michael thomas

Dr. Michael Thomas displays implantable birth control, one of the many contraceptive methods studied by UC's researchers.

In the fields of contraceptive research and women’s health, the University of Cincinnati is paving the way for the future of birth control. From cheaper, more effective options for women, to preventing the spread of diseases and viruses, UC is bringing a new perspective to improving the quality of contraception.

Michael Thomas, director of the division of reproductive endocrinology and infertility in the department of obstetrics and gynecology at UC, is leading the university’s birth control research.

Thomas is the director of UC’s Reproductive Medicine Research, a clinical research unit that is funded by federal and private institutions. He is also the principal investigator of the Contraceptive Clinical Network for the National Institutes of Health and has received grants from many pharmaceutical companies. His research interests include contraception, infertility and the effects of stress on reproductive function.

“UC has a very good contraceptive development unit,” Thomas said. “There are only 19 in the country.”

Thomas has led UC in contraceptive research and clinical trials since 1995, when UC first became a branch of the NIH’s contraceptive trials. The university just had its grant renewed for seven more years of contraceptive research.

Thomas is looking into the future development of a vaginal ring that would contain hormones to prevent pregnancy, while also containing medicine that could be used to prevent human immunodeficiency virus, or HIV.

“These types of devices could be useful in the third world, in countries like Africa, and at some point in the United States,” Thomas said. “It could be used to decrease the spread of any virus, particularly HIV.”

These types of multifunctional devices are called multi-purpose technologies. Other examples are as simple as birth control pills, which prevent pregnancy and can also decrease the risk of uterine and ovarian cancer.

“Bring both contraception and STD protection in one fell swoop. This is the goal for the future of contraceptives,” Thomas said. “We want to be on the forefront of that.”

More than six million women rely on the male condom, according to the Center for Disease Control. Condom use is especially common among teens and women in their 20s, women with one or no children and women with at least a college education.

Recently, the media has focused on the possibilities of a highly effective, non-permanent, male pregnancy prevention option. Thomas believes that the world is still many years away from an acceptable male contraceptive.

“We have to be able to decrease sperm production without decreasing testosterone,” Thomas said. “The male system is more fragile in some ways. We have to find a way to increase effectiveness without decreasing the ability to perform.”

UC’s contraceptive research team is constantly developing and testing new and innovative birth control methods.

The list of studies is long and includes trials on IUD’s, emergency contraception, vaginal rings, implants and even condoms. Recently, Thomas and his team finished testing a generic hormonal IUD, which will become available in February.

This generic version of the Mirena IUD will be much cheaper and more accessible, Thomas said. He is also working on a study for a drug to take daily that would have the same high-effectiveness as emergency contraception.

The pill and female sterilization are the two most commonly used contraceptive methods since 1982. Sixty-four percent of women who practice contraception currently use nonpermanent methods, primarily hormonal methods — the pill, patch, implant, injectable and vaginal ring — the IUD and condoms. Thomas says one method of birth control alone isn’t enough to keep people safe from an unwanted pregnancy or sexually transmitted infection.

Popularity vs. effectiveness graph

Source: The American College of Nurse Midwives, a survey on Women's Healthcare Experiences and Perceptions, October 2013.

Couples who do not use any method of contraception have an approximately 85 percent chance of experiencing a pregnancy over the course of a year, according to the Guttmacher Institute, a non-profit organization that studies and promotes reproductive health.

Dual-method use of contraception — for example, using condoms and the pill at the same time — offers protection against both pregnancy and STIs. Eight percent of women of reproductive age use multiple contraceptive methods, most often the condom combined with another method, according to an analysis from the National Survey of Family Growth.

“I would want a college student using a pill and condoms,” Thomas said. “That’s really the safest and best option. People may have more than one partner, and may not know their history, so it’s very protective to use both.”

Students use an array of methods, from the pill to only using the “pull out” method. More than 99 percent of women ages 15 to 44 who have had sexual intercourse have used at least one contraceptive method, according to the CDC.

“I’m going to completely contradict myself because I’m on birth control, but I think that the most effective way for birth control is abstinence,” said Megan Reed, a fourth-year communications and marketing major. “I wish that more groups on campus were to actually advocate for abstinence instead of like, ‘Hey here’s condoms; go have safe sex.’ When you’re here in college, I think people make drunken decisions.”

Abstinence is technically the only 100-percent way to prevent pregnancy and STIs, but adhering to the choice to abstain can be difficult. According to a 2007 federally funded study by Mathematica Policy Research Inc., participants from four abstinence-only programs had just as many sexual partners as non-participants.

“You have to be very careful,” Thomas said. “Abstinence should strongly be considered, but humans are humans. Most people 17 to 20 years of age initiate sexual activity.”

There isn’t an obvious choice for the best birth control options for everyone. Different people have very different hormones and genetic makeups, which can lead to very different affects from birth control.

“The best [contraceptive] option for each person is going to come down to the individual’s needs,” said Brandy Turnbow, the program coordinator for communications and outreach for the UC Women’s center. “Some people do better with a daily pill or a ring. It varies.”

A common misconception among young people is that birth control can only be used for pregnancy and STI prevention; it can actually be used for an array of health reasons, according to Thomas.

Many hormonal methods—the pill, vaginal ring, patch, implant and IUD—offer a number of health benefits in addition to contraceptive effectiveness, such as treatment for excessive menstrual bleeding, menstrual pain and acne, according to the Guttmacher Institute. The most common reason women use oral contraceptives is to prevent pregnancy, which accounts for 86 percent of users, however, 58 percent of pill users also cite non-contraceptive health benefits as their primary reason for using the method.

“It’s important to expand the conversation beyond just pregnancy prevention,” Turnbow said. “[Birth control] is not just used because someone doesn’t want kids; it could help them health-wise.”

noncontraceptive benefits graph

Source: Guttmacher Institute, 2011. 

Thomas believes in the effectiveness of abstinence, but still wants students to be fully prepared for the possibility of intercourse.

“If it were up to me, every floor in every dorm and every RA would have a big fishbowl of condoms,” Thomas said. “Parents would go crazy, but in the long run, it is a great idea. You want to make sure that the ability to protect yourself is readily available.”

Thomas encourages students and parents to think ahead when discussing and choosing a birth control option.

“All college students are in the same boat,” Thomas said. “In general they need to be more forward thinking and to understand that if you’re in a position where sexual intercourse is a possibility, take a moment to think about making sure you’re protected against pregnancy and STDs.”

The UC women’s center offers students resources from county health programs to explain the different types of birth control and the benefits of each. They also give out free male condoms and are currently working on getting more access to the female condom.

“We try to get students access on how to make healthy choices for their body, to help them find the most effective method for them,” Turnbow said. “The more information students have, the better.”

Turnbow, along with the women’s center, encourages students to ask questions and weigh the pros and cons for the multitude of pregnancy and STD prevention options they have. 

“We think what is most important is making sure students feel comfortable enough to talk to their health care professionals to discuss their options and make sure they get what is best for them.”