Birth Control For Men? For Real This Time?

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.”

Excerpted from the Fall 2011 issue of Ms. To have this issue delivered straight to your door, join the Ms. community.

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Image copyright Sarah Richardson, 2011. All rights reserved.

Comments

  1. I like the idea of birth control for men, but I doubt many men will want to get a shot anywhere near their testicles.

    • If 1 in 6 men over 35 have had vasectomies, that means 1 in 6 men over the age of 35 have had an injection of local anesthesia near their testicles.
      I think the demand may be there, especially for a non-hormonal method.

      • Joe from an alternate universe says:

        True. And this is little more invasive than it seems. An incision still has to be made to view the vas. Also, as in a vasectomy, men have the option for general anesthesia and many men take that option. I was operated there twice in my life (not for a vasectomy) and I was put out both times. A relative had a vasectomy and he opted for general anesthesia.

  2. Nicholas Chase says:

    I’m part of a growing number of young men getting vasectomies for ethical reasons. I know two other men my age (24) who have also gone under the knife before ever having children. I really hope this intermediate step encourages men to try it out and make it permanent! Imagine if we encouraged every young man to get this treatment as soon as or before they become sexually active. Teen pregnancy could plummet overnight! Teenage boys don’t want babies, but they really don’t want to wear condoms. To all the naysayers, I say build it and they will come. Men do want control of their reproductive organs too.

    With 23,000 children under five dying every single day from preventable conditions, and 140,000 children waiting for adoption in the USA alone, I just don’t think it ethical to create more children if we can’t take care of the ones we already have.

    • I think you’re confusing ethics with morality. Simply put, morals are subjective while ethics are objective. Your personal morals may demand that you not reproduce, but an outsider observing our society would have to conclude that it is quite ethical to reproduce and possibly abandon your children ad infinitum.

      The vast number of children are waiting to be adopted not because there aren’t families who desperately want them, but because there are so many obstacles to overcome to do so. You can’t just pop on over to the orphanage and pick one out. How many children have you adopted?

      As someone who has tried to conceive for years without doing so once, I hope you don’t come to regret your decision, and that you considered all of the implications, including the feelings of your future partners. And to encourage young men to sterilize themselves before they really know what they want out of life? What a horrible suggestion. The article is about birth control, not birth annihilation.

      • That’s kind of easy to say when you’re a woman and have all the choices in the world. If you are not ready for a baby you can choose not to have a baby. The choice is always yours. A man has no choice, he can only go along with the woman’s decision. If a man doesn’t want to be a father right now he has three things in his control: abstinence, condoms and vasectomy. That’s all he has to choose from if he absolutely doesn’t want to have his life ruined by a woman who wants a baby. It’s lose-lose. A man will choose the option that best suits him. If that means sterilization than that’s what it has too be. There isn’t a whole lot of options.

    • I agree. What a wonderful way to keep children from having children, and to allow men to wait until they are mature enough to want children in the context of a stable marriage, assuming responsibility for raising a family. There would be much less need or desire for abortions, which may stop much of the moralistic cant of the anti-abortionists. Provided, of course, the Catholic church doesn’t find some excuse to oppose it!

      • “wait until they are mature enough to want children in the context of a stable marriage”

        With the vast majority of divorces being initiated by women under ‘no fault’ divorce laws in so many countries I don’t think the term “stable marriage” applies these days. I could back that claim up with myriad references, but prefer to give the benefit of the doubt that you and others know how to find it for yourselves online and elsewhere.

    • Genevieve Berrick says:

      Since this form of contraception obviously has no effect on the prevention of STIs, it obviously would not be an alternative to condom use – which has a high level of protection against such disease.
      To suggest it would be exchangeable for teen boys seems irresponsible.

  3. The only reason men haven’t had contraception for 20 years is that femminists have opposed it. Women have “oopsed” men, (lied to us about contraception use in order to breed) so often that feminists have just assumed men would do the same thing, making male contraception a real threat. When the truth is that there are lots of men who want fewer children than most women, and so lots of women want to retain the ability to tick men into paternity.

    • broseph stalin says:

      dude… shut up.

      • Nice argument. You got nothing so you attempt to silence the opposition because you disagree. So much for conversation. This is the real threat that more reproductive options is seen as to women. A male pill will drastically bring back power the male side in the dating/mating game dynamic. Anyone opposed to the male pill knows this and this why they are opposed. Oh yeah there’s a war on women too….lol.

    • And yet your on a feminist website and has just read an article about it.

  4. When I sleep with a man whom I have met only recently and do not trust just yet, I would not trust him enough if he told me he was fixed, and I would still use condoms. With partners I am not in a committed relationship with, I want to be in control of what goes into my body — I simply cannot trust these men to take care of my body and my well-being. On the same note, I am beginning to realize that this is a major issue, and as sexual as I am, I cannot fully enjoy sex with a stranger.

    • Jessica Mack says:

      Wow, Alan, your comment leaves me speechless. The only thing I can muster as a response is to suggest you, ahem, are missing *significant* scientific facts and respect for other human beings in your argument.

    • Jessica Mack says:

      K.B., that totally makes sense. Even if a guy has had a vasectomy, he could still transmit an STI, so using a condom if neither have you been tested is the way to go. I think the ability to trust that your partner will use a male method is exactly about that — trust. We all know that takes a while to build up, so I can see why “invisible” male methods (i.e. shot, pill, etc.) wouldn’t set your mind at ease unless you felt really secure in that person.

      • Lucian Cross says:

        Agreed. Just how men really shouldn’t believe they are secure in existing “invisible” female methods. A male birth control pill, or injection, would be for men and their peace of mind; just as female birth control options (numbering close to a dozen?) give women a measure of peace of mind.
        To be be clear, you as a woman can use whatever option/s you choose (including nothing) as that is your perogative. But do not think male options are for you to decide. Yes it can be used in concert but it’s his power over himself and your separate power over yourself.

        Even then, birth control options address only reproduction, at no point should we confuse the issue of birth control with STD/I transmission/prevention from men-to-women or women-to-men. Condoms and regular testing/medical check-ups are the only rational choice.

        Makes me think the idea of “Your body, your choice” is about to be expanded and revised to include “your responsibility” for both genders soon. I understand how that is quite scary; moving to reproductive equality and all…

    • You don’t have to trust him. You have all sorts of contraception that you can use. If you don’t want to get pregnant take the female pill or one of the many other forms of birth control that women have available. But you should be using condoms anyway.

      As things are now, if you aren’t using condoms, HE is the one that has to trust YOU with his future. That’s why male birth control is so important to develop. Apart from semi-permenant sterilization and condoms a man doesn’t have any other options. And most couples eventually decide not to use condoms anymore so the man has to trust the woman completely.

      Male birth control shouldn’t be looked at as birth control for women that is taken by men. The purpose is for the man to control his fertility. That’s it. If you don’t believe that a man is taking it you have your own options.

  5. janet miller says:

    women should not worry about trusting their men to take this pill, they should be worried that their men WON’T tell them. so when we ‘forget’ to take the pill and get pregnant by one of our male friends, the whole ship could sink when we tell hubby that we’re going to have a baby. this could land a lot of women on the street. we should oppose any kind of male birth control. it takes options out of women’s hands.

    • James Huff says:

      That’s a pretty sick assertion you are making there. Essentially you are right however, and I look forward to seeing not only a non-hormonal male birth control method become culturally significant, but also mandatory paternity testing before the signing of a birth certificate.

      Science will catch up with the demands of more and more men out there.
      Take out the Non-hormonal, and Birth……and what you are left with is Male Control.

    • Lucian Cross says:

      Janet Miller,

      Thank you for your candid words on disproportionate responsibiltiy as it relates to reproductive rights. Additionally, thank you for stating your acceptance of infidelity and paternity fraud in order to trap men you claim to care about.

      Yes it takes options out of women’s hands by potentially balancing the scale and placing a measure of control in the hands of men over their lives.

    • Well, thank you for posting, Ms. Janet (Troll) Miller.

      That is, I strongly suspect that you’re really a man who’s just trying to make MS. writers and readers look bad. I cannot imagine that more than 1% of women – if that – would actually think that paternity fraud should be considered just an “option” or a woman’s moral/legal “right.”

      Not surprisingly, this is the ONLY comment here that’s been quoted at “A Voice for Men.” (They think you’re for real – and that you stand for who-knows-what-huge-percentage of women.)

      BTW, thank you, Ms. Mack, for mentioning what happened with NuvaRing. I hadn’t heard about that, and it wouldn’t have occurred to me that the current silence in the mainstream media doesn’t necessarily mean the male pill won’t turn a nice profit. I would be only too happy to see it happen.

      However, once RISUG and other methods ARE available in the U.S., I suspect that it will take at least a year of heavy publicity – with help from male celebrities, who are undeniably surrounded by golddigging groupies – before it turns into something that unmarried men start using in large numbers. After all, men in short term relationships are under a lot of pressure to use condoms until they marry; no one wants to see that change, and how many men are going to use two male methods at once?

      Besides, percentage-wise at least, few men’s rights activists (MRAs) seem to be interested – and those that are (at the website A Voice for Men) are mostly loonies who think that the lack of male BC is a feminist conspiracy. (They never seem to notice that if that were the case, they’d be able to NAME at least one famous living feminist who’s opposed it – and that feminists would have also demanded restrictions on single men’s right to get vasectomies, which they certainly don’t! ANOTHER thing they don’t notice is all the MRAs who refuse to help fund-raise for male BC or even talk about it – and how indignant said MRAs get at the idea that any man should be expected to use it if he doesn’t want to.) They think that women aren’t talking about it much because women supposedly are afraid that ALL men will start using it and depriving women of motherhood. I think they’re projecting – those men are imposing their own code of silence on the chance that it will be a Catch-22; either male BC won’t turn a profit, or if it does, judges everywhere will become even less sympathetic to deadbeat dads who never wanted children. (I, for one, look forward to that.) At any rate, those who push for “Choice for Men” know their cause is doomed once RISUG, etc., arrives.

      Of course, there will be plenty of women in long term relationships who will BEG their men to use it as backups to their own BC (especially those women with medical problems) but we’re not talking about those cases.

      I do hope, however, that doctors will discourage any man under 20 from using any invisible methods, simply because the last thing we need is more horny teens refusing to use condoms. Besides, unfortunately, girls really need to know when they’re being lied to, even though THEY also lie, so if no teen boys were allowed to use RISUG, at least the girls will KNOW the boys were lying when they claimed to be using it.

      • Oh yes – forgot to say: For an interesting debate, to say the least, check out Robert O’Hara’s 2010 piece: “The Real Reason We Do Not Have a Male Pill.”

        http://mensnewsdaily.com/2010/05/21/the-real-reason-we-do-not-have-a-male-pill/

        If you put the 59 comments in order from oldest to newest, mine start about halfway down.

        IF male BC turns out to be not all that popular, I can’t wait to hear the reaction from men like O’Hara.

        After all, if women were so afraid of men’s using a male pill “too much,” wouldn’t at least ONE woman interviewed by a reporter on the street say “no! My clock is ticking!” rather than “I wouldn’t trust him to take it”?

        • “After all, if women were so afraid of men’s using a male pill “too much,” wouldn’t at least ONE woman interviewed by a reporter on the street say ‘no! My clock is ticking!’ rather than ‘I wouldn’t trust him to take it’?”

          I wouldn’t expect that. I would expect that the women would say things to try to convince people that the male pill was worthless. I would not expect them to “give the game away.” And even if one slipped up, they don’t have to air ALL the people they talk to.

  6. First of all I really do hope that this is not somehow seen as a licence to go out and do what ever you want. The male pill don’t protect you from STD’s, but I do recognize that there are some women in our society that their main goal in life is to go out and get pregnant preferable by someone who has a lot of money so she has the rest of her life taken care of, although this don’t mean it don’t happen to men who don’t have a whole lot of money it does. I am always suspecious of a woman saying, “don’t worry I am on the pill.” NHMBCP will be an added safty net so to speak until you a man comes to a time in his life where he feels ready for a family. (Although again NHMBCP should not replace the condom but used in concert with a condom)

    That being said I am hopeful that this will bring about some more communication in relationships to know what eachothers expectations are, what are your acceptable risks (eg. something like I know you say you are on the pill but I would feel more comfortable if we use a condom so I want to use a condom) Then if you can’t agree on acceptable risks then you don’t have sex. Yes even men need to know what they are willing to risk. With the rise of the NHMBCP or some other form of male contraception other then condoms I am also hopeful that we will see more couples actually sitting and planning families, not to say that unplanned pregancies are all bad they are not, but to become a parent on your terms has to be so much better for the children of that couple.

  7. Sardomar Crowe says:

    I love the idea of vasalgel, but not so much the idea of a “dry orgasm” pill – as a significant portion of the pleasure OF orgasm for a male can BE the sensation of ejaculation, you’re basically marketing the “weak orgasm” pill for them (many women ejaculate too and often consider it even more extremely satisfying than an orgasm without it). Personally, I feel this way about condoms. While I recognize the need for them, especially in regards to disease prevention, I find them extremely restrictive, and desensitizing in the extreme, even with xxl extra thins. I also hate the smell of them, making the entire process such a massive turn off as to make the point moot. At this point the thought of them is enough to make me want to just skip it altogether.

  8. Thanks for finally writing about >Birth Control For Men? For
    Real This Time? <Loved it!

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