Why is there no male contraceptive pill?

Transcript:

Have you ever wondered why there’s a female contraceptive pill but not a male one? Well, new research might be one step closer to making it happen.

Developing a male contraceptive is difficult because men make hundreds of millions of sperm all the time. A team of scientists have developed a contraceptive pill, which makes male mice temporarily infertile. There really hasn’t been any advances in males for decades. There are examples of condoms from Roman times – so that’s 2000 years ago. Vasectomy would probably be the most recent, and that’s been around for decades.

So it could soon be widely available, but hy has it taken so long? 

The female oral contraceptive pill was first introduced in May of 1950, although it was only available in Australia from 1961 and only to married women. It’s now 62 years later, and while female contraceptives have become more varied and more accessible, there’s still no oral contraception option for men. But a successful trial in mice means that could change.

My name is Lonnie Levin. I co-direct the laboratory with Johen Buch, and we are in the Department of Pharmacology at Weill Cornell Medicine, and we study enzymes, which is the on switch for sperm. And that’s the work we just recently published. How Inhibiting this on switch is the proof of concept for an on demand male contraceptive. 

Sperm have to actually start swimming and go through a maturation process as they pass through the female. Both of those steps are absolutely dependent upon the enzyme we discovered. So if you turn off this enzyme, sperm don’t move. They remain inactive and remain stuck so that they don’t ever get to the egg. There is a good deal of ways to turn off sperm, but all of them come with side effects.

There have been trials of male hormonal contraceptive pills, which have had around a 94% success rate. But some trials have been abandoned because men were experiencing adverse side effects. We’re talking about things like acne, mood swings or depression, but you only have to read the information sheet that comes with female hormonal contraceptives to know they come with a litany of warnings for things like depression and mood swings. But also, while rare, there’s risks of blood clots and breast cancer.

It turns out that some of the side effects that the male pills have are the same side effects that the female pills have, But the females actually bear a greater risk. The females will get pregnant and pregnancy carries a risk. So the number of side effects that a female will put up with are more than the number of side effects a man would put up with.

Side effects aside, the breakthrough moment for this male non-hormonal birth control is that it’s on demand.

We developed an ability where healthy people don’t have to take a drug all the time. All the female methods that exist, They all demand that a woman takes the pill all the time. Whether they’re sexually active or not. The unique aspect of our approach is that the man only takes it when they need it.

Now, this has been really successful on mice, but it hasn’t been tested on humans yet.

In the mouse experiments, we had a two hour window. The one that we plan on going to humans with will be longer. In the window of somewhere in the 12 to 18 hour range. But still, by the next day everything would be back to normal.

So let’s say this was available today. Would people be lining up to test it? We put it to the TDA audience to find out. The survey results showed us that 73% of people said they would trust a male contraceptive pill if scientists confirm its safety and effectiveness. 

So there certainly seems to be a demand for it, if it passes clinical testing.

Clinical means that you’re testing in people. To get there, you have to prove that it works in two animals. We’re working in rabbits as we speak. Once that’s done, we figure that should take another year. We figure we’ll be at first in man studies in maybe two or three years. And if everything works out, we’re optimistically thinking that we could have a drug on the shelves in, say, 6 to 8 years.

So while men won’t be reaching for this particular pill any time soon, if it does become available, would women trust men to take it?

One of the beautiful things about our approach is if a man is going to take this pill 30 minutes before sex, the woman will see it. The woman can be part of that shared decision. So it’s now not only reproductive equality for men and female, but there is also a consensual nature to the whole act.