The Path to Novel Male Contraceptives at Duke University: An Interview with Connie Dean
By Maria Lulo
Women are presented with a wide variety of options for contraception, from the pill to an IUD, on the other hand, men are limited to only two options: condoms or a vasectomy. Research on new contraceptive methods for men has remained stagnant for around fifty years, ever since the invention of the pill, creating large inequities within reproductive health and placing the majority of the responsibility on females. Connie Dean, a senior at Duke University, has decided that the time has come to level the playing field. She is pursuing a major in Psychology and has developed an interest in reproductive health research, catalyzed by her own personal experiences and frustrations. Particularly, she has been exploring novel male contraceptive methods, aiming not only to re-energize this field of research, but also to understand how to effectively implement them in the market. Her mentors, Dr. Hard and Dr. Zucker, have provided Connie with the support and freedom to conduct research with the Male Contraceptive Initiative (MCI) in Durham. Since working at the MCI, Connie has completed an Independent Study, participated in the Vertical Integration Program (VIP) at Duke, and is currently working on her honors thesis. Her research consists of collecting and analyzing data on masculine norms and their perception of novel contraceptive methods.
The Male Contraceptive Initiative is a local nonprofit foundation whose mission is to empower men and couples to fully contribute to family planning goals. Connie began working at MCI her sophomore year, and since then she has attended meetings regularly, constantly learning and conducting research. She has also been part of the founding chair of the youth advisory board of MCI, with the idea to emphasize the importance of integrating young voices into this conversation and area of research, in order to make it more relevant to our generation. Their vision is to create reproductive autonomy for all and are currently exploring three novel male contraceptives.
1) Nesterone: is a contraceptive gel that is applied once daily to shoulders. It is a non-invasive method that is absorbed through the skin of a man’s shoulders. Early research findings have not found any significant adverse effects. The effects can be immediately reversed if the gel is not rubbed with no effect on fertility.
2) Vasalgel/RISUG: is a contraceptive method that functions by an injection of a non-synthetic chemical into the vas deferens. It is administered with a local anesthetic and an incision is made in the scrotum. The chemical is effective almost immediately after it is injected and will stay in place until removal. Removal involves another injection in which it dissolves and flushes it out. It is reversible, cheap, and can last up to 10 years. There are no widespread side effects, and no reduction in ejaculation.
3) MENT: is a one-year contraceptive implant that is placed under the skin of the upper arm. It is effective, safe, long acting, and reversible. However, the side effects do include a reduced sperm count and ejaculate volume.
Connie began investigating how conformity to masculine norms and attitudes towards sexuality impact decision making behavior regarding these three real world novel male contraceptives. Her hypothesis was that positive attitudes towards sexuality will lead to an increase in uptake, and that higher endorsement of masculine norms will lead to a lower overall uptake.
Last spring semester she conducted a brief pilot study consisting of 31 Duke male undergraduates who completed an online survey where they read a descriptive of each contraceptive and then completed a survey measuring their willingness-to-try the contraceptive and their conformity to masculine norms. This study assessed whether conformity to masculine norms could predict willingness to try novel forms of contraception, yet it didn’t find significant results due to the small sample size. However, the study did find a significant aversion towards MENT and a preference to try Nesterone over both, RSIG and MENT. Generally, the sample still showed a greater preference to use condoms than Nesterone, which could be attributed to overall familiarity. The inclination towards Nesterone could be attributed to factors of self-control and overall ease of usage, as it is the only contraceptive that doesn’t have the added step of a provider. As a sub-funding, the study also revealed how political leanings could affect contraceptive preference/usage and found that males identifying as democrats were more likely to use condoms.
The research Connie has conducted has shown that overall endorsement of masculine norms has a negative impact on health behaviors, because they are less likely to seek help or engage in positive health behaviors. Contraceptives by nature have direct ties to heteronormative gender conformity and gendered power, therefore, more research is needed to understand these driving factors to ensure the largest market uptake, as well as guiding funding and research efforts. Although men are more reluctant to seek medical help, they deviate from this norm when the help seeking acts as a means by which to preserve a more prominent component of their masculinity, such as maintaining sexual performance. Thus, understanding how masculinity and attitudes towards sex impact male contraceptive usage and preference could inform strategies to improve uptake and usage.
Connie will continue to collect data this semester as she has recently gained IRB approval and will move towards analyzing the data in the Spring. In the future, she wishes to look at this data more qualitatively in order to understand the reasons behind these preferences. This is just the beginning for Connie as she continues to contribute to the literature and research and hopes to continue catalyzing this movement in order to gain more reproductive autonomy for all.