Contraception has evolved to be more effective and accessible for women who want to avoid pregnancy. Women have a wide range of options, from the pill and patch to rings to longer-acting devices like implants and IUDs. There has been very little innovation in the area of male contraception. A male pill is still an omission.
Male contraceptives are largely unchanged over the past few decades. The condom is a barrier which prevents sperm reaching an egg and fertilizing it. And the vasectomy is a minor, but permanent, surgical procedure to stop sperm entering the semen that’s ejaculated out of the penis.
However, condoms have a high rate of failure, and vasectomy reverses are expensive, unreliable and sometimes not covered by insurance. Researchers are making significant progress in the development of a safe, reversible pill that men can take.
What is the pill called?
The female hormonal contraceptives prevent ovulation, or the release of a fertilized egg from the ovaries. Fertilization and pregnancy are impossible if there is no ovary.
The most popular pill is the combined pill. The combined pill uses synthetic estrogen and progesterone hormones — ethinyl esteradiol (ethinyl estradiol) and progestin (progestin) — to block the monthly release an egg. It thickens the cervical mucus to block sperm from entering the uterus. It can also be used to treat acne or relieve period symptoms.
The progestin only pill, or “mini-pill,” is a second form of birth control. It does not contain ethinyl esteradiol.
Why do we require a male-only pill?
According to estimates based on 2011 data, around 45% percent of pregnancies are unintended in the United States. 42% of those pregnancies end in abortion.
The person at risk of becoming pregnant has traditionally been the one who is most responsible for contraception. Female contraceptives do have some drawbacks. The pill is taken every day and can have side effects such as weight gain, nausea, and depression. It’s linked to serious health conditions such as breast cancer and blood clots. While IUDs can be effective and long-lasting, they may also cause heavier, longer or more painful cycles, as well as serious complications like pelvic inflammation disease (PID) if bacteria is introduced into the uterus during insertion.
Men’s options are growing beyond vasectomies and condoms, but a lot more work remains.
New male contraceptive options
Vasalgel, the first male contraceptive to be marketed in the United States for men, is currently the option that has advanced the most farthest in the clinical trials.
Vasalgel uses RISUG which is short for reversible inhibitory of sperm. This is similar to a vasectomy but without the permanent cut. It uses a polymer-gel injection into the tubes, called the vas deferens, that transport sperm between the testes and the penis.
The gel is positively charged and coats the inside walls of the vas. The gel is negatively charged, and when sperm swim through it, they are damaged, making them incapable of fertilizing an egg.
Vasagel appears to be effective for 10 years. It is also reversible by injecting baking soda and water into the vas. It also appears to be free of side effects.
Even though this product is promising, it still needs to be further researched before it is available.
Male pill studies
In the past year, there have been significant advances in the development and testing of a male contraceptive pill. research was presented at the American Chemical Society meeting. It showed that a non-hormonal contraceptive male pill effectively prevented pregnancy and did not produce any side effects. During the 4 week study, male mice were given a daily dose YCT529. The molecule targets a retinoic-acid receptor alpha protein (RARa). The retinoic acids, which are vitamin A derivatives critical to cell development and sperm production, are then blocked.
After treatment, the sperm counts of experimental animals plummeted. The same mice were able to impregnate the females four weeks after stopping the compound. Researchers also found that the compound was not toxic even when doses were 100 times higher than effective.
Researchers have licensed the drug to an American private company, which will conduct human trials later this year.
Early human clinical tests have also shown promising results. Both 11 beta MNTDC and DMAU, two novel synthetic compounds, are also potential candidates for the male pill. These compounds appear to be both safe and effective at suppressing the hormones required for sperm formation.
Dimethandrolone undecanoate (DMAU) and 11 beta-methyl-19-nortestosterone-17 beta-dodecylcarbonate (MNTDC) have properties that resemble androgens and progesterone to a lesser extent. Androgens is a group sex-hormones that are involved in puberty and body development. The male hormone testosterone is the most dominant androgen.
In two other recent trials of each drug 96 healthy men were randomly assigned to take 2 or 4 pills of the active medication or a placebo every day for 28 days. After seven days, testosterone levels in the active group dropped while those of the placebo group remained within normal levels. The testosterone levels of men who took the 400 milligram dose (4 pills per day) were lower than those who took the 200-milligram dose (2 pills).
The study also revealed that more than three quarters of the men who took the active drug would use it again in the future compared to less than half those taking a control.
When will male pills for men be available to purchase?
Researchers have been searching for a male contraceptive pill for many years. These studies are still in the early stages but they show promise.
These results may indicate that we are one step closer to having a male contraceptive pill on the market. Further research is needed, so we are still a long way from the male pill.
Resources
- NIH. Declines in Unintended Pregnancy in the United States, 2008–2011.
- IJMR. Safety & efficacy of an intravasal, one-time injectable & non-hormonal male contraceptive (RISUG).
- NIH. Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill.
- NIH. Daily Oral Administration of the Novel Androgen 11β-MNTDC Markedly Suppresses Serum Gonadotropins in Healthy Men.
- Endotext. Androgen Physiology, Pharmacology, Use and Misuse.
