FOXSexpert: Will Men Ever Share the Burden of Contraception?

For years, we’ve been hearing that more contraceptive options for sexually active males may soon be a reality. But that soon is starting to feel like never. Men still only have the condom, a vasectomy or abstinence when it comes to choices of birth control. So what’s holding up their show?

Research consistently reveals that men want access to better contraceptives. A 1998 study in British Journal of Family Planning found that 80 percent of males regarded a hypothetical male pill as one of their top three contraceptive choices. A 2005 global study conducted by Schering found that 55 percent of men ages 18 to 50 are interested in a “new male fertility control.”

Still, men like these are constantly getting teased with the prospect of greater control over their fertility during sex. Already we’ve been waiting years for male contraceptives in the forms of creams, monthly or quarterly injections, daily testosterone gel, patch, sperm plugs, sperm dissolvers, heat-inducing gels, hormone therapy, twice per year synthetic implants in the arm...

One researcher even developed a radio-controlled implant which blocks sperm flow with the click of a button!

Headlines are always showcasing studies holding great promise.

Most recently, research in the American Journal of Human Genetics reported that male infertility can be linked to gene mutations in the CATSPER1 gene, which produces a protein needed for normal sperm movement. Scientists speculate that blocking this gene might make for a new male contraceptive.

Research published in HumanReproduction, too, reported a mutation, this time on the PLC zeta, a protein present in sperm which initiates ‘egg activation’ upon attempted fertilization. Researchers speculate that a drug that inhibits the protein might make for a good male contraceptive.

Yet in both cases, between animal and human testing, this one is years away. And this is always the case with male contraceptives – we have to sit and wait.

Consider that, in 2003, BBC News reported that scientists had developed a 100 percent effective male contraceptive that was free of side effects and reversible. Trials conducted by the Anzac Research Institute, Sydney, Australia involved men receiving a combination of a hormonal implant under the skin and injections. None of the partners of the 55 men in the year-long study became pregnant. (The couples did not use other contraceptives).

The treatment worked by temporarily turning off the brain’s signals stimulating sperm production. The testosterone administered via the implant helped to keep the males healthy, while maintaining his sex drive, since this process also turned off his own testosterone production.

Sounds great, but.... longer, larger trials are needed. Pharmaceutical companies need to also turn their research findings into a user-friendly drug. Once again, this will take years. Once again, we get to hold our breath and hope, as we have for other promising forms of contraception that have long been on the horizon, like...

Immunocontraception: This involves a vaccine that triggers an immune system response to cells in the reproductive system. Basically, his own body is tricked into thinking that his sperm is foreign material (antigen). The problem lies in struggles to translate animal research into an effective human equivalent since the same antigen varies both between species and individuals within the same species.

Male Contraceptive Pill: This is a pill containing progestin and testosterone. Yet the orally administered combination of testosterone and progestin won’t work since testosterone gets broken down too quickly in the liver.

So another option is the pill plus a testosterone injection or implant. Progestin, the same synthetic hormone in female birth control, suppresses his ability to produce sperm. The testosterone helps to keep a man “masculine.”

Chemical Contraceptive: Researchers at Kings College London are developing a hormone-free pill that a man would pop before a date or sex. It contains chemicals that prevent emission without negatively impacting orgasm for a “dry orgasm.” This pill temporarily blocks sperm development without affecting testosterone levels.

His fertility would then return to normal, without any side effects, within a few hours. Results from trials, which were published in Nature Medicine Journal, show that there are no long-term side effects, and that the birth control’s effects are reversible.

Implant: Thousands of volunteers have been testing matchstick-sized implants in the arm. Those containing a dose of progesterone, a female hormone, temporarily reduce sperm production to levels that make him infertile. Those with doses of progestin block chemical signals from pituitary gland that command testes to secrete testosterone and produce sperm.

In either case, participants are also given an injection of testosterone every three months to keep that hormone at its normal levels, and to avoid any side effects, e.g., low hair loss or fatigue.

Clearly, academic researchers and drug companies have been pouring millions into hormonal birth control development for males. Yet despite all of the money that has been spent, it’s money that’s halting new-drug development. The pharmaceutical industry has largely decided that there isn’t enough of a market to make their investment worthwhile.

And why would that be?

While some like to point the finger at the drug companies others are blaming the men themselves. They’re not demanding male birth control, especially as a collective social movement.

Some men are downright uncomfortable with a drug that interferes with testosterone production, while others worry that a contraceptive may somehow mess with his masculinity. Some are simply quite comfortable with women taking responsibility.

Then there are the feminists who are hesitant about letting “untrustworthy” men take responsibility for pregnancy prevention. They fear relinquishing their reproductive power and male accountability. They’re certainly not encouraging politicians, who are ignoring the issue, to rally behind the unplanned fatherhood cause.

Finally there’s the fact that 10-15 percent of males do not respond to hormonal treatments at all, which is a rather high non-responder rate. Prevention attempts at effective, convenient male contraceptives are often also met with problems regarding reliability and side effects, including decreased sex drive, shrunken testicles, and mood swings.

Overall, these contraceptive methods simply aren’t ready to be rolled out – and there’s no rush. At the end of the day, it’s easier to block her monthly egg than halt his millions upon millions of sperm cells.

Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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