UK Edition
Male fertility: Is the ‘pill’ for men finally here?
It’s been a long time in the making but a new form of birth control looks set to become a reality following successful trials in the UK
A test project run by the University of Edinburgh has tasked over 100 men to use a breakthrough male contraceptive as the sole method of birth control in their relationships. However, the “pill”, in this instance, is actually a rub-on gel called NES/T.
The treatment uses a synthetic form of the hormone progestin to stop sperm flow, mixed with testosterone to ensure the man’s libido isn’t hampered. Men chosen to trial NES/T apply the gel to their upper arms and shoulders each day and then attend clinics to monitor their sperm count.
While the experiment – led by Dr John Reynolds-Wright at Edinburgh’s MRC Centre for Reproductive Health – has hit the headlines, medical professionals insist that a “male pill” becoming as commonplace as existing forms of contraception is still a way off.
“Patient satisfaction in using the gel seems high,” explains Dr Babak Ashrafi from Zava on examining the study results. “But there might still be a significant proportion of men who would find application of a gel (with the necessary wait times for drying out) cumbersome. Also, as a new drug, long-term outcomes are yet to be fully understood. That’s something which might give clinicians as much hesitation as patients.”
Of course, it’s not the first time the world of medicine has hailed the arrival of a male alternative to the pill, only for it not to reach pharmacy shelves. In 2013 researchers at Monash University in Melbourne, led by Dr Sabatino Ventura who had been working on the male pill since 1988, also trialled a method of blocking the proteins that control the movement of sperm.
“For many years it’s been a mission of the World Health Organisation (WHO), for public health reasons, to try to develop the male pill,” says Mr Channa Jayasenna, reproductive endocrinologist from Imperial College London. “It’s a co-ordinated worldwide effort and Edinburgh has been representing the UK in doing some ground-breaking work.”
Experts agree that a male pill is a difficult thing to achieve. “With women it’s quite easy to halt the menstrual cycle,” says Mr Javasenna. “But men have a conveyor belt of sperm, so even if you cut off the supply it still takes an awful long time for things to empty.”
Like many experts, however, Mr Javasenna is buoyed by these latest tests. “If you'd asked me about this five years ago I'd have rolled my eyes. But this latest trial seems to have had some pretty good results. Men struggling with low testosterone are often prescribed gels which they apply to the torso or thighs. The hormone boost is absorbed through the skin. This male contraceptive works in the same way.”
Trials continue and a commercially available male pill – or gel – is still subject to some limiting factors. “Culturally there’s the issue of our responsibility as men for birth control in a relationship. That’s going to be a challenge to overcome,” says Mr Javasenna. Also, because this treatment uses progesterone – which only naturally occurs in women when they ovulate – “switching off” the male reproductive system is not without side effects. “Men who use it may experience symptoms similar to women who take the pill, including flushes and mood swings,” adds Javasenna. “When I mention this to female colleagues they say: ‘Welcome to the real world!’”
Dr Babak Ashrafi concurs and hopes that once the trials are completed a viable alternative to the female pill will become readily available to men. “The more options available when it comes to contraception, the better,” he says. After all, for many women it can be very difficult to take the pill, especially if they have a strong family history of breast cancer.
“This option opens the conversation up to include the other half in family planning discussions,” says Dr Ashrafi. “As long as clinical safety can be maintained for the majority who are willing to take this medication, it can only be a good thing.”