If you’re a woman who has been taking birth control for years, you’ve probably wondered why there isn’t a similar birth control solution on the market for men. Currently, men can use condoms or have a vasectomy, but there aren’t any hormonal birth control options available for them. Science is working on it, but it’s taking longer than most people would expect.
Many men have made it clear that they want birth control options beyond what’s currently available to them at drugstores. In 2016, a large clinical trial was done on hormonal male birth control, but it was shut down due to copious adverse effects.
Many people believed that men couldn’t handle the effects of hormonal birth control that women deal with every day, but this wasn’t the case. 75% of men involved in the trial wanted to continue using the pill, but the researchers felt that they couldn’t, in good conscience, continue the experiment. The side effects were jeopardizing the health of the participants.
What’s the holdup?
Finding hormonal methods that work to stop sperm production (without damaging health, reproductive and otherwise) has proven difficult. One reason for this is the stark biological differences between male and female reproductive systems.
While women release one or two eggs each month, men can ejaculate up to 250 million sperm at once. Stopping one or two of something is a more straightforward process than stopping 250 million of anything. It’s hard to find a way to shut down sperm production that doesn’t adversely affect other systems in the body.
Research is another stopping point- over the years, decades upon decades of studies have been done on female hormonal contraception. The market for female contraceptives has been more demanding than the demand for male contraceptives since females can face complications (and even death) from pregnancy and childbirth. These risks cause health care providers to have a higher tolerance for side effects from female hormonal contraception than for male contraception. That said, slow but steady progress is being made in creating a safe hormonal birth control for men.
The most promising, well-researched form of hormonal male birth control is called Nestorone-Testosterone. It’s further along in clinical trials than any other hormonal male birth control. Nestorone-Testosterone is a topical gel that is applied to the arms and shoulders every day. The gel contains progestin, which is a lab-created form of the female sex hormone, progesterone. Men have progesterone in their bodies, but at much lower levels than would be found in a woman’s body.
As the gel is applied and absorbed by the skin, it interferes with the production of gonadotropin hormones. These are the hormones responsible for the production of testosterone. Testosterone in the testes allows the body to create sperm. While cutting off the testosterone production in the testes is a good idea; in theory, it causes several side effects because blood testosterone levels also tend to drop.
Many men report impotence and low libido when using a progesterone gel. This is why the gel also contains some testosterone- to offset this effect, helping men keep their blood testosterone levels high as the testosterone in their testes drops. While current clinical trials for the gel are promising, reproductive health scientists agree that it will be at least ten years before Nestorone-Testosterone is available in pharmacies.
A hormonal birth control pill for men is also in the works. Dimethandrolone undecanoate, or DMAU, is a once a day pill that works similarly to Nestorone-Testosterone. DMAU contains a steroid that has some properties of both testosterone and estrogen. Much like progesterone, men have some estrogen in their bodies naturally. Researchers recently finished testing whether the pill was tolerable for men, and the study ended with favorable results.
Currently, researchers are working to study whether the pill lowers sperm count to a level sufficient enough for it to successfully act as birth control. Much like Nestorone-Testosterone, it’s likely going to be more than a decade before DMAU is available to the public. Scientists are also working on an injectable form of DMAU, which early studies show could be effective for months. This would allow men to have a longer-term birth control option than a daily pill without the commitment and pain of a vasectomy.
While there are many different hoops researchers and pharmaceutical companies need to jump through before male hormonal contraceptives go on the market, progress is being made. Researchers agree that by 2030, the male birth control market will look much like today’s female birth control market, with a variety of options and competing brands. The benefit to society would be vast. If even 10% of men chose to use hormonal birth control, the number of unwanted pregnancies in the United States could drop by up to 5%.
In the meantime
There’s no doubt about it: relatively soon, hormonal male birth control will be ubiquitous. In the meantime, talk to your health care provider if your current method of birth control isn’t working for you. Just because we can’t pass the burden quite yet doesn’t mean that we should suffer. While male birth control is being studied, female birth control is doing the same- and our options are constantly improving.