When it comes to contraception for men, there have generally been fewer options available than for women in the last 40 years. In fact, the only current forms of male contraception include condoms or a vasectomy (semi-permanent surgery that prevents sperm from reaching semen). For women, however, the options are wider ranging and come in a variety of forms, from the pill and patch to the injection and implant.
This could be about to change though, as significant progress has been made on the male contraceptive pill in the last few years. The male pill is a form of contraception that could, if successful, prevent sperm production. It would do this by reducing a man’s testosterone levels without serious side effects.
While it’s not currently available, it could be a huge breakthrough, as it would allow heterosexual couples to choose who takes a contraceptive to prevent pregnancy.
Is there a male contraceptive pill?
There are multiple versions of the male contraceptive pill that are still being researched and developed. In fact, there are a couple of studies and clinical trials that have been testing the male contraceptive pill on humans in the last few years, but it isn’t currently available for general consumers.
There are two studies that are particularly interesting, both of which have been conducted in the US.
The first was published by the Endocrine Society in 2019 and studied the effects of the hormone pill dimethandrolone undecanoate (DMAU). The trial randomised 83 healthy men and split them into two groups. One group received a placebo and the other received DMAU. For those that were receiving the hormone, a variety of doses were given (100mg, 200mg or 400mg) and in two forms (in castor oil or as powder in a capsule). They took the contraceptive or placebo for 28 days.
All the men who received a 400mg dose experienced suppressed luteinising hormone (LH) and follicle-stimulating hormone (FSH) with no significant change in mood. This is particularly significant as FSH plays an important role in the production of sperm, while LH helps to control the production of testosterone. None of the men in the study reported serious side effects. Nine out of 83 reported decreased libido (one of which was taking the placebo tablet) and eight reported acne (interestingly, though, three of those were taking the placebo).
Overall, the study found that the higher doses were more impactful, and reduced men’s testosterone to “near castrate levels” of 50 nanograms per decilitre . Normal testosterone levels are considered to be at around 300 nanograms per decilitre.
The second study looked at DMAU’s ‘sister’ hormone, 11-beta-methyl-19-nortestosterone dodecylcarbonate, or 11-beta-MNTDC for short, and took place at LA BioMed and the University of Washington. The hormone is a modified testosterone that is thought to decrease sperm production while maintaining a steady libido in men.
Of the 40 participants, 10 received a placebo while 30 received 11-beta-MNTDC, either as a 200mg or 400mg dose over a 28-day period. Overall, the study found that sperm production dropped sufficiently and that the effects were reversible upon stopping the hormone treatment. Some side effects were reported, including fatigue, acne and headaches. Five men reported decreased libidio and two reported mild erectile dysfunction.
Both studies show that the production of the male pill is certainly heading in the right direction, but that further work and research is needed to determine the effects of reducing testosterone.
How does the male contraceptive pill work?
The male contraceptive pill would work by reducing a man’s testosterone to below normal levels. Some male contraceptives that have been tested also contain progesterone that helps to reduce the sperm production in the testicles, as well as lower testosterone.
Should the product make it to mass market, a man would have to take one tablet every day, much like women do on the progestogen-only pill, and this would control their testosterone levels to reduce the risk of pregnancy.
The pill could change the face of contraception for men. Currently, their only contraceptive options are condoms or a vasectomy. Vasectomies can be reversed, but the results aren’t always guaranteed, making it a semi-permanent form of contraception. Some couples continue to use the ‘pull out’ method as a way of preventing pregnancy, but this isn’t recommended and isn’t an effective contraceptive. The pill, however, could give more couples the freedom to have sex without worrying about unwanted pregnancies.
When will the male pill be available?
There’s no confirmed date as to when the male pill will be available to everyone. While the clinical trials do show some success, it could still be many years before an approved version makes it to market.
Sources
https://www.nhs.uk/conditions/contraception/male-pill/
https://www.abstractsonline.com/pp8/#!/4482/presentation/6619
https://medlineplus.gov/lab-tests/follicle-stimulating-hormone-fsh-levels-test/
https://medlineplus.gov/lab-tests/luteinizing-hormone-lh-levels-test/
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