Both men and women are equally responsible for procreating. However, for decades, the responsibility for preventing it has largely fallen on women’s shoulders.
Case in point: there are over 15 different contraceptive methods and options available to women that allow them to control their fertility. For men, male birth control options are limited to a mere two, with the highly questionable ‘pullout’ method thrown in as an after-thought.
For males today, preventing a pregnancy means either opting for a last minute withdrawal before ejaculation, wearing a condom, or going for a complete sterilization altogether via a vasectomy. There is also the option of complete abstinence and outercourse but they both sort of beat the purpose of needing birth control for sexually active individuals.
Unfortunately, all of these choices are far from ideal and not nearly as reliable as you’d want them to be.
The withdrawal method has no guarantee what so ever when it comes to avoiding conception, simply because sperm can be released before ejaculation. Though condoms are a very effective contraceptive method, there’s no denying that they can be cumbersome – especially when they aren’t used correctly. The vasectomies are surgical, permanent solutions to unwanted pregnancies, however, they aren’t exactly easily reversible.
Luckily for men around the world, there has been considerable progress in the provision of male contraceptive methods in recent times.
One such option is the male birth control pill.
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Amongst the very limited male birth control choices available, there are none based on hormonal contraception. The male birth control pill is the second attempt at providing a safe and highly effective contraceptive method that sufficiently suppresses spermatogenesis – or the process of sperm production – enough that men can conveniently control their fertility.
A tweaked and adjusted version of the previous attempts at hormonal male contraception, the currently proposed form of the male birth control pill contains an active compound called Dimethandrolone undecandoate or DMAU for short.
How Does The Male Birth Control Pill Work?
The male birth control pill is said to function similar to its female counterpart – that is by controlling the very process of procreation, altering the human hormonal activity enough to render men unable to impregnate a woman.
The sperm production in the testis is largely regulated by the male sexual hormone
testosterone along with a stimulatory action of the follicle stimulating hormone (FSH) and luteinizing hormone (LH). In the preliminary study recently conducted on the use of DMAU as a male contraceptive pill, it was found that the active compound dimethandrolone undecandoate causes a sharp decline in the production of all three hormones, leading to effective infertility.
The decrease in hormones leads to cessation of the sperm production, thus allowing men to engage in sexual activity without having to worry about unwanted conceptions. DMAU accomplishes this by mimicking the properties of both testosterone and progesterone, essentially tricking the male body into believing that the testosterone levels are sufficient in the body, thus preventing the hormonal pathways which lead to the production and development of the sperm.
Much like the female birth control pill, however, the male version also comes with its own set of undesirable side effects, but more on this a little later.
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Developed by a team from the University of Washington in association with the National Institutes of Health and UCLA, the male birth control pill was recently presented at the Endocrine Society’s annual meeting after being evaluated in a successful medical trial.
Presented by Stephanie Page, a leading professor of medicine and endocrinologist at the
University of Washington, it was revealed that a male hormonal contraceptive pill was administered regularly to a group of 83 men in a clinical trial over the course of 28 days or approximately one month.
In the early-phase study, 100 men between the ages of 18 to 50 were initially recruited to
take varying doses of DMAU male birth control pill in order to test the effect of the medication on the amount of testosterone and other hormones responsible for sperm production.
The study group was divided into four smaller ones with each given varying doses of DMAU. While one group was placed on a placebo, the rest of the three were given 100mg, 200mg, and 400mg of the male birth control pill, respectively.
83 participants proceeded to complete the entire duration of the study after which they were tested for their testosterone and other hormone levels.
The normal range of testosterone is between 350 to 1,100 nanograms per deciliter, with a threshold of 50 nanograms per deciliter signifying chemical castration. Based on the blood test results, it was concluded that the hormone levels were sufficiently decreased after taking the highest dose of DMAU regularly for 28 days to successfully prevent men from being able to impregnate a woman. In the blood reports of the men who took the highest doses, the testosterone levels were found in the range of 13 nanograms per deciliter.
The study was deemed safe, with no liver or kidney related adverse effects experienced by the study group at any given time during the clinical trial – a true success, especially considering the fact that chemical castration can cause significant side effects in men treated for prostate cancer.
According to Ms. Page, the rarity of the side effects being apparent during the course of the study despite the sharp testosterone deficiency is largely due to the fact that the male birth control pill contains a combination of other synthetic hormones that manage to sufficiently mimic the other systemic health related effects of the predominant male sexual hormone.
The Male Birth Control Pill VS The Male Birth Control Shot
The male birth control shot was introduced to the world during Phase II of a multi-center study conducted by the World Health Organization in 2016. The study tested the effectiveness of a combination of injectable hormone based contraceptives in 320 healthy males ranging from 18 years to 45 years.
The male birth control shot used 200 mg of a synthetic progesterone derivative called norethisterone enanthate in combination with 1,000 mg of a testosterone androgen called testosterone undecanoate per day per participant over the course of 56 weeks, to sufficiently reduce sperm production and sperm counts.
According to the results, the sperm count was successfully reduced to 1 million/ml or even less within a period of 24 weeks after regular administration of the male birth control shot with a 96 percent success rate. In the residual 274 participants that moved forward in the efficacy stages of the clinical trial, there were only 4 pregnancies recorded.
Unlike the current reports about the male birth control pill, the use of male birth control shot resulted in grave undesirable side effects such as depression and other mood disorders. At the end of the trial it was found that three cases of severe adverse effects were reported during the course of the study, namely one case of severe depression, one intentional overdose, and one resultant tachycardia (superfast heartbeat).
The injectable male contraceptives were deemed unsafe following these reports and the clinical trial suspended, once the adverse effects of the birth control shot were made apparent.
The Male Birth Control Pill Side Effects
The current study for the male birth control pill – which has yet to be published in a peer
reviewed journal – does not explicitly state the extent of the side effects experienced by the participants. The study was presented at a meeting in Chicago for leading endocrinologists where it was stated that unlike previous attempts at a hormone based male contraceptives, the DMAU pill does not cause grave ill effects to the users such as depression, increased acne, injection site infections, tachycardia, or suicidal tendencies.
However, in the preliminary clinical trial that lasted for one short month, some minor side effects, were in fact recorded and reported. They include:
- Weight gain, as much as nine pounds
- A small but noticeable decreased in healthy cholesterol levels
- Lowered libido
According to Ms. Page, the conventional side effects of testosterone deficiency, such that is created with the use of the male birth control pill – which were noticeably devoid in the participants of this study – include but are not limited to:
- Breast enlargement
- Decreased bone density
- Severe depression
- Blood clots and thrombosis
- Impaired kidney and liver function
- Unregulated weight gain
The Future Of Male Contraceptives
The male birth control pill is not the first attempt at providing a male contraceptive based on managing hormonal activity and it is unlikely to be the last until there is found a reliable, safe and effective contraceptive method for men to use regularly.
The current study that presents the birth control pill for men is very promising because the results are not marred by reports of severe adverse effects experienced by the participants, causing them to drop out entirely from the clinical trial.
The lack of such reports as of yet for the male birth control pill raise hopes that a male hormonal contraceptive method could possibly be made available for the general public sooner than expected – one that would allow the male participant in a sexual relationship to take greater responsibility in controlling fertility and preventing unwanted pregnancies.
That said, it is uncertain what a longer, and larger study of the DMAU will reveal about the pill and whether or not the men would even be willing to use such a contraceptive method when it is made available in the market.
In the meantime, apart from the pill, there seems to have been considerable progress in producing other non-hormonal birth control alternatives to give men more choices in terms of contraceptives available to them.
Currently in works are a daily use gel, as well as a non-surgical vasectomy.
The gel, called Nesotrone-Testosterone, in its clinical trial stages, is a daily use gel meant to be applied on the shoulders and arms of males on a regular basis. The gel, which contains a combination of synthetic forms of the progesterone and testosterone, works by reducing the gonadotropic activity of the hormones responsible for stimulating the production of body’s own testosterone thus causing a decline in the sperm count.
In the second stages of its human clinical trials, the possibility of the gel hitting the shelves anytime within the next decade still seems very unlikely.
Apart from the gel, the nonsurgical vasectomy also seems to be making much progress as a possible contraceptive method for men.
The nonsurgical vasectomy is a method initiated and developed by researchers in India called RISUG or the Reversible Inhibition of Sperm Under Guidance.
The process involves injecting a biocompatible gel into the vas deferens – the tube which
brings the sperm to the urethra for release – to block the sperm from being released instead of actually cutting or surgically tying the tube.
If and when required, the sterilization effects of the gel can easily be reversed, simply by delivering an injectable which breaks down the gel, thereby re-allowing sperm easy access. According to the head researcher the procedure is should be 98 percent effective, if conducted appropriately, without any severely side effects.
Though the gel seems promising, it has only being tested in animal based clinical trials and still has a long way to go before it’s deemed appropriate for use.
Despite that, things are still looking up for the male contraceptive methods. That said, till a viable, safe, contraceptive alternative is marketed and made available to the general public, men will have to stick to the conventional methods of birth control with women continuing to take the brunt of the burden of controlling and regulating their fertility to prevent unwanted pregnancies.