Male Birth Control Pill: Are We there Yet?

More than fifty years after its initial approval in the US, the female birth control pill still rules on the global contraception market. It is efficient, yet unaffordable to women in many poor countries; and its side effects make it a bad choice for many. Is it time for men to take responsibility for contraception?

Image Credit: R. Pelton

Do you know that first studies on chemical birth control for men began before the female pill was created – in the 50s. Since then, numerous pharma companies undertook new research… and dropped it. Are we finally on the verge of a new revolution?

The problem with the male pill

In terms of reproduction, just like in everything else, men are radically different from women. A woman ovulates once a month, producing just one egg; a correct combination of hormones estrogen and progestin can prevent ovulation (more on how the pill works here). By contrast, each male ejaculation contains between 100 and 500 million sperm, and men keep producing new ones every day. That’s a lot of sperm to render infertile! Various solutions have been suggested, from hormonal creams to gel injections. So far, none are approved… but we are close.

Vasagel from India

A few months ago, it was announced that a small indian company was ready to present their new sperm-inhibiting gel for approval in India. The gel is injected into the tubes through which sperm passes and attaches itself to the sperm, damaging it. The gel is supposed to work for years; once the couple decide they want to have a child, the man has another injection, which liquifies the gel, and everything comes back to normal. A 10-year-long study on male volunteers showed that the gel (called RISUG  in India) is safe and reversible. Creators hope it will enter the Indian market in two years, while in the West it is being developed under the name Vasagel. It is doubtful that the FDA will approve it anytime soon, but it is definitely something to keep an eye on.

Prison trials

It’s helpful to remember that standards of clinical trials were not always as strict as they are now. For example, the first trials of the female pill in Puerto Rico in the 50s used poor uneducated women, whose reports of side effects were largely ignored. As for men, the first birth control chemical, called WIN 18,446, was tested… in a prison! It proved very efficient and fully reversible in mice, but it turned out that combining it with alcohol was potentially lethal, and the research was dropped. At present, a team of scientists are trying to redesign WIN, making it safe (you can read the fascinating story of their research here). A hormonal cream is also in the works.

What will it be like?

According to a WHO report, up to 40% of all pregnancies in the world are unintended, of which half end in abortion. Clearly, it is in the woman’s interest to use birth control, even if it can cause side effects. Men, on the other hand, can dodge responsibility; therefore, to persuade them to take birth control measures (be it pills, injections, etc.), the proposed treatment has to be very safe and devoid of almost any side effects. This is extremely hard to achieve.

Will we be able to purchase male birth control pills anytime soon? Yes and no. If RISUG project goes ahead in India, perhaps in a couple of years you’ll be able to buy it there. As for the male pill in the West, it may still be a decade away. Meanwhile, men should act responsibly and use condoms – which, by the way, are over 100 years old.

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