Discover the male contraceptive

For decades, scientists have been trying to develop a male contraceptive effective and that does not bring serious collection effects. However, there are still no approved pills on the market. The search for male contraceptives has existed since the 1970s, however, currently the only male contraceptive methods are still condoms and vasectomy. Now, a new hormonal gel has been studied and emerges as one of the solutions to finally put an end to this story. In this matter, you know the one that could be the first male hormonal contraceptive.

The saga of the male contraceptive

Historically, contraceptive options are greater for women than for men. While they rely on birth control ranging from oral pills to patches and intrauterine devices, the only options for the male audience are condom and vasectomy. The first steps in the search for a contraceptive pill for them were taken in the 70s.

Almost twenty years later, in 1990, the World Health Organization (WHO) studied testosterone as a potential form of contraception, reducing the rate of sperm. The big problem that was found in the study was that, to achieve this reduction in sperm production, very high levels of testosterone were needed, which caused several side effects, such as irritability, mood swings, weight gain, acne and even depression. .

Since then, many other researches have been carried out, but none have been successful. In 2012, for example, a clinical study had to be stopped due to serious adverse effects caused by the analyzed drug. One of the most sensitive points of all this is related to testosterone. “When you start messing with the testosterone receptors, the body is seriously unbalanced”, explains the director of the infertility and male health program at the Brady Urological Institute at Johns Hopkins Hospital, Amin Herati.

This point ended up becoming the target of feminist movements, as women suffer from the same adverse reactions when consuming birth control pills. In this regard, Bobby Najari, assistant professor of urology and population health and director of the Male Infertility Program at NYU Langone Health, agrees with the point of view presented, further stating that there is a bit of “double weight” in in relation to research on male contraceptives, “as women face the same side effects and even risk of blood clots”.

Nestorone may be the solution to the problem

Now, a candidate being developed and tested by researchers at National Institutes of Health and non-profit organization Population Council is a hormonal gel that contains a synthetic progestin called nestorone, which blocks natural testosterone and reduces sperm production. To solve the major problem of imbalance caused by hormone levels in the male body, the gel also contains testosterone replacement to help maintain normal sexual desire and regulate other functions. (https://yellowtail.tech/)

Unlike contraceptives for women, Nestorone will not work by mouth. Instead, it will need to be rubbed into the shoulders daily and absorbed shortly afterwards through the skin. As with pills for women, the gel needs to be applied at the same time each day in order to be effective.

The research team's main goal is to get sperm counts below 1 million per milliliter of semen, as previous studies suggest that pregnancy is unlikely to occur at this level. To give you an idea, in a fertile man, the normal sperm count ranges from 15 million to over 200 million sperm per milliliter.

Nestorone is being tested in a Phase 2 clinical trial involving more than 400 couples. Mitchell Creinin, director of family planning at UC Davis Health, one of the trial sites, says the gel looks extremely promising. According to him, “So far, the drug is causing sperm counts to plummet and is preventing these couples from getting pregnant”.

He also says that the men participating in the clinical trial are very excited about the results. “One of the things we're seeing in this study is the realization of how important this is for men who are in relationships and who care about their partners. I was so impressed with how many men really want to step up their relationship.”, completes the expert.

The Phase 2 trials, in fact, are one of the most critical moments in a research. It is at this stage that the drug is tested for efficacy and safety, usually on hundreds of volunteers, looking for harmful or unpleasant drug reactions. It is also at this point that the main problems arise. Remember the interrupted test in 2012 that we mentioned at the beginning of the text? It was precisely here that he needed to be stopped because of the many identified side effects.

The main side effects of the gel identified so far are weight gain and mood problems. “There will be a small percentage of men who will experience some sort of side effect, but we know this is also true for many different female contraceptives.”, says Creinin. “We are not looking for the product that will work perfectly for every man, we are looking for the product that will work very well for the most people”.

The gel will now need to undergo testing in a larger Phase 3 clinical trial, which will likely include thousands of couples. It will also need a pharmaceutical company to manufacture it and bring it to market, as the NIH and Population Council do not have the capacity to market drugs.

There is no deadline for the product to reach pharmacy shelves, mainly because no contraceptive drug for men has reached this stage, so the Food and Drug Administration, a regulatory body equivalent to the US ANVISA, will have to decide what level of risk is acceptable before releasing the drug.

Pressure after the end of abortion rights in the US

Pressure for a new male contraceptive grew after the U.S. Supreme Court overturned a decision known as “Roe vs. Wade”, of 1973, which nationally guaranteed the right to abortion. With that, the court returned to the states the power to define whether or not to allow this type of procedure. Experts believe that with the change, half of US states will decide to ban abortion.

The decision put the court at odds with the majority of American public opinion, which was in favor of preserving the Roe v. Wade decision, according to opinion polls. At the time, of the nine members of the Court, six voted in favor of overturning the Roe decision against Wade, while the other three stood by it.

"The status of the Supreme Court decision has really brought more attention from society to the lack of male contraception.”, says Heather Vahdat, executive director of the Male Contraceptive Initiative, a Durham, North Carolina-based nonprofit that funds research into reversible, non-hormonal male birth control. “I think men want to be more engaged partners, but they just don't have the tools”, she opines.

As mentioned earlier, men have only two reliable options: using condoms or having a vasectomy. The thing is, they both bring some problems. In the case of condoms, despite having a 98% effective when used correctly, some men use it wrongly, causing the actual effectiveness drops to 85%, a drop of more than 10% in effectiveness. And believe me, that's a lot.

In the case of vasectomy, the procedure is not easily reversible, which ends up frightening men who are still not sure if they want to put an end to their fertility. Even so, the number of procedures grew in the United States after the end of abortion rights in the country. In only one center where the procedure is performed, requests for vasectomy appointments jumped from 20 a week to over 90.

When does the male contraceptive hit the market?

This is a question that still has no answer. Specialists, however, believe that it is only a matter of time before men can count on a new contraceptive method. They say that, over the last few years, there have been many advances in the search for an effective solution. Those more optimistic give a period of up to five years for us to see the novelty on the shelves of pharmacies and drugstores. Men can only wait.

See also:

Do you know the COVID-19 self-test? we made a article explaining where to buy, how much it costs and how to do the coronavirus self-test sold in Brazil.

Sources: Wired, G1.