Male birth-control almost sounds futuristic, but it was first researched back in the 1970s. So why in 2021 do men not have a wider variety of options, beyond condoms and vasectomies?
The forgotten research into hormonal male birth control
Decades old research exists on a daily hormonal contraceptive pill for men and many trials have been conducted for a hormonal injection. Despite findings showing that 55% of men want to try birth control, research was slowed down or cut short due to three main barriers:
- Technical: Researchers struggled to define a non-zero value for sperm production that equated to sterility. Surprisingly, they also found it challenging to design a way to deliver the drug so it lasts a long time.
- Financial: Delays were caused as many pharmaceutical partners resisted financing the research due to litigation concerns.
- Side effects: Depression, irregular heartbeats and erectile dysfunction as well as acne, injection site pain and increased sex drive were reported in one trial, resulting in 20 out of 320 participants dropping out and the trial halted. Some of these side effects may sound familiar as they make up a fraction of the many side effects women face when taking female control- the irony!
What can we expect in the future for male birth control?
Studies show that 90% of the time, women are responsible for managing any type of contraception. Fortunately, there are 4 new types of male contraceptives being developed:
Daily hormonal pills
There are currently two clinical trials which show potential. The first pill termed the ‘11-beta-MNTDC’ works by reducing hormone levels to a point where conception is no longer possible. Whilst side effects have been reported with this pill, it has passed a phase 1 trial. The second study looks towards Dimethandrolone Undecanoate (DMAU) as a potential daily pill, and works similarly to the first option.
Non-hormonal shot
Known as RISUG, this viscous gel is injected into the lumen of the vas deferens and works by rendering the sperm infertile. Whilst this method is expected to be effective for 13 years, its claim to reversibility depends on further trials into the second stage of this treatment. This would involve an injection which dissolves the gel. Although RISUG has not been tested on humans yet, trials show it was successful in animal studies. It can be seen as a potentially less invasive alternative to a vasectomy as no surgical incisions are required.
Hormonal gel
A two-year clinical trial run by UC Davis Health is testing a synthetic progestin gel which can be rubbed into the shoulders. It works by blocking natural testosterone production in the testes. It contains a replacement for testosterone to mitigate potential side effects such as reduced libido. This method would be reversible but may take a few months to take full effect.
Non-hormonal gel
Known as ADAM, this gel is injected into the vas deferens and prevents sperm from entering the seminal fluid. This method is long-lasting and should prevent pregnancy for over a year. It is currently undergoing recruitment for clinical trials.
It may be years before we see any new types of male contraceptives hit our shelves. Understandably, many men are still concerned about the sexual side effects (67%) and mental health side effects (53%) but rest assured, any drugs that hit the market would have undergone plenty of clinical trials as it’s in everyone’s interest to minimise any potential issues.
Enabling men to have greater ownership of their bodies and increased opportunities for shared responsibility sound great, so we are excited to see what the future brings!