Spoiler
The next chapter on qvfammaonline.blogspot.com shows one of Tsugumi's dads explaining to Megumi: "La primera pastilla que tomo le produjo leves efectos secundarios." Or "The first pill he took produced mild side effects." And thus, he refused to take them since. His alpha father is also highly protective so this is where he learned just to be threatening instead (think Dad with a shotgun threatening his daughter's date kind of protection.) This seems to have been going on his entire childhood.
Does this excuse him? No, not really. But I would like to think this was the moment where Tsugumi accepted Megumi as his equal in mind because he's okay with being sex friends. (Volume two they are literally on a date and Megumi is so excited but it looks like Tsugumi was basically treating it as if he was his sugar daddy. Hahaha. I hope things get better from there.)
I blame the uke. he has no right to be mad once it’s done. The seme was basically begging him to use suppressants