For decades, experts and pundits have been predicting that a male birth control pill or breakthrough men's contraceptive was just a few years away. This week, for example, the Washington Times is reporting on the latest supposed breakthrough that researchers published this week in the Journal of Clinical Endocrinology & Metabolism.
The line this time is that a combination of testosterone and progestin holds the key to developing a male pill. Interesting, but don't hold your breath; there isn't much new here, and the researchers acknowledge there are still many kinks to work out. The study is actually a reanalysis of previously completed research—and there's nothing to suggest it will circumvent the problem that has previously stalled promising work in this area, namely the perception among drug companies that there's little money to be made in making a male contraceptive. In fact, that's one of the main reasons that the pharmaceutical firms Bayer and Organon jettisoned their male pill programs last year, according to Chemistry World.
Perhaps Big Pharma is right, but there are signs yet that new birth control options for men may eventually straggle to market. Just this week, the FDA approved a new device called SpermCheck Vasectomy. It offers men the option, for the first time, of checking whether a vasectomy has been effective in the comfort of their own home rather than having to drag themselves into the doctors office for a test. The device will be available online and in stores by the summer, a company spokesperson says. The same company, meanwhile, has other products—SpermCheck Fertility and SpermCheck Contraception—in the pipeline. SpermCheck Contraception will allow men to gauge the effectiveness of the various male contraceptive strategies that researchers hope will eventually make it to market.
But what exactly are those other strategies? And when will they be here? Malecontraceptives.org has a good rundown of the experimental options here. I won't hazard a guess as to which is most likely to succeed as promising options have stalled so frequently in the past, but Elaine Lissner, director of the Male Contraception Information Project for one, follows the options closely and has high hopes for two nonhormonal options that have been making strides recently. An injectable compound called RISUG has completed phase II clinical trials in India, she says, and it seems to prevent a man from fathering a child for up to 10 years—although it is readily reversible during that interval. Likewise, the Shepherd Medical Co. has received FDA clearance to perform a clinical trial on a type of implant that would function much like a vasectomy. Theoretically these "intra vas devices," which are sutured to the vas deferens (the tube that helps transport semen from the testes to the urethra), are removable. However, humans tests are required to see whether fertility can be restored after long-term use.
Both female and male activists for male contraception say there are ample reasons that men should start agitating for better contraception options. Lissner lays out a slew of reasons why men—and society, too—would benefit, including the fact that the current options for men are relatively unreliable. Two of the three options available to American men—condoms and withdrawal—have failure rates of 15 percent and 27 percent, respectively, after a year among couples who use them, according to the Mayo Clinic. The third option, vasectomy, is much more reliable, but its potential irreversibility is a serious drawback.
Warren Farrell, a masculinist and men's advocate who authored the book The Myth of Male Power, makes the case for men's contraception in more pugnacious terms. He argues that men can become victims when, say, a woman in a committed relationship actively manipulates a man into having and raising children that the man wasn't ready for by "forgetting" to take birth control pills. And he points to evidence that suggests some 10 percent of babies turn out not to be the progeny of the expected father when random DNA tests are done, suggesting to Farrell that many men help raise and support children who are not actually theirs. "The market for male contraceptives would be huge," he says.
With such provocative arguments floating around it's hardly surprising that the blogosphere is simmering with shrill commentary on the topic. There are women who seem to think men are Viagra-toting Neanderthals who have little commitment or tolerance for the intricacies of contraception. (Yesterday was Viagra's 10th birthday, by the way.) And men's activists who argue that women enjoy the power over the timing of reproduction only seem to egg them on. This post from the blog Feministing, for example, heaps scorn on a male Gizmodo poster who admits that the details of a recently announced experimental form of birth control—a radio-controlled sperm "tap"—make him queasy. That procedure, according to New Scientist, would involve injecting an 800-micron-long silicon polymer valve into a man's vas deferens with a hypodermic needle that would theoretically neutralize sperm by blocking it from passing.
For the record, the description of that particular procedure makes me a bit queasy, too. But there's a larger and more important point to make here than whether men or women endure more inconvenience or even danger from contraception. It's this: Good contraception options for men remain sparse even though the development of better ones are possible and would benefit both women and men. A good male contraceptive would allow couples to share the burden of birth control, give men a sense of control over their fertility, and probably cut the number of unplanned pregnancies.
But before I used any of these products, I'd certainly want good evidence that it was safe. And there's no way I'd go to the lengths that these two bloggers went to in entertaining efforts to counter their voracious virility: One spent months simmering his testicles in extremely hot baths, and the other created a custom pair of "suspensory briefs."
Let policymakers know whether you want more male birth control options—or not—by taking our poll. (And click here if you want to see the results of a recent survey of British men's attitudes on male contraception).
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