The push for male birth control has been happening for quite some time. The effects of hormonal contraceptives on the female body can be harsh, and not all women can endure them. Nonhormonal contraceptives, such as IUD’s, can cause a lot of pain and discomfort as well. While there’s a vast array of birth control options available for women, men have a small selection limited to condoms and vasectomies.
According to research from the Human Reproduction Journal, 65% of the women surveyed, who attended family clinics in Scotland, China, and South Africa, felt that the responsibility for pregnancy prevention weighs too heavily on women. Fortunately, there are several studies and clinical trials underway, and this scenario may be about to change in the near future.
What is at stake for women
There are several types of female birth control options available:
- Hormonal methods: pills, patches, injections, and vaginal rings.
- Barrier methods: Condoms, diaphragms, and cervical caps.
- Intrauterine devices (IUD’s): Hormonal (Mirena) and copper IUD’s.
These methods can have many benefits and are shown to work for a lot of women. The combination pill, for example, can be prescribed for the treatment of polycystic ovary syndrome (PCOS) as well as endometriosis. However, this is not the whole story.
While nonhormonal methods come with their own set of issues, hormonal birth control, especially, can cause several negative side effects for women. Many may experience mood changes, such as increased anxiety or sadness. Some women report weight gain and changes in appetite. Other common side effects include headaches, breast tenderness, and irregular bleeding. Additionally, hormonal birth control can sometimes lead to decreased libido or sexual discomfort. In rare cases, it may increase the risk of serious issues like blood clots.
Explaining male birth control
Most compounds being researched as possible forms of birth control for men work by stopping sperm motility or its ability to swim. Unlike most forms of female birth control, they have the advantage of being nonhormonal.
A group of researchers, supported by the National Institute of Health (NIH) created a compound named TDI-11861. This compound binds and inhibits an enzyme called sAC, short for soluble adenylyl cyclase. sAC is important because it helps control how well sperm can swim and prepares them to fertilize an egg. In a study, the sperm from mice treated with TDI-11861 couldn’t move. Even after being placed in the female reproductive tract, the sperm stayed still. None of the female mice that mated with them got pregnant. This birth control effect lasted for about two and a half hours after the treatment and faded completely after 24 hours, making it an on-demand and reversible method.
A second compound studied in mice, called CDD-2807, is linked to the production of abnormal sperm with reduced motility. CDD-2807 is an enzyme that works by inhibiting serine/threonine-protein kinase 33, or STK33. STK3 is involved in regulating the cell cycle and ensuring proper development of sperm cells. CDD-2807 induces mutations of the STK3 gene. These mutations can affect sperm production or function, potentially leading to difficulties in fertilizing an egg. In the study, the effects on the treated mice’s ability to reproduce were gradual, and after a month of treatment, they had no pups. Their fertility was completely restored three weeks after the end of treatment.
Reducing sperm production is another birth control strategy. However, while women produce one egg every month, men produce about 1,000 sperm per second, which makes this a trickier method to develop.
A compound called YCT-529 is reported to be on a clinical trial led by manufacturer YourChoice Therapeutics. YCT-529 prevents sperm production by blocking retinoic acid—the active metabolite of vitamin A—receptors in the testes. According to pre-clinical studies, this retinoic acid receptor-alpha (RAR-alpha) inhibitor is 99% and 100% reversible, without side effects. In addition, due to the drug’s half-life, doses might only need to be taken every two weeks instead of daily.
In contrast with the previous alternatives, there’s a hormonal option on the horizon as well—a transdermal gel meant to be rubbed on each shoulder blade once a day. The gel combines the hormones segesterone acetate, or Nestorone (a progestin developed by Population Council), and testosterone. Progestin is a synthetic form of the hormone progesterone, which helps regulate a woman’s menstrual cycle and prepares the uterus for pregnancy. Nestorone blocks hormones in the pituitary gland that control sperm production, and it also reduces testosterone levels inside the testes. Since testosterone plays a key role in men’s health, it’s added to the formula in order to keep its levels in a normal range. Interestingly, the testes stop producing testosterone when a man’s body gets it from an external source, which leads to a drop in sperm count.
The gel has been shown to suppress sperm production faster than other experimental hormone-based methods. The findings come from an ongoing clinical trial involving 222 men who used the gel daily for at least 3 weeks. Most participants (86%) reached the target sperm count for effective contraception within 15 weeks of starting treatment, with sperm production suppressed in less than 8 weeks on average.
This rapid suppression time is a significant improvement compared to previous methods using injections. At the moment, research is focusing on confirming the gel’s effectiveness, safety, acceptability, and how quickly fertility returns after stopping its use.
The question still remains whether men would be willing to take a contraceptive. And if they did, would women trust them to carry this responsibility alone? According to the Journal of Sex Research, 34% to 82% of men participating in recent drug trials would be willing to take birth control. Women claimed to have a desire to share the responsibility in preventing pregnancy, and around 43% to 94% said they would give male birth control a chance. According to another study published in 2000, 24 years ago to this date, only 2% of the total of women participating in the survey said they wouldn’t trust their partners to take (hormonal) contraception.
Conclusion
Looking ahead, the future of male birth control appears promising, with ongoing advancements. Research continues to prioritize safety, effectiveness, and the quick return of fertility after usage. As attitudes evolve towards shared responsibility in contraception, these advancements pave the way for more options and greater equality in family planning, promising a future where women are not unfairly burdened as the only ones responsible for preventing unwanted pregnancies.
