The male birth control pill

Alison Massey

For decades, women have had the option of taking oral contraceptives to prevent pregnancy. According to a 2012 report by the US Centre for Disease Control, of the 62% of women of reproductive age in the US who used contraception, 28% of these used a contraceptive pill. This means that roughly 10.6 million women in the US relied on this method in 2012. There are other types of hormonal contraceptives that women can use to interrupt their menstrual cycle, including the hormonal patch or injection. Until now, the only contraceptive used by men has been the condom and vasectomy. Mpho Motiang of UP’s Centre for Sexualities, Aids and Gender (CSA&G) says that condoms and “coitus interruptus” (pulling out) are the most common methods of birth control, but with current strides in the production of a new male contraceptive pill there may soon be a new option.

According to the UK’s National Health Service (NHS), there are different types of birth control pills for women, which either stop women from ovulating or create a mucus plug to stop sperm reaching the egg. These pills all use artificial hormones (mainly oestrogen and progesterone), which stops many women from wanting to take them due to fears of the pill interfering with their naturally produced hormones. There are many possible side effects to the pill and the NHS says these may include acne, tender breasts, migraines, lowered sex drive, nausea and vomiting, mood changes and other symptoms. The pill will also not work if you forget to take it (every day at around the same time), if you are on antibiotics or certain other medication or if you have either vomited or experienced diarrhoea within a few hours of taking it. Still, many women like that it does not interrupt sex and that, in many cases, it helps regulate their menstrual cycle and reduce period pains. Motiang says that “many women opt for ‘the pill’ after weighing up what they need to get out of using the pill but some people don’t like the side effects and thus pursue alternatives”.

This all begs the question, “why has there never been a pill for men too?”. The Huffington Post explains that one of the main reasons is that men, in general, have faster metabolisms, meaning that their bodies process hormones faster. This has complicated birth control research as it means that when men take a pill in the morning the effects wear off quickly and they would have to take more than one a day, which is not practical. A recent study into a new, once-daily pill has made a step in the right direction, though. A pill has been developed called dimethandrolone undecanoate (DMAU), which works by supressing testosterone production in the testes themselves, meaning that testosterone levels in the rest of the body will not be highly affected.

Vox reports that DMAU is still in testing and the researchers who ran the study cannot yet guarantee that it fully suppresses sperm production. But, according to The Telegraph, the men in the study did not experience many side effects other than some weight gain and decreased high density lipoprotein cholesterol (HDL, considered the “good” cholesterol). Effects on liver and kidney function also seem to have improved since the last study, although researchers say that the study was too short to be conclusive. Researchers are also testing an injectable form of the pill, much like the female hormonal injection, that would eliminate the problem of having to remember to take a pill every day. According to Vox, however, this has shown some side effects. It should also be noted that none of these options prevent STIs and that condoms are still the only effective method for this.

Vox also writes that even further along in development than the pill is a gel that can be rubbed onto a man’s shoulders which works the same way that the pill does (by releasing hormones that affect sperm production). This has shown promising effects, including (after the addition of extra testosterone to combat the lowered levels in the testes) a decrease in negative side effects like lowered sex drive and problems with ejaculation. This bodes well for the pill, since it works using a similar mechanism.

This study on the male pill has continued in April and is meant to last three months, promising more progress in the area of male contraception options. According to Vox, even the gel, which is the option furthest along in the research process, could take another ten years to hit shelves. Motiang points out that in South Africa “we are currently having a problem of people taking up prevention and being consistent in using those options. Having more options for men to opt into [will] create a shift, but not work like a magic bullet. The best way to reach the objectives of this question is to create an environment where sexual and reproductive health are accessible, affordable and accepted.” He also emphasizes that although South African men would indeed benefit from the male pill, “there is no point in only focusing on not having an unplanned baby but leaving yourself vulnerable to an ‘unplanned’ infection”.

 

Photo: Lanna Matthews

 

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