent study, published in April 2021, offers a systematic review of whether men will use novel male contraceptive methods, and whether women will trust them. The commentary offered reveals that “men spoke of how women had been “burdened” by contraception and that they felt it only right to take on the responsibility if possible,” supporting the shifting social paradigm around contraception. According to the study, men also described a “conflict between traditional and modern gender roles and contraception being another avenue through which they could lead more equal lives with their partners.”

I ask you now to continue this conversation with the people you know. Ask your partner, your siblings or your friends: what responsibility do you take, or are you willing to take, when it comes to contraception? What do you think it would take for novel male contraceptive options to become widely available? And lastly, as Blair pondered in 2018, why do conversations about abortion still place the burden of responsibility on women?


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