Hormonal contraception for men may finally become a commercial reality within the next few years, experts suggest. Research offers reassuring evidence that it is not only effective, but reversible.
Researchers from UCLA and the University of Sydney analyzed sperm data from male hormonal birth control studies conducted over the last two decades. They found that most men’s sperm counts returned to normal within four or five months of stopping treatment.
“It is one thing to know that male hormonal contraception works, and another thing to know that fertility can be easily restored when a man chooses,” says researcher Peter Y. Liu, PhD, MD. “This is an important step in the evolution of male contraception.”
In the more than four decades since women got the pill, the birth control methods available to men have not changed much.
The search for a safe, effective, and commercially viable hormonal contraceptive for men has been a slow one. But experts tell WebMD that scientific advances within just the last few years may soon give men more birth control options.
The version that appears closest to commercial reality combines an implant of the steroid hormone progestin and shots of another steroid hormone, androgen, says Diana Blithe, PhD. She is the program director for the National Institute of Child Health and Human Development’s male contraceptive development program.
Progestins are often used in women’s contraception. Androgens are the major hormones responsible for the development and maintenance of male characteristics.
The implant would last for a year; men would need to get the shots every three months. This is a big improvement over earlier versions of male hormonal birth control, which required androgen shots as often as every week.
“We are much closer than we were just a few years ago,” Blithe tells WebMD. “Contraceptive formulations have improved and there is a general feeling that men will embrace this.”
Return of Fertility
The newly reported research involved a review of the raw data from 30 studies of male contraceptives published between 1990 and 2005. In all of the studies, sperm output was monitored every month after discontinuation of contraception until sperm recovery.
A threshold of at least 20 million sperm per milliliter of semen is a widely accepted indicator of fertility.
Data were available for close to 1,500 men. The average time for sperm recovery to 20 million/mL was three to four months. Older age, Asian race, shorter length of treatment, and higher sperm concentrations prior to treatment were all associated with faster recovery.
Using probability calculations, Liu and colleagues estimated that 67% of men using hormonal contraception can expect to be fertile again within six months of discontinuing treatment, while 90 percent will regain their fertility within a year, and 100% will return to normal fertility within two years.
The study is published in the April 29 issue of the journal The Lancet.
“The findings should reassure men that this really is a reversible process,” Blithe tells WebMD.
In addition to the implant-shot combination, investigators are also examining biodegradable testosterone pellets and gel delivery methods for hormonal birth control in men. And the search for new and viable nonhormonal male contraception continues.
“These methods aren’t going to replace the pill, but many women can’t take the pill for whatever reason, and there are a lot of couples out there that would love an alternative to condoms and vasectomies for male contraception,” Blithe says.
Liu says there is nothing revolutionary about men taking the lead in birth control.
“Family planning has been a shared responsibility throughout history. It is only within the last forty years or so that it has really shifted to women.”Your Complete Guide to Birth Control
By Salynn Boyles, reviewed By Ann Edmundson, MD
SOURCES: Liu, P.Y. The Lancet, April 29, 2006; vol 367: pp 1412-1419. Peter Y. Liu, MD, PhD, consultant physician, ANZAC Research Institute, University of Sydney, Australia. Diana Blithe, PhD, program director, male contraceptive development program, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md.