It seems like a birth control method for men is always seven to 10 years off. Today, men still only have two real options: condoms or vasectomy. Meanwhile, women have 11. Having lots of choices for women is great, of course, but it also “forces women to assume most of the financial, health-related, and other burdens of contraception," writes Lisa Campo-Engelstein, assistant professor at the Alden March Bioethics Institute at the Albany Medical College, in the AMA’s Journal of Ethics. “Men’s reproductive autonomy is diminished by ceding major responsibility for contraception to women.”
So what’s the holdup? Funding is the biggest problem. Drug companies see birth control as a problem that’s “solved,” even though current methods can be expensive, have uncomfortable (or, for some, unsafe) side effects, or aren’t very effective. Moreover, contraception is largely viewed as a women's issue, both culturally and medically. “For women, the FDA weighs the harms of pregnancy against the side effects of birth control,” Campo-Engelstein tells mental_floss. "But since there are no physical side effects to pregnancy for men, it’s not seen as a health issue."
Dr. John Hesla, a reproductive endocrinologist at Oregon Reproductive Medicine, tells mental_floss that in order to win FDA approval, a male contraceptive should be “…close to 100 percent effective, easy to administer, reversible, inexpensive, and have few or no side effects.”
That's a high bar. Here are five promising contenders.
1. VASALGEL: THE NON-SURGICAL, REVERSIBLE VASECTOMY
Vasalgel is like a vasectomy, except it's reversible and doesn’t involve surgery. Instead of cutting the vas deferens (the traditional surgical option), a polymer gel that blocks sperm (but not ejaculate) is injected into the same space. When and if a man wants to remove the gel, another injection dissolves it. It takes 3 to 5 days to become effective in preventing pregnancy after the initial injections, but the reversal process takes a bit longer—up to four months. A similar contraceptive called RISUG is currently in advanced clinical trials (Phase III) in India, and some men there have been using it for 15 years, but Vasalgel has so far only been tested—successfully—on rabbits in the U.S. Its development is currently being funded via crowdsourcing through the Parsemus Foundation. The company aims to make enough money to stay afloat “with affordable pricing and wide availability as its mandate,” and aims to make Vasalgel commercially available by 2017. You can watch a video from Viceon Vasalgel above.
2. DRY-ORGASM PILL: NEAT FREAKS REJOICE
The dry-orgasm pill (sometimes known as the “clean-sheets pill”) is based on a now-abandoned blood-pressure medication. It’s a fast-acting, hormone-free pill that temporarily shuts off the muscles that propel semen, but doesn’t inhibit any other part of the sex act, including orgasm. Drug companies are wary of a pill that results in a lack of ejaculate—they figure men wouldn’t like it—but it could be a tool in the anti-AIDS arsenal, since seminal fluid is a carrier of the virus. Pilot studies on animals have show the drug’s effectiveness, but more studies are needed. The doctors researching it at King’s College and University College London are seeking funds to do so.
3. HORMONAL GELS: TEMPORARY BUT EFFECTIVE
A combination of testosterone/progestin gels that are rubbed into the skin have been found to inhibit sperm production (but without affecting sex drive, ejaculation, or muscle mass). Sperm counts return to normal after use stops. This and other hormonal gels are in Phase II trials, according to the Population Council. But topical treatments may not be ideal: “Hormonal gels can be problematic,” says Campo-Engelstein, “in that you have to keep it away from [one's] partner and kids,” who shouldn’t be exposed to the hormones.
4. GANDARUSA: INDONESIA'S PLANT-BASED SOLUTION
Gandarusa is derived from a plant (Justicia gendarussa) indigenous to Indonesia. Native people there had originally used it as an herbal remedy for stress, but noticed that it seemed to have contraceptive effects in men. It has been studied in Indonesia since 1985 and is currently in Phase 3 clinical trials there. The compound, which is ingested as a daily pill, is thought to disable the ability of sperm to penetrate the egg, but doesn’t have other reported side effects. Prior human trials have seen only one pregnancy among 300 men tested. Completely new trials would have to be run in the U.S. for it to become available here. You can see a video about Gandarusa above.
5. MENT: An Implant for the Guys
User-independent contraceptives like vasectomy (or IUDs for women), which don’t require daily thought or regular attention, are ideal, says Campo-Engelstein—especially since men aren’t used to regularly seeing doctors for their reproductive health care, as women are required to. (“It’s hard just to get men in for regular physicals,” she notes.) MENT, developed by researchers at the Population Council, is, like Vasalgel, another “in and done” method of male contraception. This one-year implant relies on a synthetic testosterone-like compound to inhibit sperm cell development without impairing libido. According to the Population Council, a small, one-year study of 11 men found that eight, who had four implants, had zero sperm count—an effect that lasted in many subjects for months, until the implants were removed.