Why there is no birth control pill for men

Why is there no male birth control pill?

“The idea of ​​creating a male contraceptive has been around for almost as long like the female contraceptive, “Adam Watkins, professor of reproductive biology at the University of Nottinghan, told BBC World.

According to Watkins, the main medical challenge has always been that, while the woman releases one egg per month, the man produces millions of sperm daily.

Such is the challenge, that even if the man loses 90% of his ability to produce sperm, he is still fertile, says the expert.

Although this is not the main reason why it has not been developed an effective and safe pill.

“I think that if it has not been developed effectively it has been because of the success of the female contraceptive pill. It works so well and is so efficient that, from an economic perspective, many of the pharmaceutical companies do not feel the need to invest in a new one.”

For the expert, this has led the pharmaceutical companies not to invest in research and development of projects that lead to a model of a safe contraceptive pill for men.

“For different reasons, the burden of contraceptive care was placed on women. They have been the ones who have almost fully assumed that responsibility, which is a bit unfair,” added the academic.

Perhaps the oldest contraceptive in history is the condom: since almost 2,000 years before Christ there are references to this method of birth control linked to the male anatomy, through a material that acts as a physical barrier and prevent the arrival of sperm to the egg.

In the 18th century, the last advance in the male field was introduced: vasectomy, a surgical procedure that cuts off the supply of sperm to the semen, from the blockage of the vas deferens.

Then, already in the second half of the 20th century, with the advancement of the female contraceptive pill, the path to a pill for use in men also began.

The task was simple, in principle.

“In theory, targeting (controlling) sperm production should be a simple process. The biology of sperm production and how sperm swim to the egg is well understood,” says Watkins.

There are currently two areas of research in this field.

On the one hand, hormonal contraception, which uses synthetic (artificial) hormones to temporarily stop the development of healthy sperm.

And the second is the non-hormonal method, using other techniques to prevent healthy sperm from entering the vagina and being able to fertilize.

However, studies aimed at developing an effective male pill have been affected by problems such as the side effects caused by its components.

By case, in 2016, a study that injected men with testosterone and progestogens, similar to the hormones found in the female pill, had to be stopped early.

“It was noted that there were side effects such as pimples on the skin, mood disorders and increased libido, which the men considered too severe and intolerable, so the investigation was canceled.” Watkins pointed out.

“However, many experts may view these side effects as relatively minor compared to those experienced by women taking the pill, including anxiety, weight gain, nausea, headaches, reduced libido and blood clots.”

To this, experts point out, it is added that the condom has been incorporated as a cheap method and without side effects.

“The condom also serves not only for birth control, but also to prevent sexually transmitted diseases, which has also prevented a way out of reproductive health from being sought on the male side,” says Watkins.

However, for other reproductive health experts, it is necessary to go beyond Big Pharma’s lack of interest in supporting research and the biological complexity of male fertility, to develop an effective pill for men.

For Dr. Lisa Campo-Engelstein, director of the Institute for Bioethics and Health Humanities at the University of Texas and an expert in the study of the future of reproductive health, that there is no contraceptive pill is not because science does not have been able to achieve.

“It is clear that the male contraceptive pill does not exist not because of a scientific issue, but because of a gender issue, social norms. This work was exclusively for women,” Campo-Engelstein tells BBC Mundo.

“Today, women bear most of the financial and health burdens related to contraception. In general, female methods tend to be more expensive than male ones because most require at least one visit to the doctor and some involve a prescription or prescription that must be repeated periodically, “he adds.

In fact, the academic indicates in her article “Why there should be the male pill” that, in the US, many health insurance plans do not cover contraception.

And states that require insurance plans to include it mostly have opt-out clauses for religious or ethical reasons.

That is why Campo-Engelstein makes a strong call for a pill for men to be developed soon.

“Many women want to stop taking the pill due to the strong side and hormonal effects it has on their body, but many times they do not do so because the man only uses the condom, which is not 100% effective,” says the academic.

“The issue of contraception should be of all those involved. Although it is true that men increasingly take more responsibility in this regard, the truth is that there is still much to do,” he explains.

For both Watkins and Campo-Engelstein, the day of the male pill will come.

“I think there have been changes that will lead pharmaceutical companies to dedicate resources to this development. And there are many men who are willing to take it, because that gives them control over their body,” explained Witkins.

The academic highlighted two works that could become the basis for an effective and safe method: the “clean sheets pill” pill and the “clean sheets pill”vasalgel“.

The clean sheet pill works by limiting the release of sperm and, by preventing the expulsion of sperm and the fluid in which they are transported, simultaneously prevents unwanted pregnancy and the spread of sexually transmitted infections.

However, this pill has so far only been tested on animals. As such, there will probably be ten years to go to a version suitable for human use.

“And vasalgel is a polymer substance that is injected into the genital area, especially in the vas deferens, where semen is transported. Although it allows the movement of the liquid, what it does is stop the passage of sperm”, explains Watkins .

However, Campo-Engelstein points out that laboratory technique and results are not enough to achieve the social change that is needed in this area.

“As a matter of social justice, we must move towards a shared contraceptive responsibility. To do so, we need to dedicate more resources to developing contraceptive methods for men,” he notes.

“But if there is no change in the prevailing gender norms for reproductive health responsibility, it seems unlikely that men will use contraception at the same rate as women, even if the products and methods exist,” concludes the doctor.

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