Where's the male Pill?

Many promising male contraceptives are in development, but none has come to market. So why has it taken so long?

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Counterintuitive as it sounds, extra testosterone can suppress sperm-cell production. Photo by Dennis Kunkel Microscopy/Corbis

Counterintuitive as it sounds, extra testosterone can suppress sperm-cell production. Photo by Dennis Kunkel Microscopy/Corbis

Jalees Rehman is a cell biologist and physician at the University of Illinois at Chicago. His scientific blog The Next Regeneration is part of the Scilogs blog network.

‘I am too young to die,’ said my patient. ‘My kids are small. They still need me.’ I explained that having a heart attack did not mean that she would die. We had caught it early. Within the next minutes, she would have an angiogram to remove the blood clot in her coronary artery, and we had already started her on a nitroglycerine drip and an infusion with a blood thinner. But I understood her fear. Women in their early 40s and in good health are not supposed to have heart attacks. She was not overweight, she never smoked, she had no history of high blood pressure or high cholesterol, and nobody in her family had ever had any heart problems. As we wheeled her away, she said that her chest pain was easing up. She was trying to be brave, but I could still see tears in her eyes.

Twenty minutes later, the interventional cardiologist and I stared at the angiogram images. My eyes kept flicking back to the electrocardiogram that had prompted our diagnosis. It had indicated the presence of a clot blocking an artery of the heart, but the angiogram showed completely pristine arteries: no clot, no plaque. I gave my patient the good news and saw her smile and utter a prayer.

Over the course of the next 24 hours, blood tests confirmed that she’d suffered a heart attack. Perhaps she had an exceedingly rare condition in which transient spasms of coronary arteries can cause a heart attack. Perhaps there had been a clot in her artery but it had dissolved before the angiogram, thanks to the intravenous blood thinner. The blood tests and ultrasound images showed that the damage to the heart was minimal, probably because the blood flow had normalised so quickly. I was happy for her and her family, but I was bothered by a nagging question. Why would a young, healthy woman with normal coronary arteries suffer a major heart attack?

She was taking one regular prescription medication: an oral contraceptive. One of its rare but significant side effects is the increased rate of blood-clot formation. The risk varies from one pill to another, but can be twice, threefold or even higher for oral contraceptive users when compared with women who do not use them. The risks are still small: a recent study monitored 1.6 million women in Denmark (ages 15-49) over a 15-year duration, and found that only 3,311 women had a stroke related to a blood-clot formation, and 1,725 women had a heart attack. My patient was using an oral contraceptive for which multiple studies had confirmed an association with blood-clot formation.

In clinical practice, it is often very difficult to prove cause and effect. Diagnoses are derived from the recognition of correlations or patterns, and frequently based on educated guesses instead of definitive scientific evidence. In this case, we advised our patient to stop using oral contraceptives. She recovered completely, and has had no recurrence of a blood clot or other major health problems. We will probably never know for sure whether contraceptive pills contributed to her heart attack, but her case serves as an important reminder that these risks are real.

The arrival of the birth control pill in the 1960s was hailed as a social revolution that decoupled sexuality from reproduction. It empowered women by giving them true reproductive control, because it allowed for reliable and reversible contraception. Women could delay or prevent reproduction without having to abstain from sex, and they could discontinue usage if they wanted to have a child. Over the years, many additional female contraceptives have been developed so that women today can choose from pills, injections, patches or intrauterine devices — many of which are even more reliable than those of the 1960s.

By contrast, the choices for male contraception are far more limited: it’s either sterilisation (a vasectomy) or condoms. Vasectomy has been used since the late 19th century, while the condom has an even longer linage. In the 16th century, the Italian anatomist Gabriello Fallopio described a condom made out of a linen sheath, used to prevent the transmission of syphilis. By the 18th century, condoms were prized as male contraceptives, and were even mentioned by the Italian adventurer Giacomo Casanova, who described them as ‘English Overcoats’.

Condoms can prevent the spread of sexually transmitted diseases, but, as a reproductive control strategy, they are not as reliable as their packaging suggests. Unintended pregnancies occur in up to 18 per cent of couples who rely on condoms for contraception. Vasectomies are very effective, with less than a one per cent ‘failure rate’, but they are extremely difficult to reverse. A change of mind means complex microsurgery with uncertain results. In a society that increasingly recognises that men and women should share responsibilities and opportunities equitably, the lack of adequate reproductive control methods for men is striking — and puzzling — especially since many newer methods for male contraception have been developed during the past decades yet none has become available for general use.

Newer approaches to male contraception can be divided into two groups: hormonal and non-hormonal. Hormonal male contraceptives act by reducing testosterone levels in the testicles, which drive the production of sperm cells. Most hormonal male contraceptives that have been studied in clinical trials involve the administration of testosterone, either as an injection, implant, oral pill or patch. It might seem counterintuitive to supply extra testosterone in order to suppress sperm-cell production, but this approach works by taking advantage of an internal brake in the male reproductive system. Testosterone production in the testicles is activated by hormones released from the pituitary gland of the brain — the follicle-stimulating hormone (FSH) and the luteinising hormone (LH). Some of this testosterone seeps out from the testicles into the bloodstream and signals to the brain: ‘Stop releasing FSH and LH, there is more than enough testosterone to go around!’

A testosterone-containing contraceptive mimics this function by increasing testosterone levels in the bloodstream, thus activating the shutdown signal. The brain responds by turning off the FSH and LH production; the testicles stop making their own testosterone. Testosterone levels in the testicles start to ebb, eventually dropping below the threshold required for adequate sperm-cell production. The levels of testosterone in the bloodstream supplied by the contraceptive are sufficient to maintain masculine features and male libido, but cannot compensate for the loss of testosterone in the testicles, and thus cannot restore sperm-cell production. Newer-generation male hormonal contraceptives combine testosterone with another class of synthetic hormones called progestins, also used in female contraceptives and extremely effective at activating the FSH/LH shutdown.

So far, clinical trials have shown that it takes time — six weeks or longer — until sperm counts drop low enough to stop fertilisation. Short-term studies of the side effects of male contraceptives have not revealed anything major: acne, weight gain, increased libido. Most male contraceptive trials have been small, often recruiting only 10-100 men, and the measured ‘success’ was based on achieving undetectable or minimal sperm counts. Yet the ultimate test of efficacy is not a drop in sperm counts but the prevention of unintended pregnancies in couples who rely on these contraceptives as their primary method of reproductive control. Such efficacy trials require the recruitment of a large number of volunteers and their costly long-term monitoring. Large-scale studies are also needed to ascertain the long-term safety profile of male hormonal contraceptives.

‘None of the big companies will touch hormonal male contraception again’

One of the largest male contraceptive efficacy trials ever conducted was sponsored by the World Health Organisation (WHO) and CONRAD, the US-based reproductive health research organisation. Called Phase II TU/NET-EN, this landmark multicentre study was designed to answer key questions about the long-term safety and efficacy of male hormonal contraception, and enrolled more than 200 couples between 2008 and 2010. The contraceptive used was a long-acting formulation of testosterone (testosterone undecanoate, or TU) combined with a long-acting progestin (norethisterone enanthate or NET-EN), administered via injections every two months. The trial included an initial treatment phase to suppress sperm production, and a subsequent ‘efficacy phase’ that required couples to rely exclusively on this form of birth control for one year. However, in April 2011, the trial was terminated prematurely when the advisory board noticed a higher than expected rate of depression, mood changes and increased sexual desire in the study volunteers. By the trial’s end, only 110 couples had completed the one-year efficacy phase; their efficacy results should be released in the near future.

The trial did not include a placebo control group, so the investigators could not determine whether the observed side effects were due to the hormone combination or a side effect of frequent injections. Just like we do not perform ‘placebo’ or sham surgeries on patients, we cannot in good conscience enrol people in a placebo group of a contraception efficacy trial, because most of the couples in the placebo group would end up with an unintended pregnancy.

The discontinuation of the WHO/CONRAD trial was a major setback in bringing male contraceptives to the market. It also raised difficult ethical questions about how to evaluate side effects in male contraceptive trials. Since all medications are bound to exhibit some side effects, what side effects should be sufficient to halt a trial? Female contraceptives have been associated with breakthrough bleeding, mood changes, increased risk of blood-clot formation, as well as other side effects. Why should we set a different bar for male contraceptives?

The twist here is that female contraceptives prevent unintended pregnancies in the person actually taking the contraceptive. Since a pregnancy can cause some women significant health problems, the risk of contraceptive side effects can be offset by the benefit of avoiding an unintended pregnancy. However, men do not directly experience any of the health risks of pregnancy — their female partners do. Thus it becomes more difficult, ethically, to justify the side effects of hormonal contraceptives in men.

What of non-hormonal contraceptives for men? Instead of targeting the hormonal axis that connects the brain and the testicles, non-hormonal contraceptives act directly on the production, activity or movement of sperm cells. One such approach is known as a ‘chemical vasectomy’. Developed by Dr Sujoy Guha in India, RISUG (which stands for ‘reversible inhibition of sperm under guidance’) has already entered Phase III clinical trials. In a standard vasectomy, the vas deferens (the natural transport channels for sperm cells in the testicles) are cut and sealed so that sperm are unable to enter the seminal fluid. In RISUG, a synthetic polymer is injected into the vas deferens with the same effect, but with the dramatic benefit that this polymer can be removed during a further, simple procedure that should restore normal movement of the sperm cells.

RISUG is not without caveats. Unlike taking a pill or receiving an injection, it requires a small surgical procedure. And the data on RISUG reversibility is based on animal experiments. We do not yet know whether reversing it in humans would restore male fertility. The clinical trial data obtained in India has been very encouraging so far, both in terms of safety and efficacy. The non-profit Parsemus Foundation has obtained the rights to use and market the RISUG method in the US as Vasalgel, and intends to initiate the first US-based clinical trials this year or next. RISUG is probably unable to generate the kind of profits that would attract the attention of a pharmaceutical company: the synthetic polymer is inexpensive, and a single polymer injection is sufficient to suppress fertility for years. So the only hope for general availability is support from the non-profit or government sector.

Other non-hormonal contraceptive methods are currently under investigation in animal studies. Dolores Mruk and Chuen-yan Cheng, scientists at the Population Council in New York, have shown that the chemical Adjudin causes reversible infertility in animals by inducing the release of immature sperm cells. A collaboration between laboratories at Baylor College of Medicine in Houston and the Dana-Farber Cancer Institute in Boston showed that JQ-1, a small molecule that targets the epigenetic enzyme BRDT, was able to reversibly inhibit sperm-cell production and fertility in male mice. But these are a long way from availability. It might take five years or longer for additional safety and efficacy studies in animals before even a small pilot human study can be conducted.

If these hormonal and non-hormonal male contraceptives have been developed during the past decades, and some have been shown to be reasonably efficacious in small clinical trials, why are they not yet available for general use? Eberhard Nieschlag, professor at the University of Münster in Germany and a leading researcher in male fertility, recently described the impact of the suspension of the WHO/CONRAD efficacy trial on his field:
For male contraceptives to become approved for general use, more safety and efficacy data from larger clinical trials are required. The suspension of the WHO/CONRAD trial should have prompted an investigation into the scientific basis of the side effects, and could have led to a new trial with improved male hormonal contraceptives. But the pharmaceutical industry was not prepared to make that investment.

There is a multitude of reasons for the pharmaceutical industry’s reticence when it comes to male contraception. The efficacy and acceptability of female contraceptives sets a high competitive bar. The ethical problem of justifying potential side effects without any direct health benefits for men is another deterrent. And recent controversies related to the health insurance coverage of female contraceptives in the US underscore the even greater uncertainty of who would pay for male contraceptives if they were brought to market.

These investments make sense only if there is a large market for male contraceptives. Preliminary surveys seem promising: in 2000, Anna Glasier, professor of obstetrics and gynaecology at the University of Edinburgh, and her collaborators published an international survey of 1,894 women attending family planning clinics in Scotland, South Africa and China. Most women supported the idea of a ‘male pill’, and suggested that their partners would use it.

Newer male contraceptives require a very significant shift in the responsibility and burden of contraception between men and women

In 2005, a follow-up study by Klaas Heinemann at the Centre for Epidemiology and Health Research in Berlin surveyed more than 9,000 men in Europe, Asia, North America and South America. The willingness of respondents to use newer male contraceptives was highest in Spain (71 per cent), Germany (69 per cent), Mexico (65 per cent), Brazil (63 per cent) and Sweden (58 per cent). Nearly half of the men in the US (49 per cent) and France (47 per cent) expressed an interest. On the other hand, disapproval of newer male contraceptives was highest in Indonesia (34 per cent) and Argentina (42 per cent). These surveys reveal that there is a broad, international willingness among men and women to use male contraceptives, but such an endorsement of a hypothetical ‘male pill’ is a far cry from implementing it. To use newer male contraceptives would require a very significant shift in the responsibility and burden of contraception between men and women. We won’t know how that will work in practice until male contraceptives become widely available.

Scientific and cultural challenges might also explain the lacklustre involvement of the pharmaceutical industry. The efficacy data from small clinical trials has shown that there is significant biological heterogeneity in terms of how men respond to hormonal contraception. Suppression of sperm-cell production seems to be far more effective in Asian men, for example, than in Caucasian men. It is very likely that even within each ethnic group, there is a significant variability in the response to contraceptives. Instead of a ‘one pill fits all’ approach, male contraceptives might only be effective if individually tailored. The cultural challenge of introducing male contraception is also formidable. The Catholic Church strongly opposes all forms of contraception and, as the surveys have revealed, there is significant variation in men’s attitudes to male contraceptives.

It is thus not surprising that pharmaceutical companies are reluctant to invest millions in large-scale clinical trials. But without such trials, male contraceptives will not receive the regulatory approvals needed to bring them to market. We have reached an impasse. As a society, we recognise the importance of providing options for reproductive control, yet the responsibilities (and side effects) of effective contraception are carried largely by women. Men might never be able to share the physical burden of pregnancy, but they can share the responsibilities of child-rearing and contraception. If the market cannot support this, we need to find an alternative route.

Pharmaceutical companies make investment decisions based on profits, while non-profit organisations and government agencies have the luxury of supporting research that leads to equitable sharing — something that does not carry a defined monetary value. Non-profit organisations and government agencies are not in the business of manufacturing pharmaceuticals, but if they could conduct the larger clinical trials required and identify efficacious and safe male contraceptives, then the investment risk will be minimal for any interested pharmaceutical manufacturers, who could capitalise on the research to mass-produce and market the contraceptives.

Jump-starting the listless development of new male contraceptives will require a substantial amount of education and support. The Parsemus Foundation, the non-profit behind Vasalgel, and the Male Contraception Information Project, in San Francisco, have made a good start on the challenge by providing information about research on male contraceptives. Politicians need to be lobbied to ensure the adequate funding of government research agencies that specifically pursue the development of male contraceptives. There is also a place for public support: research studies are always looking for male volunteers, and non-profit organisations studying male contraception rely on donations. Male contraception is an excellent example of an opportunity for crowd-funding.

There has been a societal failure to produce a contraceptive method for men beyond the condom or the vasectomy, but now we have the chance to rectify that. Who will take the next step?

 

References and links to the research mentioned above are available here.

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Comments

  • rameshraghuvanshi

    Traditional society just like India male will give response to contraceptive pill or not very doubtful.When in 1975 Prime mister Indira Gandhi`s son forcefully started campaigned for sterilization of men he her mother vary tragically defeated in election.From that moment Indian government fully stopped campaign of birth control that why population is biggest in the world. so I am doubtful is effective contraceptive pill people of accept or not.Indian male prejudice way think these pill make them impotent.

  • sprawler

    Fascinating stuff. It amazes me it’s not on the market yet.

    Linked on Sprawler: sprawler.tumblr.com

  • Squiggle

    I'll repeat what my college sociology professor once opined to our class:

    Offering every twelve year old male in America $1,000 to get a reverse-able vasectomy would probably be the most profound and cost effective act of public policy ever in terms of reducing poverty, etc.

    • sleepydumbdude

      Hell I just wish my insurance would cover one. It would cover my wife's pregnancy pretty well which would cost more but not a vasectomy.

      • jagiela

        Insurance does NOT cover pregnancies- being pregnant is a natural condition not an illness. Insurance will cover the COMPLICATIONS of pregnancy though.

        • misgina

          It may not be an illness, but it does require a lot of medical care even without complications. Insurance covers not only complications but pregnancy care and delivery. Also, being fertile is a natural state and not an illness either, but that doesn't mean it doesn't need to be addressed.

        • Ciro Galli

          Pregnancy is a never-ending list of complications believe me. It's only complications till you die.

        • bladibla

          A fetus does have almost all the classifications of a parasite ;) (joke)

          • jagiela

            Except that it "gives" in return- a child takes care of you in your old age and the body knows it and responds accordingly. It will do anything to keep that kid alive

          • JenJen10

            How about the black woman I talked to (single) who told me she only had children in order to get someone who would take care of her in her old age? Is that a good enough reason to have a baby?

    • 013090

      A reliably reversible vasectomy is the key, and is something we don't have at this time.

  • bburrito

    Governments dont like this because who in their right mind would allow for a product that would significantly cut down pregnancies. Accidental pregnancies would plummet. And guess what, I would be willing to bet that MOST pregnancies are accidental. Population growth rates would plummet and along with it the stock in any company that requires population growth to grow their own company.

    • Amidoinitright

      "who in their right mind would allow for a product that would significantly cut down pregnancies"

      Like birth control pills & condoms?.Government could abolish abortion if they were worried about population growth. Instead they are making everyone buy birth control with their taxes. and handing out condoms in elementary school. Sorta blows your hypothesis away.

      "along with it the stock in any company that requires population growth to grow their own company."

      what company has a business plan dependent on population growth?

      • JenJen10

        The Catholic Church.

  • MarkW99

    Feminists have been quietly opposing the male pill for years. Google it. On the grounds that it will lead to men lying saying they're on "the pill" and result in more pregnancies. Bullshit, BTW. The goal is control of reproduction by women, for women. Meaning that if she wants to be preggers, the fems want her to have unfettered access to sperm, screw what the male wants. This also gives her access to his paycheck as well.
    Learn to love the condom, boys.

    • jagiela

      Which is also why the feminazis demand that abortion decisions be left up to the woman alone- she can terminate the pregnancy if her pill fails but he gets stuck with one if his pill fails and she wants the kid. She can have the kid (and he gets to pay for its support) if she wants it even if he doesn't. (A fairer system would be that he could declare the pregnancy "unwanted" and offer to pay half the cost of an abortion)

      • kucheza

        I prefer "feminazgul".

    • nickal648

      Okay, I'm not sure if you're invoking Poe's Law here...
      Lying about being on contraceptives sucks for whoever is being lied to, regardless of sex in a huge myriad of way. End of story.
      What if we had a place were men could sell their sperm, women could get pregnant, and the ladies won't have access to his paycheck? Oh right! I remember now, those are called SPERM BANKS.
      Pretty sure men will never love condoms, either.

  • Michael Hanlon

    An unwanted pregnancy imposes a completely different set of costs on the mother and the father. If the latter is not in a relationship with the former and does not want the child, all else being equal the 'costs' to him are effectively zero (CSA decisons permitting). However the 'cost' to her is huge and will last decades. Thus there is a big incentive for women to avoid getting pregnant when they do not want a baby; a far less incentive for men. This is why the 'male pill' will never take off. Men who sleep around have no incentive to use it over less invasive and potentially less harmful means of contraception such as the condom. Women who sleep around have zero reason to trust that a man who says he is on the pill actually is. Condoms are visible; a change in testosterone levels is not. In stable monogamous relationships the alternatives are female contraceptives (with the drawbacks highlighted by the article), barrier contraception (not sure where that 'up to 18%' figure comes from - the 'up to' caveat makes the 18% meaningless), vasectomies and the possibility of the male pill (or 'pill-plus-minor-surgery, as it always turns out to be). I guess the market fro the last is simply too small.

    • jagiela

      Men incur a great risk from an unwanted pregnancy as anyone who has dealt with child support would know. The risk is even greater when the male is in a long term relationship with the woman and doesn't want to raise a child.

      • Michael Hanlon

        Men do incur a risk, for the reasons you say, but not as much as women. A woman's options when she has an unwanted pregnancy are limited, and not pleasant.

        • DList

          Nonsense, Michael.

          • Logic

            How would having male contraception prevent women access to female contraception? The who incurs more risk argument is irrelevant. Sure women incur a larger risk, but for men like me that wouldn't bail on the mother of his child or his child, the decision about when and with whom to have a child is probably the biggest decision we ever make. Allowing men the ability to control pregnancy wouldn't hinder a woman's ability to control pregnancy. The lying about being on the male pill argument doesn't make any sense. Men could also poke holes in condoms and lie about that. I'm going to go out on a limb and say most guys don't go around trying to rack up children like beanie babies in 96. We go around terrified that we're going to have to be fathers before we're ready.

        • Jim C

          Once a pregnancy happens, it's really out of the male parent's hands isn't it? However, all this risk calculus differential seems to ignore the relationship itself. Maybe taking on the responsibility for contraception is something that the male want's to offer his female partner, and maybe not being able ot effectively offer that has it's own ramifications... There are two many possibilities in an actual relationship to even contemplate. I think if these simple generalized risk assesments are of any value to specific situations, then it must be in rather shallow relationships, no?

          • JenJen10

            If only men were out of the picture totally once a woman has a child. Unfortunately for many women who don't want the man in their lives, men can and often do use the courts to push their way into women's lives & cause trouble. I know a poor woman who got pregnant while drunk & with a stranger on a date, he pushed himself on her while she was depressed from breaking up with her long-term boyfriend, and she, being religious, refused to have an abortion even though she was too poor to raise a child and was herself the product of an unhappy fatherless home. She assumed the father would be out of the picture totally, that she would bring up her daughter the same way her mother did, alone, maybe with child support payments. But the rapist came back into the picture & took her to court demanding parental rights to see his daughter. And because she had never filed charges against him for rape, the court gave it to him.

      • Daniel Rizzo

        ONCE FOR ALL APPROVE THE MALE CONTRACEPTIVE PILL AND WATCH SINGLE MOTHERS RATES GO DOWN.

    • Amidoinitright

      you have it totally wrong. The woman has complete control over whether to have the baby once you get her pregnant. You might have met her yesterday & be paying child support to her for the next 18 years. This is an extra method the man can use that he has 100% control of. And whats even better, birth control is free now, right? It's covered by your parents obamacare policy.until you're 26. A man would be stupid not to use this.

  • Discussedwiththestupidity

    How many people misunderstand the Catholic Church's teaching on contraception!!!! It is NOT contraception that is the question, it is a the completely SELFISH WAY of contraception the world seems to go for. Why should not BOTH (parties) be involved in becoming (or not becoming) pregnant? The technology is there!!! THINK about it!

    • jagiela

      The Catholic Church's opposes all artificial means of birth control. It doesn't oppose natural forms of birth control- abstinence (which is 100% effective and either party can practice on their own) and the rhythm (which can be as effective as the pill )

      • Disgustedwiththe stupidity

        you got it

      • nickal648

        Show me your data, I'll show you mine (well, let's be honest, I doubt you'll read these):
        Highest teen pregnancies in states with Abstinence-only sex education:
        http://www.ncbi.nlm.nih.gov/pubmed/22022362
        http://thinkprogress.org/health/2012/04/10/461402/teen-pregnancy-sex-education/
        Why the rhythm method fails:
        http://www.sciencedirect.com/science/article/pii/S0306987709003405

        • Disgustedwiththestupidity

          It's a learning process and it seems most people have just plain forgotten how to THINK! I will follow those links.

        • jagiela

          I've provided the link that shows the rhythm method to be as effective as the pill without the side effects.

          http://www.scientificamerican.com/article.cfm?id=periodic-abstinence-natural-family-planning-stm-as-effective-as-the-contraceptive-pill

          Abstinence is 100% effective with no harmful side effects in people who practice it. What type of sex education people receive has nothing to do with what method they may practice or IF THEY PRACTICE BIRTH CONTROL AT ALL

          • Daryle Brown

            Yes, and if you read the article you would see that the researchers cherry picked the best and most compliant users of this method, which is complex and onerous. Effectiveness in birth control is not measured by perfect performance under ideal conditions - it is measured by actual, practical effectiveness, when used by normal people, under normal conditions. Condoms would be alot more effective on paper if the results of their use had been cherry-picked, too.

          • Daryle Brown

            It actually mentions "who has that kind of self control" in the title of the article. I think we'd all like a simple, hormone and side effect free form of birth control, but you are too optimistic, here- even more so than the author of the article you quote!

      • SmilingAhab

        The rhythm is not as effective as the pill, because that's not how reproductive anatomy works - if it was, the population rate would not be near what it is now (and is also part of the reason NFP doesn't work):
        http://www.biolreprod.org/content/68/6/2107.full

        And abstinence is hilariously ineffective at preventing pregnancy, no matter how simple the initial deduction that not putting it in = no baby (basically, because emotions and instincts exist):
        http://pediatrics.aappublications.org/content/123/1/e110.full
        http://www.guttmacher.org/media/nr/2010/01/26/index.html

        And philosophically, there is no difference between NFP and chemical/barrier contraception, because they're both prophylactics - both defy the Tetragrammaton's command to be fruitful and multiply. But since NFP doesn't work, the Curia has no problem pushing it. One new baby, one new acolyte for the Church after all.

        • nickal648

          I love you. Also, this post showed up right after mine. lol

        • Disgustedwiththestupidity

          Rhythm is a very old method. 30 years ago the temperature and mucus methods came and now, who knows (or cares? I'm saying that sarcastically)?

        • jagiela

          A new German study, however, has found that, when practiced correctly, a
          method of periodic abstinence known as the sympto-thermal method (STM)
          leads to an unintended pregnancy rate of only 0.6 percent annually. This
          rate is comparable with that of unintended pregnancies in women who use
          birth control pills, the most popular method of contraception in the
          U.S.

          http://www.scientificamerican.com/article.cfm?id=periodic-abstinence-natural-family-planning-stm-as-effective-as-the-contraceptive-pill

          Abstinence is 100% effective. The only way it fails is if you don't follow it- no sex, no kid Sperm must meet egg.

          The theology of birth control is complex but your conclusion is absolutely wrong. If more children is what the Church sought, it would be advocating a "be fruitful and multiply" doctrine and practices like early marriage for girls, polygamy and female promiscuity. It would also oppose natural family planning.

          • human nature

            Security guards and surveillance cameras at supermarkets aren't completely effective. However not taking things without paying is a 100% effective measure against theft. We should abolish guards and cameras, and maybe locks too, and simply tell people not to take things. It is simply a matter of resisting the urges. Do you see the analogy jagiela?

          • jagiela

            Nothing to your "analogy" at all. The major difference is that the person taking the stuff WANTS to take all the stuff, with abstinence, the person doesn't want all the stuff (a baby or AIDS for example)

            If a person doesn't want a baby, only abstinence is 100% effective. The failure rate of other methods are massive- birth control pills are 99.4% effective. Sounds good but a woman who is on the pill for twenty years (and a lot are) would have a 12% of an unwanted pregnancy.

            Or to put it another way: If ten girls each took the pill for 15 years, one of them should turn up pregnant. The odds of a single act of intercourse resulting in a pregnancy may be low, but the chance overall becomes pretty good.

    • SmilingAhab

      Think =/= agree with you.

  • Disgustedwiththe stupidity

    Does not anyone GET it???

  • aspie

    Me, I'd be much happier with libido reduction options. I'm always going to be single and would prefer not to have sexual urges or distractions altogether.

    I've had some success with banding in reducing the size of one testicle, though with some pain about once or twice a year. 6 month use of birth control pills probably would have made me a eunuch, but I wanted to leave some testosterone for health. Age has helped with reduced libido, though lower energy/drive is definitely a side effect.

    The elephant in the room that no one wants to talk about is male and female libido reduction. To me, that's a far better choice than pornography, abortion, etc. But also consider how many industries make their bucks playing on sex drives. Very like the food industries that push massive portions on the obese....

    ps. I don't care about social relations since I'm also quite likely aspie or hfa. The extra drama is most unwelcome.

  • SmilingAhab

    I see that most people have formed a social-cultural conclusion around why there is no male contraceptive, and it's understandable. But there's a biological reason that's far simpler than all the social critique: the buggers are nearly impossible to destroy, slow down or stop. They're caustic, they have redundant everything, and there's millions of them.

    Men are designed through evolution to be disposable and able to drag ourselves through hell to pass on our genes, and our reproductive systems are built the same way - hormonal cycles included. The reason then that there are so few options for male contraception is because sperm has destroyed every idea thrown at it. It flies in the face of our biological raison d'etre, and the male body will do what it does to every other detriment to passing on its genes: destroy it.

    And the hormonal pills are dangerous because increased libido without balancing the other essential male hormones, dihydrotestosterone and androstenedione, is a major strain on the social self-control impulses that keep men from being animals; there's already a major collective self-control problem amongst this half of the species, and adding to it will make assault and rape worse.

    • lucy

      Finally someone who knows what they're talking about. I study hormonal physiology at university and constantly have female friends asking me why no one has made a decent male hormonal contraceptive yet and how unfair/sexist it is blablabla. It's relatively simple to prevent one egg a month from releasing/implanting compared to preventing millions of spermatozoa from escaping, especially whilst also trying to maintain normal hormonal function elsewhere in the body.

    • http://www.anamericanhousewifeintexas.com/ Leslie Loftis

      I'm revisiting this article to grab it for a link in a Guy's Guide piece I'm finishing up. (Hope you are still following this.) I was surprised on both reads that it didn't touch on potential aggression problems. Besides the resilience of sperm and the 'only one needs to make it though' problem, aggression potential strikes me as quite ominous.

  • contrariant

    I'll go out on a limb and suggest that a male contraceptive would dramatically reduce the pregnancy rate, and provide men with a new level of sexual freedom. I've read about the RISUG method, and it seems to be a good alternative to vasectomies, yet the the USDA not only ignores the data from India but imposes a reversibility standard that is beyond any possible level of reversibility in vasectomy.

    Men need to support contraception.

    • Tyler Lucas

      Actually the USDA is not ignoring the data. Vasalgel is based on RISUG and is going through and has passed initial trials (rabbits).

      • contrariant

        Data collected in India is not being considered. They're doing human trials over there but it can not be used to support studies in the US, or else why would they be doing trials on rabbits?

        Learn something about the process.

        • Tyler Lucas

          The US DA trial process has never accepted foreign trials, even European or Canadian ones. Reversibility needs to be part of the trials because it is one of Vasalgel's claims, and a good thing, too!

  • Mandy

    I know many ,many men in relationships who wish they could take something short of vasectomy so their women partners did not have to take hormones. I like the India research very much and hope that moves forward.

  • angi

    WTF!? THUS??

    The twist here is that female contraceptives prevent unintended pregnancies in the person actually taking the contraceptive. Since a pregnancy can cause some women significant health problems, the risk of contraceptive side effects can be offset by the benefit of avoiding an unintended pregnancy. However, men do not directly experience any of the health risks of pregnancy — their female partners do. Thus it becomes more difficult, ethically, to justify the side effects of hormonal contraceptives in men.

  • Jeremy

    They are worried there wouldn't be a large enough market (every male on the planet)?

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