A Birth control Pill for Men?

A Birth control Pill for Men?
A Birth control Pill for Men?

In the last few decades there has been an increased awareness on the part of scientists to find the perfect male contraceptive similar to the pill that is being swallowed by millions of women all over the world every night. While the pill had been acclaimed as a symbol of woman’s liberation from the shackles of unwanted pregnancy, a man still has to depend on cruder safety devices like the old fashioned condom or on precarious factors like his partner’s willingness to adopt a foolproof contraceptive method. But though large amounts of money have been spent on research in this field, no breakthrough has been achieved mainly because male contraception seems to be in several ways trickier than female contraception.

Firstly, the task of reducing sperm count from 500 to 300 million per ejaculate to the level at which fertilisation becomes impossible, is like attempting to stop an advancing army of soldiers instead of trying to halt the march of only one soldier, i.e. the egg produced by the female. The whole operation is rendered more difficult by the fact that sperms are constantly being produced by a man whereas a woman releases only one egg every month—in other words the invading army in the former’s case is a never-ending stream of hordes of soldiers!

It has been noticed that chemicals or drugs that attack sperm such as anticancer drugs and amoebicides may also harm other organs. Even steroid hormones, such as oestrogen or progesterone that prove relatively effective and safe in women cause complications in men who require larger doses. Apart from this while 98 to 99 per cent of women respond to steroids the figure drops to only 76 per cent for men. Even some men who do respond start producing sperms again after using steroids for a while.

Another disturbing and perhaps embarrassing fact is that most substances suppressing sperm production also suppress libido. Initial hopes that a monthly injection of progestin (a synthetic steroid with progesterone action) and a monthly shot of male hormones would overcome this problem, as had been indicated by some earlier studies, faded way in the light of subsequent discoveries that such a regimen could not be depended upon to guarantee maintenance of low sperm production.

The whole issue is made more complicated by certain biological and cultural beliefs that seem to put the ultimate burden of contraception on women. Since women are the ones who generally rush to doctors due to social pressures complaining of unwanted pregnancies, comparatively greater attention has been paid to studying female reproductive physiology, and hence, the demand for female contraceptives is higher—though it might be argued by sociologists that in this age of permissiveness it is the relatively more promiscuous male who would be more in need of protective barriers like the sheath which indirectly acts also like a contraceptive.

A very significant development in this connection was a discovery made in the Peoples Republic of China in the early 1970s. A team from the Chinese Academy of Sciences had been investigating an outbreak of fever in Hopei province. They had found to their surprise that the male victims were also sterile. Investigations led the scientists to conclude that the dietary staple food of these people contained cotton seed oil which apart from causing fever had also reduced their sperm counts.

It was noticed that unlike other contraceptive methods which affect the production of testosterone, the male sex hormone, gossypol (a constituent of cotton seed oil) acts directly on the sperm and certain sperm producing cells by inhibiting an enzyme involved in the production of sperm.

Subsequent observations made on ten thousand men who had taken gossypol pills indicated that the substance became almost 100 per cent effective after having been given in low doses for two months, although it had brought on occasional harmful side-effects such as fatigue or even temporary paralysis due to reduction of levels of potassium in the blood. Another disturbing piece of evidence was that even two years after stopping the pill, 20 per cent of the men remained sterile and some more registered low sperm counts. All the same because of gossypol’s potential value as a powerful contraceptive, researchers are not only unwilling to abandon it but are hoping either to produce a safer derivative or to find methods to counteract the side-effects of gossypol.

The identification of a class of neurohormones has generated a new mood of optimism. These neurohormones or neuropeptides may not affect libido and can be used by both men and women. (It is not irrelevant to mention here that the connection between neuro­hormones and sexual performance had been established by experiments conducted in England and Germany.

In one study in the United Kingdom, the neurohormones, LRH (luteinising hormone-releasing hormone) showed impressive results in stoking sexual power in young men whose development had lagged because of brain tumours, and in older men who had suffered through long bouts of impotence. Studies in Germany have revealed that LRH does seem to facilitate sex activity in cases of psychological impotence.

(Luteinizing hormone-releasing hormone causes the pituitary gland in the brain to make and secrete the hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In men, these hormones cause the testicles to make testosterone. In women, they cause the ovaries to make estrogen and progesterone).

Rats given LRH perform more often and efficiently, thus revealing a discernible change in sexual behaviour.

One such neurohormone known as LHRH occurs naturally in the brain. It stimulates the pituitary to release other hormones that trigger the ovaries to release eggs and the testes to produce sperm. Ironically, while in small doses this potentially unisex hormone had the property of encouraging fertility, in large frequent doses it confuses the body to shut off the reproductive system.

In 1971 two scientists, who also happened to be rivals, Roger Guillemin and Andrew Schally took great pains and isolated LHRH from the hypothalamic fragment of hundreds of thousands of sheep and pigs. In 1977 they were awarded the Nobel Prize in Physiology or Medicine for their epoch-making work. After that several developments took place rapidly. A synthetic analogue of the hormone, which is 200 times more potent than the original, was being tested in several places in the United States.

Injections of this hormone given to male volunteers of a prestigious university in the United States over a six to ten week period resulted in lower sperm production. However, the sex drive also dropped along with the sperm count and a significant number of men even suffered hot flushes such as those experienced by women during menopause. Researchers were hopeful of counteracting such effects in future experiments with doses of testosterone.

Scientists are optimistic that a major breakthrough can be achieved by investing time, energy and money in this rather new and fascinating field of research. One recent institute in the United States which has involved itself in extensive contraceptive research had estimated the cost of a new method at about 20 million dollars.

Measures for achieving birth control effectively by non-drug contraception have depended on sterilisation procedures and barrier contraceptives that are intended to prevent the sperm from meeting the egg without interfering with the basic body processes. In men sterilisation would involve blocking the passage way—the vas deferens—that carries sperm from the testicle to the penis.

In one method the vas is lifted out of the scrotum tied and cut and then put back—an operation that is repeated on the other side also (sometimes the vas is sealed off by an electrical needle or scarred shut by chemicals). In view of the fact that such methods are difficult, laborious or ‘irreversible’ scientists are focusing their energies on a valve that could be inserted into the system and which can be moved from an ‘off’ to an ‘on’ position whenever fertility is desired. This procedure would require sophisticated surgical techniques which may take a few years to be perfected.

It is known that men have used contraceptives to prevent pregnancies as far back as 1850 B.C. They’ve used everything from honey and crocodile dung to do it.

Throughout history, much of the responsibility for contraception and birth control has fallen on women. These days, they’re front-and-center for three of the most common forms of birth control:

  • Sterilization (surgery)
  • “The pill” (which contains hormones that prevent pregnancies)
  • LARCs, or long-acting reversible contraceptives, like an intrauterine device (IUD).

Certainly, men play a significant part in preventing pregnancies. Some wear condoms (another popular method of birth control) or have sterilisation surgery (called a vasectomy).

Still, the search for the long-promised male version of “the pill” continues. Research shows that many men would welcome the choice of a hormone-based male birth control pill. Depending on who you ask, up to 83% say they’d use it. But coming up with a safe, reliable, effective male birth control pill is slow work, because scientists are after a lot in an ideal male pill. First of all it should be effective, and also

Cheap Easy to use

  • Free of serious side effects
  • Easily available
  • Reversible

The science of male birth control is tricky, too. In order for a pill to be effective, researchers look for it to do at least one of a few things:

  • Slow or stop the creation and formation of sperm
  • Stop the sperm from leaving the body
  • Slow down the sperm to keep them from reaching their destination
  • Keep sperm from fertilising the egg (possibly through a nonhormonal drug)

So far, most results at this have been injectables, not pills. That’s not ideal. Some pills made have the potential to create problems for the liver. You’d have to take others more than once a day — again, not ideal. And other side effects — things like acne, weight gain, altered sexual drive, and mood changes — can happen, too.

Work continues, though. Many researchers are using testosterone, either alone or with other hormones, in their potential contraceptives. These may be closer to the market than other options. But other, nonhormonal methods are in the mix, too.

A large study of an injectable hormone combination showed promise in 2016. Even with some side effects, 75% of those interviewed after the study said they’d use it again.

A procedure called RISUG — reversible inhibition of sperm under guidance — has been under development for decades in India. With this treatment, you’d get a one-time shot of a long-acting substance. It goes into the tube that carries sperm out of your testes (called the vas deferens). After that injection, sperm can’t leave the body. If circumstances change, another shot can clear the blockage and reverse the procedure.

But a safe, effective male birth control pill is still in the making.

A study of 82 men in early 2019 determined that a hormone-based pill called dimethandrolone undecanoate (DMAU) was safe when used every day for a month. It also had no serious side effects.

Another promising pill, 11β-MNTDC, was announced in March of 2019.

Trials are ongoing for both.

Research on barrier contraceptives for men is obviously confined to improving the quality of the condom which since its invention by Dr Condom in the eighteenth century has been around in one form or the other. Though the last few years have seen a spurt in production of better quality condoms with additional fringe benefits like modifications in texture and thickness and variation in colours, and even flavours, scientists are eager to produce what they describe as a ‘biodegradable’ condom that reduces the problem of disposal, one with a built-in spermicide to increase efficiency and is made of a material that allows the heat to penetrate so as to increase sensation.

However, when all is said and done it is the search for an ideal male contraceptive that appears to attract the imagination of scientists today. They hope that by the year 2030 or they would be able to produce a pill that will interfere with sperm production and at the same time avoid the undesirable side effects of the steroids. Tests are at present being carried out on ‘inhibin’ a hormone secreted by the testes.

If these experiments prove successful, recombinant DNA tech­niques could also be employed to produce it in quantities to make it available at a reasonable cost. In other words, the ultimate aim of scientists is to use the very same techniques that create life to guard against the appearance of more life than our planet can afford to support, with its limited energy resources.


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