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男女避孕的差異有多大?一個例子告訴你

男女避孕的差異有多大?一個例子告訴你

Sy Mukherjee 2018-04-02
美國華盛頓大學研究人員最近發現,男性通過藥物短期避孕或許切實可行。

藥劑師遞給病人一盒避孕藥。Photograph courtesty of BSIP/UIG via Getty Images

在美國國立衛生研究院(NIH)資助下,美國華盛頓大學研究人員最近發現,男性通過藥物短期避孕或許切實可行。早期臨床試驗顯示,服用大劑量簡稱DMAU的藥物以后,男性受試者體內的激素出現變化,(理論上)導致精子數量下降,同時出現的其他變化也增加了女性受孕的難度。此項技術還處于試驗階段,但已引發不少討論,顯示出科學界和社會公共衛生政策討論很受性別影響。

不少人對這項早期研究提出明確警告,比如藥物可能產生嚴重的副作用,要想切實證明效果還需要更大規模、更細致也更經得起同行評審的研究,一場復雜的討論也已掀起,爭論在于這種預防措施實際應用前景究竟如何。改變激素水平的藥物可能導致體重增長、性欲減退、情緒變化等副作用(女性服用避孕藥已飽受類似負面影響),男性會不會接受?即便接受,他們會不會遵醫囑服藥?

在華盛頓大學進行研究以前,業內知名專家已在研究此類問題。但避孕相關的科學和政策制定絕大多數影響都施加在女性身上。美國國家公共電臺(NPR)在一篇新近報道中概述道,由于各州政府打壓避孕服務,一些女性轉而采用數字醫療等新型醫療技術。

NPR舉例稱,數字技術的避孕應用程序發展迅速,女性可以無需看醫生或者去醫院就能購買激素類避孕藥,尤其是在所謂的“避孕沙漠”。“避孕沙漠”是指,有些因為當地政策嚴格,有些則是社會經濟發展落后,這些地區的女性很難購買避孕工具。降低售價和保護隱私也能提供很大幫助。

在這方面,男性和女性的待遇差別巨大。面向男士的避孕創新成果還在研發初期,效果尚待驗證,就已經因為可能對身體健康和社會方面的影響承受壓力。另一方面,效力已明確的女性避孕手段在某些地方卻求之。(財富中文網)

譯者:Pessy

審稿: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.

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