Reproductive Technology: How Far Do We Go?Resources to Learn More

Male Contraception

Nobel Presenter: Diana Blithe, National Institutes of Health

Overview of the Topic

With the arrival of “the Pill” in 1960, contraception in America became more accessible and safer. Other contraceptive options for women followed: intrauterine devices (IUDs), female condoms, hormone implants, and the ovarian ring. At present, there are as many as 11 contraceptive options for women. Meanwhile, contraceptive options for men remain limited, of which the condom and vasectomy are by far the most prevalent. While popular, each of those comes with its own problems. The condom fails approximately 16% of the time and vasectomies are difficult to reverse. There is currently no long-acting reversible contraception (LARC) available for men.

Prior to the introduction of the Pill, the focus of contraception was on intercourse itself, where the role of men was obvious, and their capacity to prevent pregnancy through condom use or withdrawal was evident. While empowering women with more options to control their fertility, a perhaps-unintended side effect of the technological proliferation of female contraceptives was an ever-greater shifting of the burden to women. Gender norm differences can lead both women and men to experience anxiety, suspicion and fear about leaving contraception in the hands of their partner. Those concerns can also take different shapes for partners in long-term relationships and for those in more temporary sexual relationships.

Research in contraceptive methods for men is thus prompted both by the dearth of current options and a desire to distribute the responsibility and possibility for controlling reproduction more equitably. Current research is focusing on medications (hormonal pills or injections) and surgical injections, which alter sperm, or inhibit their passage through the vas deferens. A 2016 clinical trial of a male contraceptive pill was halted when an independent safety review board determined that the risks to participants outweighed the benefits. A LARC developed in India that uses non-hormonal gel to render sperm infertile has been in development for thirty years, hampered in its development significantly by lack of funding. The product may be brought up for approval in India in 2017. Human clinical trials in the United States are described as “in the works.”

Diana Blithe is the Program Director for the Male Contraceptive Development Program at the National Institute of Health. She is involved in overseeing several current clinical trials testing the safety and efficacy of new male contraceptive agents.

Questions to Consider

Why might there be such a large difference between the number of available female and male options for contraception?
How does funding for male contraceptive research compare to the funding supporting female contraception? What reasons might exist for these differences?
The FDA can cancel a trial if side-effects are greater than those existing for treatments already on the market. If the standard of comparison is a condom, then the bar is quite high for safety. How do we compare safety of the (female) Pill to safety to this form of male hormonal contraception?Does the 2016 cancellation of a clinical trial for a male contraceptive injection represent appropriate oversight, or participant safety standards that are too stringent?
What concerns might women have in relying on male contraception? What concerns might lead men to seek their own contraceptive resources?
What public health consequences might result if condoms were widely replaced by male hormonal birth control?
Why might men prefer LARC to existing forms of male contraception?

Resources for Diana Blithe’s Work

Contraceptive Clinical Trials Network associated with the National Institutes of Health

Contraception Research and Development at the National Institutes of Health

Male Contraceptive Development Program at the National Institutes of Health

Pipeline for Contraception (NIH) A review article by Diana Blithe; currently available only through interlibrary loan.

Works Consulted and Resources for Further Reading

Birth Control: Medicines to Help You (FDA) (17 pp.)
The Food and Drug Administration’s summary of currently-available birth control methods.

Male contraception: A clinically-oriented review.
A technical summary of existing and experimental methods of contraception for men.

Gender Norms and Contraceptive Trust

Block that Sperm! The Future of Male Birth Control (The Atlantic) (6 pp.)
An overview of issues and approaches to male contraception.

No more larking around! Why we need male LARCs.
An argument for the development of long-acting, reversible contraceptives (LARCs) for men.

A New Kind of Male Birth Control is Coming (Bloomberg) (7 pp.)
A male contraceptive gel injection developed by biomedical engineer Sujoy Guha may come up for approval in India in 2017. The reversible procedure would provide contraception for years at a low cost.

The Revolutionary New Birth Control Method for Men (Wired) (11 pp.)
Sujoy Guha’s 30-year development of an injectable gel that renders sperm incapable of fertilizing an egg. In discussing the development of this technology, the article sheds light on the process by which such technologies are funded and evaluated.

Successful male contraceptive gel trial brings new form of birth control closer (The Guardian) (3 pp.)
The February 2017 article reports success with Vasalgel gel in primate trials. Human trials will begin when funding is secured. The research is being supported by the Parsemus Foundation, which “works to advance innovative and neglected medical research.”Efficacy and Safety of an Injectable Combination

Hormonal Contraceptive for Men (JCEM) (164 pp.)
The journal article discussing the contraceptive for which clinical trials were suspended in October 2016, when an independent safety board determined that the risks outweighed the benefits for participants.

New Perspectives in Male Infertility: Identification of New Molecular Target for Male Contraceptives (Science Daily) (3 pp.)
Researchers at Osaka University working with mice have identified a molecule in sperm that, when absent, renders male mice infertile.

A New Push for the Male “Pill" (Scientific American) (5 pp.)
An overview of male contraception and a new hormonal male contraceptive gel, a project led by the National Institutes of Health and Nobel speaker Diana Blithe.