Modern Day Male Contraceptives: Why we may never have anything more than condoms.

Have you or your partner fumbled trying to put on a condom? Has the condom ever broken? Or worse: things are getting spicy and neither of you has one on hand—did the male partner forget to buy some this time? These are all common events when trying to have sexual intercourse, some of them potentially resulting in unplanned pregnancy. Of course, the female partner could have been using some form of contraception, which decreases the chances of unplanned pregnancy. She could have used The Pill, a Depo-Provera injection, female condom, intrauterine device (IUD), Levonorgestrel intrauterine system, a diaphragm, cervical cap, the sponge, spermicide, the vaginal ring, or a contraceptive patch. However, the silly male forgot the condom! They were left with the option of the withdrawal method, which has a failure rate of 22% (Sutton & Chalmers, 2017). Who is to blame here? Should someone have been more prepared? Is it fair to think the female should have been taking a hormonal contraceptive, or should they both be expected to carry around condoms? Many people would say that the female should have been more prepared (after all, it is easier to stop one egg from being released than it is to stop millions of sperm [is it really??]), but why must the burden of pregnancy prevention be borne by females all of the time?

 An increase in the number of male contraceptives may ease this socially constructed responsibility off females. To date, though, males have been provided with, at most, three methods of contraception. These methods include condoms, withdrawal, and vasectomy. The typical failure rates of these methods are, 15%, 19%, and 0.05% respectively (Sutton & Chalmers, 2017). At first glance, the latter rate seems wonderful. However, a vasectomy is invasive and pretty much irreversible. With these limited options in mind, researchers have been working hard to find a way to provide another form of male contraceptive.

 A popular idea is male hormonal contraception. There are many possible options, such as injections or pills. These hormonal methods are derived from exogenous testosterone or, much like the pill, include a combination of hormones, testosterone and progestin, or even androgen and progestin (Wang et al., 2016). These methods decrease testosterone production and, in turn, decrease sperm production. These methods have been shown to be effective and have few side effects, with the combination contraceptives being more effective (Wang et al., 2016). So, this is one form of a male contraceptive hormone that is in the works, but why is it taking so long? In addition to lengthy clinical trials, it is likely that researchers are looking for the next male contraceptive to be 100% effective. Yet apparently, such a contraceptive already exists. Created by Dr. Sujoy K. Guha in India, reversible inhibition of sperm under guidance, or RISUG, could be the biggest form of contraception since The Pill. The easily reversible “vasectomy” works by injection of a polymer, styrene maleic anhydride (SMA), into the vas deferens (Gifford, 2011). The sperm can still pass through, but in doing so, they become functionally inactive; the membranes are ruptured and motility is removed (Gifford, 2011). Proven to be close to 100% effective by Dr. Guha since 1979, the RISUG method of contraception has yet to hit the market. But why? There doesn’t seem the be a solid reason: A single injection could be effective for 10 years, unexpected pregnancies would decrease, family sizes would be limited, and males would be provided with a reliable and less frustrating contraceptive than what exists currently. This method has also been around for decades… one begs to know why such a revolutionary male contraceptive hasn’t been introduced to the public. Surely clinical trials don’t take that long!

So, what is the hold up? If we think about commonly available contraceptives, such as a birth control pill or condoms, they are in high demand. They are a one-use product that has to be repeatedly purchased, at a troubling price for some. At the end of the day, the companies who mass produce these products are multinational businesses. Their first priority is sales. With a technique like RISUG, people won’t have to pay continuously. To put it in perspective, if someone used one $0.50 condom and had sexual intercourse every day for a year, it would cost the individual $182.50. RISUG costs approximately $10 and would be effective for 10 years (Dayal, 2017). In 10 years, assuming one could keep the rate of 1 sexual interaction per day; with condoms, the cost comes to $1,825 but with RISUG it is still just $10.

 With unexpected pregnancies accounting for a large portion of total pregnancies, it seems like it’s time for a more reliable contraceptive. A male contraceptive like RISUG is not only effective and affordable, it takes the pressure off females to bear the burden of contraception. It puts the worry of contraception on the back burner and lets people enjoy sexual activities. It seems as though we have this contraceptive but foreign governments and businesses haven’t let it hit the market. Let’s place the right to birth control ahead of the bottom line. Let’s put Dr. Sujoy K. Guha’s lifework to use. Stop fumbling with the condom and just enjoy.

Joshua Wilson, BScH, Queen’s University

References

Anthes, E. (2017). Why We Can't Have the Male Pill. Retrieved from   https://www.bloomberg.com/news/features/2017-08-03/why-we-can-t-have-the-male-pill

Dayal, S. (2017). New male contraceptive is safe, effective, inexpensive - and can't find a company to sell it. Retrieved from https://nationalpost.com/news/world/new-male-contraceptive-is-safe-effective-inexpensive-and-cant-find-a-company-to-sell-it

Gifford, B. (2011). The Revolutionary New Birth Control Method for Men. Retrieved  from https://www.wired.com/2011/04/ff_vasectomy/all/1/

Sutton, S. S., & Chalmers, B. (2017). Contraception and Pregnancy Options. In C. F. Pukall, (Ed.), Human Sexuality: A Contemporary Introduction (second edition, pp. 153-177Don Mills, Ontario: Oxford University Press.

Wang, C., Festin, M. P. R., & Swerdloff, R. S. (2016). Male Hormonal Contraception:       Where Are We Now? Current Obstetrics and Gynecology Reports, 5, 38–47. http://doi.org/10.1007/s13669-016-0140-