A safe and effective birth control pill for men is one step closer to becoming a reality, according to new research presented this week at a leading medical conference. Scientists at the Endocrine Society’s annual conference in New Orleans informed that the once-daily pill designed to stop sperm production has passed initial human safety tests and proven quite effective.
This means men will soon have a fourth contraceptive option besides condoms and the “pull-out” method, both of which are dubious, and vasectomy, which is complicated and takes a toll on the male sex drive. The options for men are no longer as scant, reports Vox, as scientists may also be on the verge of discovering a contraceptive body gel and non-surgical vasectomy procedure.
More importantly, it will empower sexually active men to take on the responsibility to control fertility, by replacing the debilitating “morning after” pill designed for women.
Here’s how the pill could work
Biologically, the primary challenge of creating a hormone-based pill for men is to make sure that it doesn’t blunt the male libido or lead to erectile dysfunction.
Hormones, as we all know, trigger the creation of new sperm cells constantly in male testicles, up to 1500 per second. It is this effect that a male pill seeks to temporarily eliminate, without lowering hormone levels to such an extent that it creates side-effects.
This latest male pill, being tested by researchers from Los Angeles BioMed Research Institute and the University of Washington, should hopefully achieve this goal, researchers at the event in New Orleans said.
Forty men have tested positive in this regard. While 10 were administered a placebo, 30 men were given 11-beta-MNTDC, an androgen-based drug which reduced reproductive hormone levels greatly, restoring them to normal after the trial.
The drug contains a form of progesterone that blocks the production of hormones LH and FSH required in sperm production. It also has a testosterone-like compound which balances a drop in the male hormone caused by the progestin. It is the latter which maintains other masculine traits like body hair, deep voice, sex drive and function, and lean body mass.
Five men on the pill reported mildly decreased sex drive—and two described mild erectile dysfunction—but sexual activity was not decreased, no participant stopped taking it because of side-effects and all passed safety tests.
No significant side-effects like mood alterations have been noted as yet, which is a step-up from an earlier two-phase study to develop an injection that needs to be given every other month for longer-acting birth control hormones. It was suspended after some of the volunteers reported side-effects, including mood disorders or depression.
The researchers behind the work are cautiously optimistic about the findings. “All we have shown so far is that it shuts down the hormones that control the function of the testes,” says Professor Christina Wang.
Stephanie Page, a professor of medicine and co-senior investigator on the trial at the University of Washington in Seattle, told the Guardian, “The goal is to expand contraceptive options and create a menu of choices for men like we have for women. We are neglecting a major potential user population with the limited options currently available to men.”
“Our results suggest that this pill, which combines two hormonal activities in one, will decrease sperm production while preserving libido,” she said. “Any product that males would take should have a 90 to 95 percent efficacy rate, comparable to the rate for the female pill. That’s critical.”
Wang happens to be behind the tests on two other prototype for hormone-based male contraceptives, one gel
But there is no cause to rejoice yet as scientists at ENDO 2019 believe it could still take a decade to bring the once-daily pill to the market for commercial use. Bigger, longer trials are needed to check to see if it would work well enough to control birth.
What’s taking so long?
The female pill was launched nearly half a century ago, primarily due to efforts led by the second wave of feminists who fought for reproductive autonomy on the plank of female health risks.
Fifty years later, they still remain an option only available to women. Experts say that the societal and commercial will is largely against a male pill, despite opinion polls suggesting that more young men are willing to consider taking a pill should it become available.
Speaking of the former, it would continue serving the patriarchal agenda to transfer the entire onus of reproductive health onto women, regardless of the side-effects of both pill and abortion.
Even pharmaceutical companies seem to be on board with this bias, as funding for developing oral contraceptives for men is deceptively little, relying mostly on philanthropic and academic sources.
Pharma like most male-dominated industries have resisted the idea at the core of which lies gender equality; the industry has so far been slow in getting behind these projects despite good evidence that both men and their female partners would welcome the additional choice. It could be a matter of pricing, as male contraceptive pills could be significantly cheaper or more readily available.
As Gloria Steinem says in this Guardian interview, “If men could get pregnant, abortion would be a sacrament.”
It is thus clear that getting big pharma interested to bring this product to market when the trials are successful will be an uphill battle. But we will cross that bridge when we come to it.
One can also not ignore the seminal question: Will men use it?
Even if men were to adopt this responsibility, whether women should trust men to reliably take it, is a pertinent question in the age of condom stealthing.
A less ominous but equally catastrophic eventuality would be if they forgot about it. A survey in 2011 found 70 out of 134 women in the UK have reason to worry that their male partner would forget to take a pill.
Nonetheless, the importance of this drug cannot be undermined especially in countries where sex, and any healthy conversation around birth control, is pretty much taboo.
In emerging right-wing nations including the US, options and availability of contraceptives are dwindling. Even if the male contraceptive were to come around, as long as the Food and Drug Administration (FDA) remains under the thumb of conservative governments, such drugs are less likely to be approved.
Researchers in India have gotten fairly far in the development of a nonsurgical vasectomy called RISUG, which stands for reversible inhibition of sperm under guidance. Developed by biomedical engineer Sujoy Guha of the Indian Institute of Technology, it involves injecting a polymer gel into the vas deferens to block sperm, rather than cutting it (as in vasectomy). Easily reversible with a shot that breaks down the gel, RISUG should launch in India within the next couple of years, says Bloomberg.
That said, it continues to be imperative to get legal approval for safe abortions in India, where some states even banned the sale of emergency contraceptive on moral grounds, to the tune of huge uproar. Therefore, the availability of another contraceptive choice, which is designed for bodies that aren’t historically controlled by the state or social norms, nor prone to suffer the long-term effects of the conventional pill or invasive procedures like RISUG, is a stupendous milestone.
Whether men will find this an easy pill to swallow is a different issue.
Prarthana Mitra is a Staff Writer at Qrius.
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