Condoms have been used to prevent pregnancy since the Middle Ages. Over the years, they have become more effective and comfortable to use.
However, the invention of the contraceptive pill in the 1960s, followed by the IUD in the 1960s, dramatically changed the human ability to control reproduction. The range of pills, patches and implants available to women has expanded. Still, the elastic sheath that covers the penis is the only medically approved method of male contraception, aside from vasectomy.
But now researchers are looking at both hormonal and non-hormonal contraceptives for sperm carriers.It is hoped that couples will start treating contraception as a more shared responsibility.
“We want to create a menu of options for men similar to what’s available for women,” says Stephanie Page, a researcher and endocrinologist at the University of Washington.
(Note: Because the studies referred to here have typically been conducted on cisgender men between the ages of 18 and 50, this article will refer to the drug as a “male contraceptive” and will refer to Although we refer to demographics as “male” or “male,” people of other genders can use contraception (i.e., make sperm.)
Hormone therapy receives new research
Dr. Page’s laboratory Conducting clinical trials Together with researchers at 15 other sites around the world, we are testing a topical gel that men apply daily to their shoulders. The gel contains a synthetic hormone, a combination of testosterone and progestin, that signals the brain to lower testosterone levels in the body. decreases sperm count.
Couples were enrolled in Dr. Page’s study, and nearly 450 couples are enrolled worldwide. Having a woman involved also means that “she agrees as much as he does, so they’re really both participants,” Page says.
trial Do it step by step. In the first phase, the man applies the gel daily, but the couple uses another method of contraception during sexual intercourse. Couples then enter a second stage when the numbers are low enough to prevent pregnancy. Stop using other birth control methods and men continue to use the gel daily.
In the third and final stage, the man stops using the gel and the researchers begin monitoring the man’s sperm count again. The researchers hope their results will demonstrate that the effects on fertility are reversible, just as women can restore fertility when they stop taking oral contraceptives. .
Brian NguyenProfessor of Obstetrics and Gynecology at the University of Southern California, Keck School of Medicine, and also researching male contraceptives.Please support your female partners. ”
“I hear men get really sick of hearing about their partners suffering from hormonal side effects and possibly complications related to IUDs and implants,” he says. “And they want to do something.”
Nguyen’s lab is also working on hormone pills that work similarly to gels, and Page’s lab hopes to eventually develop an injectable hormone solution.
In the 1990s, the World Health Organization sponsored trials of androgenic contraceptives, but men were given high doses of testosterone, but these drugs never reached the market. Researchers believed they were not effective enough to be marketed and had serious side effects, including toxicity to the heart, liver and kidneys, and a potential increased risk of prostate cancer.
Stephanie Page of the University of Washington says the gels and tablets currently being tested do not have the same risks.
“We have worked very hard to develop a method that does not affect other physiological parameters, so we do not see any effects on kidney function, liver function, etc.”
In terms of side effects, some participants reported weight gain, changes in libido, acne, or mood swings,” she notes, noting that they were “an indication that some women use female hormonal contraceptives.” It is very similar to what you would experience in
A Promising Non-Hormonal Approach
Another area of research targets precise points in the sperm life cycle, such as the ability to swim or fertilize an egg.These drugs are a little more accurate than hormonal drugs, says Logan Nickels, research director Male Contraception Initiativesupporting researchers working on non-hormonal contraceptives.
“They target a very specific link in the sperm generation or life chain. When you try to break that link, there are no other bodily functions or broader signals that are disrupting.” If so, people using these methods are likely to have little to no side effects, he says.
“The male reproductive system is really cool in that there are hundreds of links in this chain. [so] If you remove one of them, you’re effectively an infertile man,” says Logan.
Another non-hormonal method being tested in Australia A gel that is injected into the vas deferens (the tubes that carry sperm to the urethra in preparation for ejaculation) to block sperm transport. Logan says it could be like a reversible alternative to vasectomy.
why is it taking so long?
Page estimates that it will be another seven to ten years before these new methods are commercially available. So why did women have to take responsibility for contraception for so long?
“Women carry the burden of life-threatening pregnancies,” says Paige. “And her first energies were directed at giving women control over their reproduction.”
And male birth control development is more complicated, she says. Females typically release one or two eggs a month. A man produces millions of sperm a day. A single ejaculation contains about 15 to 200 million sperm per milliliter of semen. Researchers had to figure out how low the count had to be to reliably prevent pregnancy, and they now say he needs to be less than a million sperm per milliliter of semen. Decided, she says Page.
Also, the FDA’s criteria for approving male contraceptives are ambiguous.
The pharmaceutical industry and the FDA use data from clinical trials to weigh the benefits and risks for patients. But Dr. Page says the risk calculation should be different in this case.
“When we think about risk, what are we protecting men from? With female contraception, women are protected from the risks of pregnancy and the risks of unsafe abortions. actually uses contraceptives to protect their partners.
Another barrier to bringing male contraceptives to market is efficacy. According to Planned Parenthood, a woman’s contraceptive implant and her IUD are 99% effective on her, and oral contraceptives are 93% effective. Male contraceptives may need to be just as good at preventing pregnancy in order to be marketed.
“Pharmaceutical companies invest millions and millions of dollars in drugs before they make a dime profit,” says Nickels. “And when they make calculated risks or calculated investments, they try to make sure their money is seen at the end,” he says.
Nickels, Page and Nguyen all expressed optimism that male contraceptives could hit the market within the next decade, but funding could be a limiting factor.
Logan predicts that either injectable non-hormonal gels or topical hormonal gels will hit the market first.
For male contraceptives to be successful in the market, it’s important that men are better educated about what women experience, says Brian Nguyen.
“Men are often shielded from discussions about menstruation, pregnancy, labor and infertility. The only way to improve is to talk more and more openly with men about their responsibilities in reproduction and processes that are not just women’s affairs.”
Women have long waited for that change of mindset. But even if it doesn’t happen anytime soon for most heterosexual men, perhaps the freedom to fly the sheath will be motivating enough.
The audio for this episode was produced by Rebecca Ramirez, edited by Gisele Grayson, and fact-checked by Abe Levine. Tre Watson was an audio engineer.