(191) Contraception: How Ecology and Gender Equality are the New Deal
Authors: Choucroun D 
Published: March 2024

Abstract

Introduction
Since more than 10 years health care providers often hear from their patients that they want a natural contraception without hormones because of their potentials side-effects on bodies and environment by water contamination. In fact numerous scientific articles available on the web etablish that steroid hormones in wastewater are micropollutants and endocrine disruptors, especially wastewater treatment plants can not eradicate synthetic progestins after excretion. Nevertheless the situation remains paradoxical since the morning-after pill contains up to 50 times more hormones than the daily pill and is widely used, in France 2,2 millions of morning-after pills are sold each year. Looking for "green solutions", users are turning to menstruations apps, but are they aware of the pollution generated by materials and operations of digital industries? This is another paradox in the new contraceptive behaviours.

Objective
know different possible causes of contraceptive refusal take into account potential environmental effects when prescribing contraceptives and opt for the least polluting solutions. be aware of the environmental impact of digital health techniques take account of claims for gender-equal contraception

Methods
Literature review on PubMed for the 12 last months, Google Scholar since 2 years and mainstream media with the keywords: hormonal contraception and water pollution contraception and ecology Contraceptives residues and health Data Centers pollution contraception and gender equality Male contraception

Results
On Google Scholar numerous articles deal with the pollution of waste water and drinking water by steroid hormones at concentrations ranging from ng/L to g/L. Synthetic hormone compounds toxicity is widely recognized and can affect cell metabolism, causing various diseases such as obesity, infertility, endocrine disorders, even neoplasia or neuro-degenerative disease, although the effect of environmental synthetic hormones on the nervous system is still poorly documented. These data are public and can influence contraceptive behaviours On PubMed the focus is on endocrine-disrupting chemicals such as phtalates, dioxins, polychlorinated-biphenyl, biphenol A and analogs, I found only 2 surveys about residues of synthetic human hormones. 21 relevant surveys are found on PubMed about gender equality in contraception: these studies show an emerging interesr among men in controlling their fertilizing power, but a low support of pharmaceutical industries, leading them to use restrictive methods such as thermal contraception.

Conclusions
This work aims to highlight the contraceptive shift in progress. Consumers claim an ecological position, but use methods that contradict their stated convictions, such as morning-after pill or menstruations app causing digital pollution. Men want to involve themself in their reproductive health but are they heard enough? A low-risk, inexpensive and non-pollutante method such as vasectomy is still subject to false beliefs due to a lack of information and education, male hormonal contraception remains anecdotal (only in France). These observations highlight the role of the health care providers in sexual and reproductive health education and counselling, and of the industry's support, listening to people.

Disclosure
No.