Male contraception makes promising steps

The Pill, vaginal rings, diaphragms, IUDs, birth control shots, female condoms, the Patch, implants, Plan B, and female sterilization. Aside from being various forms of birth control, these products have one central trait in common: they’re all for women. Since the push for pregnancy prevention and sexual health that took place in the 20th century, innovations for new forms of birth control have arisen yet are vastly centered on women’s responsibility for its utilization. And they are certainly using it. Birth control pills alone supply reversible contraception for approximately 11 million women.

But what about birth control options for men? According to Planned Parenthood, men can choose from only five non-medicinal options: a male condom, outercourse, vasectomy, abstinence, and withdrawal. These current options are not only limited but each poses unattractive drawbacks: withdrawal lacks in high effectiveness; male condoms can decrease penile sensation; vasectomies seem like a scary procedure, which includes an equally scary procedure to reverse; outercourse usually just leads to intercourse, and abstinence is just plain unrealistic. Fortunately, the need for more male birth control options has not been ignored. Researchers have recently experimented with hormonal and non-hormonal options for men. Though they would not protect against sexually-transmitted diseases, male birth control could be an attractive alternative. It would balance the contraception responsibility, increase the effectiveness of pregnancy prevention since half of all pregnancies in the United States are still unexpected, and alleviate women’s concerns over female birth control’s potentially hazardous side effects, like increased risks of blood clots, heart attack, strokes, breast cancer, cervical cancer, benign liver tumors, and interference with other medications.

The quest for a viable, safe, and effective male birth control has been characterized by continuous trial-and-error, experimentation, and creative innovation. Researchers first focused on developing some sort of hormonal sperm blocker, since most female birth control options consist of manipulating certain hormones. This resulted in too many complications and excessive effort on the part of men. Men would have to take testosterone supplements along with frequent injections of progestogen. Side effects were also undesirable. The male Pill was thus shown to be a dud, and researchers have scrapped the conventional hormone-centric birth control and put resources towards non-hormonal ones. Some recent endeavors to master sperm control include plugs that form sperm blockades, sperm-zapping ultrasounds, sterilizing heat treatments, and a radio-controlled implant to prevent sperm flow with a click of a button.  These undertakings are at elementary trial stages at best and many have yet to be adequately tested for effectiveness and safety. Nevertheless, the motivation is there. Research and resources are being accumulated for such experimentation and some recent pursuits have shown that we are getting closer to a marketable breakthrough.

Last year, two non-hormonal birth control options gained considerable traction. A compound known as JQ1 has been found to penetrate the cells of testes and shut off sperm development. Preliminary tests show promise, and the best part is that it’s entirely reversible. Within two months of discontinued use, testicular functions return to normal with no obvious adverse side effects. Of course, the study has not been conducted on humans yet, but the results on mice were overwhelmingly positive. Similarly, scientists have been testing on a contraceptive agent known as gamendazole. This also has successfully interrupted sperm maturation with full recovery after discontinued use. Gamendazole is actually quite close to becoming a realistic option for men. It’s been tested on rodents, rabbits, and primates. Researchers are currently in the process of getting approval for human trials, and if everything goes smoothly, we could be seeing this product, probably in pill form, on the market within 5 to 15 years.

Attracting even more widespread attention is RISUG, or Reversible Inhibition of Sperm Under Guidance. It was developed 30 years ago by an Indian scientist, Sujoy Guha, and has shown to be safe, simple, highly effective, and completely reversible thus far. RISUG, commonly known as VasalGel, is a gel injection in the vas deferens that instantly sterilizes men for 10 to 15 years. The procedure is short and needs to occur only once. If desired, an injection of a compound that dissolves the gel can be administered in order to recover full fertility. Though still technically considered in its clinical testing phase, numerous human trials have been conducted with incredible success. And by incredible I mean 100% success in the prevention of sperm flow. RISUG undoubtedly holds much promise and advocates are pushing FDA approval to be on the U.S. market by 2015. The main obstacle for its emergence into the market? Pharmaceutical companies. (Surprised? I wasn’t either.) Apparently, some medical endeavors run the risk of being too good. Given its impeccable and long-term effectiveness after just one injection, pharmaceutical companies are concerned it will not accrue a significant profit margin and are hesitant to fund it or even give it attention. However, with the coverage it’s already received and the hopeful approval of the FDA, I highly doubt RISUG will be left unfunded.

Though male birth control has yet to be on the market, it is clear that its reality is well within our grasp. With more clinical trials and cooperation with the American medical industry, we can open the gates to further control our sexual well-being and personal choices, especially for men, who currently have very few avenues to own their sexual activity. More methods of birth control implies fewer unplanned pregnancies, more individualized sexual control, and (hopefully) more informed and calculated personal decisions made. This trend of more forms of birth control is a positive one, yet it is still contentious. I’m sure its presence in the market will be met with enthusiasm, skepticism, and disgust. It will certainly be interesting to see how the politics of male birth control unfold along religious, gender, and party lines.

 

—Angela Della Croce ‘15 is an Economics major.

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