Men simply don’t have an effective, reversible form of birth control comparable to the female pill. What’s taking so long?
When it comes to controlling our own fertility, it sure sucks being a guy.
Since the 1960s, women have had access to safe, effective, reversible, hormonal birth control. And it seems like every year there’s a new TV commercial selling women the latest contraceptive pill, patch, shot, or implant.
A few months ago I read about encouraging advances in the science of male contraception. That led me on a long search to speak to the leading minds in the field.
As readers know, I had a vasectomy several years ago. But I have several buddies who are either on the fence about wanting kids or don’t want them right this second. So, for those guys, I wanted to ask these scientists: What’s taking so long?
It turns out the science behind male contraception is almost, well, there. But, there may be other factors keeping those drugs from the market. More on that later.
Presently, when it comes to keeping our sperm from reaching a partner’s egg, we have four options, each of them with major downsides.
First: abstinence. Look, if Catholic priests can’t stick to this standard, you shouldn’t, either.
Second: pull ’n’ pray. Use this method and you’ll soon unwrap neckties every third Sunday in June.
Third: condoms. Reversible? Check. Effective? Sure, as long as they don’t break. But let’s face it, nobody likes using condoms, especially when you’re in a long-term relationship.
Fourth: vasectomy. Ridiculously effective, yet permanent. They’re great for when you’re absolutely sure you never want to attend a parent-teacher conference, but not so good if you’re not so sure.
Men simply don’t have an effective, reversible form of birth control comparable to the female pill. Why has it taken so long to develop these methods for men?
According to the docs, the challenge is twofold. The first lies in differences in the biology of men and women. During pregnancy, the hormone progesterone naturally halts ovulation. Men, however, never stop producing sperm.
The second challenge lies in numbers. A woman releases just one egg during her cycle; men produce a thousand sperm every second. Researchers into male contraception have to deal with literally billions of egg-seeking swimmers.
But fortunately for us, they’re getting results. Sure, there are some obstacles to overcome—mainly funding for further research and a lack of pharmaceutical companies taking an interest in the field—but, as scientists tell me, we could be only a few years away from temporary, reversible male contraceptives.
When used correctly, these new contraceptives should be just as effective as their female counterparts. And like the Pill, they will protect only against pregnancy, not STDs—which means condoms won’t be history just yet.
♦◊♦
Dr. Diana Blithe, program director of the Contraceptive Development Research Centers Program funded by the National Institutes of Health, says the most effective known method is to administer some sort of progestin molecule, a synthetic hormone similar in function to progesterone, which regulates pregnancy in women.
In men, progestin suppresses the body’s ability to make enough testosterone to support sperm production, so sperm count levels drop well below what’s needed to fertilize an egg under normal circumstances.
At this point, it would take a large-scale study for this method to get FDA approval. When administering progestin to men, it’s necessary to administer back some androgen like testosterone, because without it, Blithe says, a man would begin to experience hot flashes and have trouble achieving an erection. Testosterone is currently commercially available as a transdermal gel, but development of an oral form remains a challenge.
There are several ways to administer the progestin: daily pills or gels, and long-lasting implants or injections. Men could choose the method they prefer. Blithe thinks the long-lasting versions would make a better option; unlike pills, the injection and implant don’t depend on remembering to take it—a major reason why the Pill often fails.
The testosterone-replacement part, however, could be effective in daily dosage form. “If you don’t take it, you start to feel the effects,” explains Blithe. “That’s self-motivating in that respect.”
♦◊♦
Dr. John Amory is an Associate Professor of Medicine at the University of Washington, where he’s currently in the middle of clinical trials testing a “gel-gel” combination of progesterone and testosterone.
How does this gel work?
First, a simple explanation of male fertility: To make sperm, the brain first tells the pituitary gland to secrete two hormones, LH and FSH. In men, those hormones affect the testes, signaling them to produce sperm and testosterone. The testosterone then gets into the bloodstream and goes back to the pituitary, which helps regulate its own production.
The gel approach would simply boost the amount of testosterone in the man’s bloodstream.
“It’s what we call a negative-feedback loop,” explains Amory. “If you give somebody testosterone from the outside, in a dose slightly more than his body would make, it will suppress the production of LH and FSH in the pituitary. That deprives the testis of the signals that are required for spermatogenesis.”
Amory’s current study is looking into the effectiveness of using two gels to suppress sperm production. One gel contains progesterone; the other, testosterone. Men apply the gels once a day.
“It’s like putting on sunscreen,” Amory says.
It should take about two to three months for the gel treatment to become effective. And the good news is, it should be completely reversible. Men should begin producing sperm again about three to six months after they stop using the gels.
But it will still take several months before Amory and his researchers get their results.
♦◊♦
Another approach is being examined by Dr. Debra Wolgemuth, Professor of Genetics and Development at Columbia University. For the past five years, she’s researched new methods in male contraception; one of the most promising involves the use of inhibitors of retinoids, the metabolites of vitamin A.
Her investigation into these retinoid inhibitors as a contraceptive began when she came across a paper showing that scientists at Bristol-Myers Squibb had synthesized compounds that proved toxic in the testes. A light bulb went on:
“One person’s toxin can be another person’s contraceptive,” Wolgemuth laughed in a phone interview.
As you probably know, vitamin A is a compound found in foods like carrots, liver, and broccoli, but it has to be converted into an active form before it can be used in biological processes. One of its active forms is retinoic acid, which affects processes such as gene expression.
In the testes, retinoic acid binds to proteins in the cell called retinoid acid receptors, which regulate the production of various proteins needed for sperm formation. Block those proteins, and sperm don’t form correctly, making the male infertile.
In earlier studies, Wolgemuth found that male mice with a mutation at one of the retinoid acid receptors were sterile, while females with the same mutation were still fertile.
Wolgemuth’s latest scientific paper shows that using retinoid inhibitors to induce infertility is reversible, one of the key components to creating a marketable contraceptive.
“We’re trying to ask questions like, How long can we keep the mice on the drug and still allow them to regain fertility when we stop? And we’re also interested in how low a dose we can give,” she said.
♦◊♦
So what’s causing the holdup? The research is there, the resources may even occur naturally, and—trust me—the market is ready. Blithe agrees: there are certainly plenty of people interested in male contraceptive options. That’s especially true with couples where the woman can’t take hormonal contraceptives for health reasons such as diabetes or obesity.
But the Pill has been around since the 1960s. So why has it taken so long to get male contraception to market? The joke in the male contraceptive field goes that we’ve always been five years away from male contraception being available.
I contacted representatives from Merck, maker of Implanon and Nuvaring, and Bayer Healthcare Pharmaceuticals, makers of Yaz and Mirena. Reps from the companies wrote in separate emails that they’re not currently researching male contraceptive methods. When asked why not, the reps didn’t respond. Bummer.
Besides the science challenges mentioned earlier, Blithe believes there are some barriers at pharmaceutical companies. The developed techniques couldn’t be too expensive for men to afford them. And, Blithe notes, there’s a lot more money to be made in cancer and lipid-lowering drugs than in male contraception.
“So when you say it’s five years away, well, it could be a lot sooner, it could be a lot longer, depending on whether a company will take that responsibility,” she said.
Are you listening, Big Pharma?
♦◊♦
Earlier:
Why I’m Proud of My Vasectomy
My Parents Made Me Do It
♦◊♦
An alternate version of this piece appeared on AlterNet.
—Photo courosa/Flickr
Check This Out…
[…]Here are some of the sites we recommend for our visitors[…]…
What the f*** is going on with this thread… I spent most of my life wanting to have lots of sex with lots of men, but I sure as heck didn’t want a baby. I have no interest in having a man buy me a drink, much less bleed him dry by using an innocent human life as bait. Men’s birth control would be great–an extra security measure for all of us, especially for women whose bodies can’t handle birth control and who are in a monogamous relationship and don’t want to use condoms. It would decrease unwanted pregnancy, which… Read more »
What the fuck is going on with this thread… I spent most of my life wanting to have lots of sex with lots of men, but I sure as hell didn’t want a baby. I have no interest in having a man buy me a drink, much less bleed him dry by using an innocent human life. Men’s birth control would be great–an extra security measure for all of us, especially for women whose bodies can’t handle birth control and who are in a monogamous relationship and don’t want to use condoms. It would decrease unwanted pregnancy, which is good… Read more »
Wow, the sexism in this thread is horrifying. Generalisations that all feminists hate men, that women will get pregnant to trap a man, women are control freaks who couldn’t handle a man having reproductive choice. A.) Feminists dont hate men. People who hate men, hate men. The rest of us just hate ignorance. B.) While I cant say this *never* happens, that train of though is 90% paranoia, like being kidnapped by a total stranger. It’s possible, but unlikely. C.)Men have always had reproductive choice. They’re called condoms. Yeah yeah, they’re not the greatest, but you’re crying “oppressed” when the… Read more »
Cheap, reliable, and private birth control for men would certainly change the gender dynamic. Giving men control of reproductive choices could be scary for a lot of women.
“I can’t stand it, I want a baby and he’s on the damned pill!”
Don’t hold your breath. I work in pharmaceutical R&D. From a recent New York Times article: “… administration has become so concerned about the slowing pace of new drugs coming out of the pharmaceutical industry that officials have decided to start a billion-dollar government drug development center to help create medicines … the drug industry’s research productivity has been declining for 15 years … drug companies have typically spent twice as much on marketing as on research, a business model that is increasingly suspect … ” http://www.nytimes.com/2011/01/23/health/policy/23drug.html?_r=1 Summary: Pharmaceutical companies are so terrified of lawsuits that they have given up… Read more »
The reason its been waning so badly is because the pharmaceutical industry is more about profit than helping people. I would not be surprised if someone held a patent or two on some method of male birth control but then instead of actually developing drugs with it they decide “there’s no money it” and then use it as a club against anyone else trying to work on something similar (if there’s no money in it for you then why not let someone else work on it?). I’d like to see a male birth control pill (if for no other reason… Read more »
Always 5 years away, always false promises…
Vasectomies are actually reversable, although not 100%. Sperm can also be cryogenically stored.
Great present for your son’s 16th b-day so that he doesn’t end up ruining his life because of HER choice.
Good luck finding a doctor to perform a vasectomy on a 16 year old.
Unfortunately, doctors do discriminate against men’s choice.
Great. Now a urologist owes a vasectomy to any adolescent that walks in the door, presumably accompanied by his jackass of a dad who sees a harpy under every hill and dale. For your information, the only thing my urologist said to my request for a vasectomy was the price.
I stopped reading this after the rape joke. Seriously?
What rape joke? are you reading the same article I did? Or do you think a man controlling his OWN reproduction is somehow raping a woman?
She means the catholic pedo joke.
“First: abstinence. Look, if Catholic priests can’t stick to this standard, you shouldn’t, either.”
Where do you two get the idea that this is a “rape” or “pedo” joke? All it says is that even the “holiest” among us have trouble living up to abstinence. Talk about stereotyping and hyper-sensitivity!
Many feminists are very upset at the possibility of loosing their 100% monopoly on all reproductive rights:
http://www.dailymail.co.uk/femail/article-1251868/Of-course-women-dont-want-male-pill–end-happy-little-accidents.html
Feminists consider a male birth control pill as rape. To a feminist, the ability of all women to control a man’s life, earnings, and liberty is a God given right. I no longer try to understand this, I simply accept that there exist individuals who believe that women are human and men are beasts of burden indentured to serve the “humans”.
You don’t know any actual feminists, do you?
My mother is a professional, paid faminist in the academic world. She makes her living by spreading the gospel of playing the victim and hating men.
Living in her house was like a rat living in a Biology laboratory. Avery time my mother would learn a new man-hating trick from fellow feminists, she would try her new cruelty on one of her four young boys.
Then she doesn’t represent me as a feminist.
Yes she does. Her writings are used to teach the feminist classes that you attended, her expertise is called upon all over the world by the feminist institutions that enforce your policies, and the message that she transmits to the media is passed on in your name.
No person who calls themselves “feminist” can white-wash her participation in the horrifying dehumanization campaign perpetuated by the feminist war on men.
I’m a feminist, and I seriously do NOT consider male birth control to be anything similar to rape at all, ever, end of story. Male birth control is sensible, and there is a market for it. I’m in favor.
You didn’t understand it in the first place, or rather, you don’t understand that there is no ‘it’ to understand.
AlexNY, rape is serious stuff. Get your definitions right. Rape: carnal knowledge without consent. However, an individual consenting to sex is consenting to a specific type of sex under specific circumstances. Saying you’re on birth control when you’re not I can see as a violation of consent. If you’re being honest about birth control use, than there is NO way a man using birth control is raping a woman. Only instance it would be rape: man knows woman is only having sex with him to make a baby, both people are clear on that being the only reason they’re doin’… Read more »
Yeah, Cate, it isn’t a rape joke. Sorry, it just isn’t. Unless you believe rape is the only way Catholic priests obtain sex.
There was no rape joke. No wonder there are so many false-rape accusations (50-60+% of claims are bogus) with such thinking.
The FBI statics are that 8% or rape reports are false (the same rate as false reports of property crime) Not 50-60. Where the hell did you get that number? Tool.
http://polimicks.livejournal.com/5618.html
theres one
There is one problem. If the Mrs gets pregnant you (The male)are still responsible. Yes she has a lover and you get stuck!
There exists a reversible, non-hormone based alternative that gets little attention from the pharmaceutical industry precisely because it is cheap (and did I mention reversible?) Now known as RISUG (see http://www.newmalecontraception.org/vas.htm) basically they inject a polymer into the seminal vessels that your sperm has to swim through such that when they get through the other side the little guys are so tired they will never break through an egg. To reverse it.. simply inject a little acetone melt the polymer (viola– fertility restored). ALL w/out messing w/ any of a guys hormones or taking a pill or applying a gel… Read more »