The latest developments in male birth control may be just the ticket for men who want to take more responsibility for family planning. While condoms and vasectomies are the only options currently available, researchers are working to develop several other methods of male contraception.
Hormonal male birth control pills and injections are among the most promising options. They work by suppressing the brain’s message to the testes to produce the hormone testosterone.
Oral Pills
Developed by women in the 1950s, birth control pills, or “the pill” as they’re known, have transformed how people live. They prevent pregnancies by limiting the follicles that produce eggs, thus preventing conception and pregnancy. They’ve also sparked several other innovations like long-acting reversible contraceptives (LARCs) and condoms, which prevent sperm from getting to an egg.
Male contraceptives have sat on the back burner for decades, but new research shows they could be an easy way to stop unwanted pregnancies in men. Researchers have developed a new oral pill called undecanoate, or DMAU, that blocks the brain’s signal to the testes to make testosterone, the key hormone in sperm production.
While the drug has not yet been tested in humans, studies with mice show that it works just as well as other medications to suppress sperm production without side effects. That’s because the pill, a natural compound called triptolide, binds to testosterone receptors in the testes and disables them.
Another potential male contraceptive is a gel that stymies the testes’ ability to make the steroid estradiol, which is crucial for sperm development. That gel is in a few different clinical trials and could be available in as little as three years, Page says.
There’s also a pill being developed that stymies the steroid differently. The DMAU pill blocks the hormone in men but does so at a lower level than the estrogen-based birth control pills currently available.
If the DMAU pill is effective and has few side effects, it may become an easier option for many men to use. The pill could even be an option for teen boys who aren’t ready to have children, Page says.
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The pill’s main draw is that it’s reversible. After a couple of weeks, the pill’s effect is reversed, and the sperm count in the body is restored to normal levels.
This is important because men have much higher sperm counts than women, which can be dangerous if controlled. If men’s sperm counts get too low, they can cause an uncontrollable form of infertility that can result in miscarriages or permanent infertility.
It’s been challenging for scientists to develop male contraceptives because sperm is produced in the testes and not in the ovaries, as is the case with female hormonal contraceptives. But that’s changing.
According to Page, the biggest challenges are targeting the brain’s message to the testes and finding a pill dose that suppresses sperm production without side effects. She says it’s a more complicated process than developing female contraceptives, but if the method works and is safe, she believes a male version will be an option in a few years.
One reason a male birth control method has remained out of reach is that scientists have had trouble getting it approved by the Food and Drug Administration, Page says. But she thinks that a more rigorous testing process will help.
The Latest Developments in Male Birth Control
When the female birth control pill emerged in the 1950s, it changed how men and women thought about contraception. Although scientists had investigate male versions of the medicine in the years before it was approve, interest in them remained low until recently.
Despite the pill’s success, many men are still dissatisfie with their options for controlling fertility and want more options. Studies have shown that an estimated 17 million men in the US would be willing to use a new male contraceptive if they were available.
Researchers are working on various ways to control sperm, including hormones that stop or slow their production. But bringing these drugs to market is challenging. It’s also expensive to test a male contraceptive in humans. And drug companies aren’t intereste in spending millions of dollars on an unteste drug before they see any profit.
One approach
One approach is to target a specific gene that controls the formation of sperm. It’s calle RAR-a, and Knocking out the gene in mice makes them sterile. Other researchers are trying to block vitamin A’s role in sperm development by targeting a different gene.
A method also uses a chemical to prevent sperm from reaching the egg. This approach works better in some cases than others, says Daniel Nickels of the University of California, San Francisco.
Another strategy, which has been teste with mice, involves physically blocking sperm from leaving the vagina. That’s calle reversible inhibition of sperm under guidance, or RISUG. It’s an injectable medication that binds to the follicle in the vas deferens and changes its structure to prevent it from opening.
And yet another approach involves a gel applied to men’s shoulders. This gel contains a mixture of two hormones that control testosterone levels. When the gel is use, it signals the brain to suppress testosterone levels in the man’s body and reduce his sperm count.
These approaches all work differently, but they all have the potential to give men a safer and more effective way to control their fertility. That could mean fewer unwanted pregnancies and healthier babies, says Page.
The first approach
The first approach is a pill take orally, which stifles sperm production. It’s still in the early stages, and Page says it’ll likely be a few years before it’s ready to go to market.
Until then, researchers at Weill Cornell Medicine in Manhattan are trying to develop an injectable, non-hormonal contraceptive. It works by shutting off an enzyme in the semen, which allows sperm to swim.
While this method is still in its early stages, it’s showing promise. And the company behind it is starting human trials soon.
A third approach focuses on physically stopping sperm from traveling to the ovaries, but this method requires more time and money to test in humans. It’s being studied with rabbits, and if it works well, the company can sell this method as an implant that clings to the vagina for weeks or months.
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