Men have few options but that could soon change.
The idea of male birth control is not new, but soon it could become a reality. The Supreme Court’s decision to overturn federal abortion rights is renewing attention around developments to help men take more responsibility for preventing unwanted pregnancies.
“The decision to overturn Roe v. Wade has absolutely resulted in people shifting their attention to how men can and should play a bigger role in the conversation around reproductive rights,” says Heather Vahdat who’s an executive director at the non-profit Male Contraceptive Initiative.
As far as options go, though, there aren’t many. Unlike women, who can choose anything from pills to patches, the only two effective birth control options for men other than abstinence are condoms or a vasectomy. But there are drawbacks to both: Condoms aren’t always effective (the Centers for Disease Control says they have a 13 percent failure rate), and vasectomies are very effective but they’re also costly or even impossible to reverse in some cases.
The good news is there could soon be more male contraceptives available. Here’s a breakdown of some of the unique challenges and new medications that could be available in the near future.
New developments in male birth control
Efforts to develop more forms of male contraceptives have been around since the 1970s, which is about a decade after the Food and Drug Administration approved the first birth control for women. But there hasn’t been much progress — until now (and unlike some of the current options, they’re more reversible).
Contraceptive Gels
The hormonal gel NES/T, which is applied to a man’s shoulders and upper arms once a day, is the furthest along in development. Lead researcher Christina Wang, who works at the Lundquist Institute at Harbor-UCLA Medical Center, tells KCM that the prospective contraceptive has already been proven to successfully suppress sperm count, and is currently in the late stages of Phase 2 clinical trial. The next steps would be Phase 3 studies before seeking approval from the FDA.
But how does it work? It essentially blocks the body’s signals from producing its own testosterone and sperm, while also preventing some of the negative effects on sexual function, such as low sex drive.
Devices
The medical device firm Contraline has developed a hydrogel implant called ADAM, which is injected into the vas deferens to block the flow of sperm. Similar to intrauterine devices (IUDs) for women, this implantation involves a minimally invasive, outpatient procedure and is designed to last for years (with an option to reverse it). As far as the timeline goes, it’s currently undergoing clinical trials in Australia, and the company is planning further studies before filing for FDA approval, according to the Male Contraceptive Initiative, which is funding these efforts.
Birth control pills
There are a few oral contraceptives under research. For instance, YCT529, a non-hormonal pill, reduces sperm counts by attaching to a special receptor in your body for vitamin A. According to early research presented to the American Chemical Society, it has been proven 99 percent effective at preventing pregnancy “without obvious side effects,” and human trials are expected to begin later this year.
Injections
As it turns out, the same hormone that plays a key role in men’s sexual development can also be used to suppress the release of the pituitary hormones that stimulate the production of sperm. In a 1996 study, researchers at the World Health Organization found that 98.6 percent of 399 men injected with testosterone saw reduced sperm counts needed for contraception. But the WHO and other studies have shown that testosterone alone is not as reliable as combinations with other hormones like progesterone.
Side effects of male birth control
Many of the male contraceptive options in clinical trials right now target lowering testosterone and having low levels of this male sex hormone can lead to depression, acne, or even an increase in cholesterol levels. If it’s a testosterone shot, there could also be some pain at the injection site, and as far as the gel goes, there might be some skin irritation, though Dr. Wang says this is “very uncommon” among the men participating in the study for NES/T.
But these side effects can vary from person to person, not to mention the fact that some of these birth control options, like the pills, have only been tested on mice so far. But in general, Dr. Wang doesn’t believe any of these side effects will deter men from using contraceptives because they offer a promising future for those who want to take a more active role in their reproductive health. Research shows if a new male contraceptive method is available, more than 50 percent of men would try it.
“Men want to participate in the family planning, we think that they’re ready to take up some shared responsibility,” she tells KCM.
So, what’s the holdup?
Experts say there are several roadblocks when it comes to developing new contraceptives for men. This includes limited funding because most of it goes toward female birth control and certain biological challenges when it comes to ensuring protection, like the fact that men can make several million sperm per day during spermatogenesis. There are also longstanding societal beliefs that the people who can get pregnant should bear the responsibility for preventing pregnancies.
But Vahdat thinks the biggest challenge is going to be the lengthy regulatory procedures concerning male birth control. After all, in some ways, it will be a first, given that the FDA has never approved male birth control for men.
“The biggest hurdle is that regulators are going to think that they need to be a bit more careful because the outcome for men is not physical,” says Vahdat. “But we would argue that there are two people that have caused an unintended pregnancy.”
