Ok fellas, when it comes to the bedroom, how does acne get you going? Specifically, acne on you? How about depression, fluctuating libido and localised pain? I’m guessing none of the above appeals all that much.

Unfortunately for the men participating, though, these were the widely reported side effects in a 2016 Clinical Trial for an injection-based hormonal contraceptive. Unsurprisingly, perhaps, the Trial was wrapped early on health grounds.

And therein, it seems, lies the problem. Contraceptive options for men have always been pretty limited. Apart from acquiring something of a reputation as “mood killers,” condoms aren’t entirely reliable, and they’re often used incorrectly (no sniggering at the back!). Besides that option, there is always vasectomy…

The Combined Oral Contraceptive Pill long available to women introduces pregnancy-mimicking synthetic hormones. Ultimately, these work by “tricking” the body into temporary infertility, by halting ovulation. No such method exists in the case of men, however. A male hormonal contraceptive needs to decrease the regular production of sperm; in order to do that, it needs to inhibit testosterone.

And, as any regular reader will know, generally speaking that’s the opposite of what we would condone.

Apart from the frankly hair-raising list of symptoms mentioned above, low testosterone levels in men can adversely affect healthy erectile function and body muscle mass – all in all, not that good.

The Problem

The problem for researchers, then, has always been finding a solution that introduces the right balance – decreasing testosterone production enough at the testes to reduce sperm count, whilst maintaining enough in the bloodstream to counteract any unpleasant side effects.

Researchers behind a new contraceptive believe they may have cracked it. The project, run by the U.S. National Institutes of Health (NIH), and the slightly George Orwell-sounding Population Council, will involve over four hundred couples from around the world (MIT). The study will be the largest of its kind in the U.S. and has been more than a decade in the making.

The product being tested is a topical gel, to be applied, oddly enough, to the upper arms and shoulders.

Although the effect is said to last for up to seventy-two hours after a single application, its directed use is once daily. And before anyone has visions of looking slimier than Pete Venkman after a particularly ghoul-heavy shift, only around half a teaspoon of the fast-drying formula is necessary.

The new contraceptive contains two synthetic hormones: a form of progestin, and our old friend testosterone. As you might already have guessed, the progestin acts to inhibit sperm production, whilst the testosterone counteracts any resultant hormonal imbalances in the body.

Following a successful six-month pilot scheme, Trial Chief Diana Blithe is confident that the gel has advantages over previous oral and intravenous treatments. In the injection-based trial mentioned earlier, for example, one large dose was administered to participants every two months, with the subsequent hormonal changes dissipating slowly over time.

Blithe argues that the gel, applied far more regularly and in smaller dosages, would allow for a more controlled approach. On top of this, because the testosterone present in the gel is absorbed via the skin, it stays in the bloodstream longer than was the case with previous methods.

Even the Male Contraceptive Initiative – a non-profit body that expressly promotes non-hormonal male birth control – has expressed some optimism about the new gel. Chief Executive Aaron Hamlin stated,

“If you are able to spread the dosage out over time…it seems like a better approach than having spikes that occur every so often, like with the shot.”

Quite so. But it isn’t quite all good news, however. The gel takes a number of months of continuous application to suppress sperm numbers sufficiently – less than one million per millilitre (which, admittedly, still sounds rather a lot,) is apparently the magic number.

On top of this, the body’s reserve of sperm, created prior to treatment, must be exhausted before the product can safely be used without other forms of contraceptive.

The gel’s full Clinical Trial begins in April, and will run for four years. Even if you’re prepared to wait that long, though, some evidence suggests that an appetite for a hormone-based male contraceptive just isn’t there. A 2010 study discovered that only a quarter of men worldwide would consider using one. whilst research in the UK the following year found that almost half the women canvassed worried that their male partners would simply forget to take a daily treatment. Boys will be boys!

And if that doesn’t make you think twice, there is always the fact that the sperm count of one participant, in a recent World Health Organization trial, has remained at a level considered “sub fertile” after a staggering four years. Whilst, admittedly, that trial was testing an intravenous procedure (the potential drawbacks of which the gel does not apparently share,) perhaps it is not such a bad thing that rigorous testing is required, where the results can go so awry.

Until such time as a fully tested, proven-safe male hormonal contraceptive is on the shelves then, we suggest you continue to stay safe in whichever way you can.

  1. Hermann M. Behre, Michael Zitzmann, Richard A. Anderson, David J. Handelsman, Silvia W. Lestari, Robert I. McLachlan, M. Cristina Meriggiola, Man Mohan Misro, Gabriela Noe, Frederick C. W. Wu, Mario Philip R. Festin, Ndema A. Habib, Kirsten M. Vogelsong, Marianne M. Callahan, Kim A. Linton, Doug S. Colvard; Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men, The Journal of Clinical Endocrinology & Metabolism, Volume 101, Issue 12, 1 December 2016, Pages 4779-4788, https://doi.org/10.1210/jc.2016-2141 (2016)
  2. Niloufar Ilani, Mara Y. Roth, John K. Amory, Ronald S. Swerdloff, Clint Dart, Stephanie T. Page, William J. Bremner, Regine Sitruk-Ware, Narender Kumar, Diana L. Blithe, A New Combination of Testosterone and Nestorone Transdermal Gels for Male Hormonal Contraception 2012

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