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Reproductive Health

Male Birth Control: Is it Safe and Will Guys Use it?

by MARIA DEL RUSSO

When it comes to birth control for women, there is a wide variety of options one could utilize in their journey to preventing pregnancy. But for men? Not so much. Traditionally, there have only been three paths for birth control for men — sterilization (also known as a vasectomy), the pull out method (which is only 78% effective in typical use) (1) or barrier methods such as condoms. Of the three, condoms are the option that most men reach for, since they are easy to use and access, and they also prevent some sexually transmitted infections. Vasectomies, on the other hand, are painful, invasive, and are seen as permanent solutions to birth control. 

The common thought behind the lack of options for male birth control is that men don’t want to be responsible for it. Women, after all, are the ones who get pregnant. But according to a survey by the Contraceptive Development Network at Department of Obstetrics and Gynaecology, that isn’t the case. They found that the majority of men, between 44-83 percent, would welcome the option of hormonal birth control pills. (2) 

The issue, though, is simple biology. In an average amount of ejaculate, sperm production varies from 20 to 150 million sperm per milliliter. (3) Women, on the other hand, only ovulate about 300 to 400 eggs in their entire lifetime. (4) So controlling that much sperm while also keeping men healthy is a tricky puzzle that researchers haven’t quite cracked yet. 

That said, some options are already on the market and options in development that already show promise. So let’s dig a little deeper on what those options may be, and whether they might be right for you and your partner. 

Male Birth Control Pills

While there is no male birth control pill available on the market at this very moment, research seems to suggest we aren’t too far off from one. This past year, the Endocrine Society published their findings on 11-beta-MNTDC, the abbreviated name of a hormonal birth control pill for men. It’s a modified version of testosterone which combines the actions of androgen and progesterone. When combined, these hormones work to lower sperm count while maintaining libido, so it works similarly to female birth control pills. It signals the body that hormone levels are just so that it should stop producing the necessary tools for reproduction. 

According to the study, there were very few side effects from the pill, and it was deemed safe by researchers, although it has yet to be reviewed by the FDA. It takes between 60 and 90 days to affect sperm count, though, so it takes a little longer to kick in than female birth control, which typically is effective within two weeks. That said, the effects are reversible as soon as you stop taking the pill. Thanks to these results, researchers believe we are about ten years out from safe, reversible birth control for men. (5)

Male Birth Control Gel

If ten years seems like a while to wait for birth control, then you’re in luck. A gel, named Nestorone-Testosterone, has been in development for about ten years. It’s meant to be applied to the arms and shoulders every day and works to suppress the hormones that create testosterone in the male testicles. This routine, in turn, shuts down sperm production, but it can also lower libido. That’s why the gel also has testosterone. It’s meant to help with the libido issue without jump-starting the production of sperm. Oral contraceptive pills work the same way in women. The progesterone shuts down ovulation, and the synthetic estrogen in the pills makes up for what is lost. 

And it works. In 2012, a study funded by the National Institute of Child Health and Human Development found that the gel suppressed sperm production in about 90 percent of men to less than 1 million per milliliter or less. That’s the amount needed to prevent pregnancy. (6)

The gel is now in its second clinical trial, but researchers are hopeful that it will be available to the market in the near future. (7)

Nonsurgical Vasectomy 

Typically, vasectomies involve cutting or tying the vas deferens, which is the duct that carries sperm to the urethra. If the vas deferens are incapacitated, and sperm can’t reach the urethra, they don’t get carried out of the penis with ejaculation. Surgical vasectomies can be painful and require a lot of downtime, and they’re also permanent. But researchers in India have developed RISUG, which is short for reversible inhibition of sperm under guidance. It’s the injection of a polymer that blocks the sperm from escaping the urethra — and it’s 98% effective in preventing pregnancies. (8)

While RISUG will be available in India soon, US markets aren’t there yet. A nonprofit called the Paraseum has licensed the technology to be marketed here, and their product, named Vasalgel, is still in preclinical trials. And while it shows promise in rabbits and monkeys, it’s still years behind the pill and the gel as far as market-readiness. (9)

So while more technologically-advanced options are still far off, it’s crucial for men wanting to prevent pregnancy to use condoms. And if preventing pregnancy is a more permanent endeavor for you, a surgical vasectomy is also an option.

References

1. Planned Parenthood. How effective is pulling out? Accessed September 3, 2019. View resource.

2. Contraceptive Development Network at Department of Obstetrics and Gynaecology. Potential impact of hormonal male contraception: cross-cultural implications for development of novel preparations. Accessed August 26, 2019. View resource

3. Medicine Plus. Semen analysis. Accessed August 27, 2019. View resource.
Cleveland Clinic. Female Reproductive System. Accessed August 27, 2019. View resource.  

4. Endocrine Society. Second potential male birth control pill passes human safety tests. Accessed August 26, 2019. View resource.

5. Department of Medicine. A new combination of testosterone and nestorone transdermal gels for male hormonal contraception. Accessed August 26, 2019. View resource

6. Biospace. Interview: First-of-Its-Kind Male Contraceptive Gel in Phase 2b Clinical Trial. Accessed August 27, 2019. View resource

7. Bloomberg. A New Kind of Male Birth Control Is Coming. Accessed August 26, 2019. View resource

8. Paraseum Foundation. Vasagel, A  Multi-Year Contraceptive. Accessed August 26, 2019. View resource