WASHINGTON- This week marks a new addition to the annals of contraceptivehistory: dimethandrolone undecanoate, a potential new birth control pillfor men, is being touted as the “best hope” for a non-permanent malecontraceptive option yet.

Developed with funding from the National Institutes of Health by a team atthe University of Washington, the formula is a tweaked version of previousfailed attempts.

While it comes with some caveats – the pill must be taken with food inorder to be effective, tests showed that usage had slight negative impacton cholesterol levels and over time might raise the risk of heart disease -right now the drug has shown itself to be safe for short-term use. (Thenext step? A trial that will show whether or not the pill actuallydecreases sperm production, followed by another that will test its efficacyin control groups of married and long-term partnered men.)

But dimethandrolone undecanoate also comes with a side effect that has beenfrustrating women for decades. It caused men to gain weight – a fact thatcouldn’t help but make this woman wonder if that will be the latest reasonthat the responsibility for preventing pregnancy will continue to restlargely on the shoulders of women.

The truth is, while the advent and evolution of birth control hasfundamentally reshaped women’s place and participation in culture, for thatto happen, women had to be willing to take on a certain level of risk andpotential downsides.

Enovid, the first brand of birth control, which contained more hormonesthan necessary to prevent pregnancy, was linked to an increased (thoughrare) likelihood of heart attack and stroke. It took a decade forscientists to recognize those risks and reformulate a pill with lesshormones that was just as effective.

In the interim, for some women the costs – weight gain, water retention,nausea, dizziness, breast tenderness, headaches, vomiting – outweighed thebenefits. For others, at a time when an abortion was either illegal ordifficult to obtain, the downsides were worth it, if it meant not gettingpregnant. It took Congressional hearings, in 1970, to compel the FDA toinclude a package insert detailing the potential side effects in each packof pills-a practice the American Medical Association initially opposed.

(The AMA contended that an insert would undermine a doctor’s authority with”his” patients. At the time, female physicians made up less than 10 percentof the field, which might in part be an explanation for why it took so longfor women’s complaints to be taken seriously.)

Years later, the Dalkon Shield IUD would become another example of a birthcontrol product ultimately deemed to pose too high a risk to women’shealth, after hundreds of thousands of women sued the makers for knowinglymarketing a product that increased the potential of life-threatening pelvicinfections. It took decades for IUDs to recover as a preferred option forAmerican women, and today women still have reason to be concerned that theydon’t have all the health facts.

Then there’s the stress that women have endured, largely on their own,linked to not just the risk factors, but also because of the burden ofresponsibility to prevent pregnancy itself. This is unlikely to ever appearon a package insert, but taking a pill every day, or getting a shot everymonth, or changing an IUD every few years takes planning, access to medicalcare and financial resources. At a time when women’s reproductive rightsare under under siege and public health resources like Planned Parenthoodare fighting to keep funding, many women are finding their options strained.

It’s mentally draining, all this flux that could leave women in the lurch,which is another weight on our shoulders that often goes unacknowledged.Add standards of beauty and the pressure to maintain a certain size andshape to the mix, and it’s not particularly surprising that women are twiceas likely to have an anxiety disorder as men.

Will dimethandrolone undecanoate make it to market and help rebalance thescale a bit?