After more than two decades of research, male birth control is still a mirage, perpetually a few years away from becoming a reality.
The saga goes like this: After a promising breakthrough, pundits predict that a hormonal contraception for men is right around the corner. Then a pharmaceutical company halts research or the contraceptive isn’t effective enough and the promised pill, implant, patch, or injection never materializes. Repeat.
So nearly fifty years after the birth control pill was approved for use in the United States, women still shoulder the burden of preventing pregnancy and men—outside of condoms and vasectomies—continue to have few options.
Why the Delay?
The reasons for the hold up are fairly simple—too many sperm, too little money. Creating an effective hormonal birth control for men is challenging. In women, the birth control pill works by preventing the ovary from releasing a single egg every thirty or so days. Men, on the other hand, are constantly making sperm and stymieing their production is tricky. One ejaculation alone can be an onslaught of as many as 800 million sperm. For that reason, the incarnations of male hormonal birth control has not yet been as effective as the pill, which prevents 92 to 99 percent of pregnancies.
Intertwined with the biological impediments are the financial ones. Pharmaceutical companies don’t trust that the payoff will be worth the investment. In 2006, major pharmaceutical companies like Wyeth, Schering, and Organon began to halt their development programs. Though studies have had no trouble finding volunteers and at least two surveys show that significant percentages of men would consider a hormonal contraception, drug manufacturers are not convinced. In 2007, a spokeswoman for Organon told the journal, Chemistry World, that “despite twenty years of research, the development of a (hormonal) method acceptable to a wide population of men is unlikely.” Indeed, shifting the responsibility to men would take time. And it would have to be accompanied by an education campaign that would address men’s fears that it would damage their health and dampen their masculinity.
For two decades, researchers have studied all kinds of possible male birth control methods. At this stage, the most promising appears to be injections of testosterone possibly coupled with another hormone. In a recently completed two-year trial of 1,000 Chinese couples, hormonal therapy shots were 95 percent effective for preventing pregnancy overall and 98 percent effective when the levels of semen dropped as expected. Although testosterone generally triggers sperm production, injections of the hormone have the opposite effect. The brain senses the testosterone in the blood, thinks there’s plenty to go around, and tells the testes to stop making the hormone. A problem with the injections is the lag time between therapy initiation and its desired effect—it can be as long as three months. A new international trial similar to the one in China is underway. Men in stable relationships will get injections for at least a year and a half.
If a male hormonal contraceptive should ever make it to the market, it will benefit men and women. Some look at a male birth control as an equalizer—and a bit of a payback— since many women have had to worry about contraceptives and suffer from side effects like acne, weight gain, and mood swings for years. In fact, the opposite is true. An effective male birth control would empower men. For the first time, they would have control over their bodies in the same way women do. Since roughly 50 percent of pregnancies in the U.S. are unplanned, men have a very good reason to take charge.
Still, it would take a good deal of education and likely, a lot of prodding from his partner, to convince the average guy to do something that would reduce his sperm count. Perhaps the first male converts would do it because their partners are unable to use birth control and their friends will see that it’s not emasculating after all. The word would spread and eventually birth control would be as much of a male issue as it is a female issue. Or maybe that’s just a mirage.