When the birth control pill hit the U.S. market 51 years ago, the hope had been for a male method to follow close at its heels. Yet, despite decades of research and periodic hopeful headlines, progress has been largely indiscernible.
Now, researchers are touting new developments: a reversible vasectomy, a “dry orgasm” pill and a miracle plant from Indonesia, to name a few. The demand appears to be there, considering that 1 in 6 U.S. men over age 35 has had a vasectomy. But with so many false alarms, should we believe that this time’s the charm?
Research on male contraception began in the 1970s, initially focusing on the use of hormones to manipulate sperm production. But while trials demonstrated efficacy, results were marred by nasty side effects and onerous administration (one potential method combined an implant below the skin with monthly injections).
A decade later, Elaine Lissner was just graduating college with a big idea: She founded the Male Contraception Information Project (MCIP) in the late 1980s to track progress and raise awareness of male contraception. Lissner says, “I thought everything would change quite quickly, [but] the world wasn’t ready…for male contraception in 1992. Everyone was focused on HIV and [the abortion pill], and nobody had time for [this]. I couldn’t get any funding.”
“Only nonprofits and universities continued to work [on this],” says Regine Sitruk-Ware, executive director for research and development at Population Council and a veteran researcher in the field. Then, in 2003, the mapping of the human genome enabled a change in gears. Instead of tampering with the body’s hormones overall, researchers could zero in on specific mechanisms to affect sperm viability. Now research is focused mainly on nonhormonal methods, as well as those with added benefits such as protection from HIV or baldness.
One such method, likely to be the first on the market, is RISUG, or the “reversible vasectomy.” Currently in Phase III trials in India, it entails a one-time injection into the vas deferens of a harmless chemical solution that deactivates sperm passing through it from the testes to the penis. So far RISUG has proven to be effective, safe—and reversible with a second injection.
Several other methods are just around the corner. Plant-based pills, like one being manufactured from the gandarusa plant in Indonesia, may offer natural, nonhormonal options. Researchers in the U.K. are working on a “dry orgasm” pill based on medications that restrict sperm from becoming semen—thus orgasm occurs but ejaculation does not. Other methods, such as the use of moderate heat or ultrasound on the testicles, are noninvasive and relatively simple ways of inhibiting sperm production.
But obstacles still loom. Contraception is about many things—reproductive choice, personal freedom, partner trust—but perhaps mostly about money. In 2015, the global contraceptives market for men and women will reach an estimated $17.2 billion, yet industry players have done little to sustain male-method development (beyond or even including male condoms) because they still don’t see potential demand or dollars.
“Market research has shown little interest from males, so companies have continued to [bow] out,” says Sitruk-Ware. The problem with such research is that it’s based on a premise that could change once an actual product is available. That was the case with the vaginal-ring contraceptive NuvaRing: Initial projections said women would be uninterested. Yet recent NuvaRing sales in the U.S. are up more than 40 percent.
Luckily, the odyssey for a male method is benefiting from recent broad momentum around contraception globally. “The difference now is that we’ve been through a lot of years of consciousness raising,” says Lissner. “There’s a reason I stuck this out.”
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Image copyright Sarah Richardson, 2011. All rights reserved.