男女避孕的差异有多大？一个例子告诉你

在美国国立卫生研究院（NIH）资助下，美国华盛顿大学研究人员最近发现，男性通过药物短期避孕或许切实可行。早期临床试验显示，服用大剂量简称DMAU的药物以后，男性受试者体内的激素出现变化，（理论上）导致精子数量下降，同时出现的其他变化也增加了女性受孕的难度。此项技术还处于试验阶段，但已引发不少讨论，显示出科学界和社会公共卫生政策讨论很受性别影响。

不少人对这项早期研究提出明确警告，比如药物可能产生严重的副作用，要想切实证明效果还需要更大规模、更细致也更经得起同行评审的研究，一场复杂的讨论也已掀起，争论在于这种预防措施实际应用前景究竟如何。改变激素水平的药物可能导致体重增长、性欲减退、情绪变化等副作用（女性服用避孕药已饱受类似负面影响），男性会不会接受？即便接受，他们会不会遵医嘱服药？

在华盛顿大学进行研究以前，业内知名专家已在研究此类问题。但避孕相关的科学和政策制定绝大多数影响都施加在女性身上。美国国家公共电台（NPR）在一篇新近报道中概述道，由于各州政府打压避孕服务，一些女性转而采用数字医疗等新型医疗技术。

NPR举例称，数字技术的避孕应用程序发展迅速，女性可以无需看医生或者去医院就能购买激素类避孕药，尤其是在所谓的“避孕沙漠”。“避孕沙漠”是指，有些因为当地政策严格，有些则是社会经济发展落后，这些地区的女性很难购买避孕工具。降低售价和保护隐私也能提供很大帮助。

在这方面，男性和女性的待遇差别巨大。面向男士的避孕创新成果还在研发初期，效果尚待验证，就已经因为可能对身体健康和社会方面的影响承受压力。另一方面，效力已明确的女性避孕手段在某些地方却求之。（财富中文网）

译者：Pessy

审稿：夏林

A recent study from University of Washington researchers (and funded by the National Institutes of Health) has rekindled hopes that a short-term male birth control pill may actually be viable. In an early trial, high doses of dimethandrolone undecanoate (DMAU) demonstrated hormonal changes that would (in theory) reduce sperm production and cause other changes that make it more difficult to impregnate someone. But the conversation around this highly experimental technology highlights how different scientific and social health policy discussions can be influenced by sex and gender.

There are many important caveats about this early research—including the likelihood of significant possible side effects, and the fact that far larger and more detailed, peer-reviewed studies will be required to establish efficacy—and it’s opened up complex conversations about how such a prophylactic measure would work out in practicality. Would men be open to such a hormone-changing therapy, which may entail side effects including weight gain, libido loss, and mood changes (the kinds of adverse events that have long accompanied female hormonal birth control)? If they were, would they take the medication as prescribed?

Prominent experts have been probing those precise issues in the wake of the University of Washington’s research. But the science and policies affecting birth control overwhelmingly affect women. And digital health is one new kind of medical technology some women are turning to as states crack down on family planning services, NPR outlines in a new report.

For instance, digital birth control apps—such as those that allow women to purchase hormonal birth control without having to go to a doctor or another health provider—are on the rise, according to NPR, especially in so-called “contraception deserts.” These are regions where it may be particularly difficult to get to a family planning facility, whether because of local policies or socioeconomic road bumps; lower prices and privacy are also big draws.

It’s a striking dichotomy. Preliminary, unproven birth control innovations for men are already facing pushback over possible physical and social effects, while proven ones for women (with long-evident physical and social effects) are, in some places, difficult enough to acquire that entirely new kinds of technologies have to be used to get them at all.