AN early advertisement for the first female contraceptive pill depicted a figure from Greek mythology, a naked Andromeda bursting free from her chains.

“From the beginning, woman has been a vassal to the temporal demands – and frequently the aberrations – of the cyclic mechanism of her reproductive system,” the accompanying text proclaimed.

“Now, to a degree heretofore unknown, she is permitted normalization, enhancement or suspension of cyclic function and procreative potential.”

All those long words were, you have to suspect, designed to mask the fact that this was a pill that would allow women to have sex without facing all the usual consequences.

Not something drug marketers wanted to shout from the rooftops 60-odd years ago. In fact, most early ads for the Pill seem to feature a smiling married couple with their neatly attired children, in what was presumably a deliberate obfuscation.

“We can’t say the Pill stops people having children,” you can almost hear the creatives in a 1960s advertising agency arguing. “It just normalises, enhances and suspends …”

I wonder how those Mad Men might have spun the marketing for a male contraceptive pill had one been available at the time?

That’s not such a far-fetched thought. The pioneers of research into oral contraceptives had tested similar products on men as early as 1957.

Research efforts targeting the suspension of male fertility have since focused on everything from drugs based on cotton waste to the injection of gold nanoparticles into the testes, which are then heated with an infrared laser.

A hormonal gel is under development, which reduces sperm concentration when rubbed into the shoulders, though researchers say that men using the gel would have to avoid transferring it to others, posing considerable challenges for Graeco-Roman wrestlers.

It’s not all hormonal. Other researchers are targeting genes involved in sperm production, developing valves that could literally allow a man to turn sperm flow on or off, or devising polymers that could be injected into the vas deferens to create a sperm-proof barrier.

But none of these ingenious solutions has yet come to market, leaving the humble condom as a man’s only recourse.

“The joke in the field is that the male contraceptive has been 5 years away for the past 40 years,” US researcher Dr John Amory recently told Bloomberg Businessweek.

Part of the reason effective male contraception may have remained out of reach for so long is that there is little financial incentive for the industry to pursue it, suggests a recent article in JAMA.

Female contraceptives are highly effective, and often available as inexpensive generics, which might make it hard for a pharmaceutical company to recoup an adequate return on their investment.

On top of that, there’s the question of side effects and the lawsuits they could lead to.

Manufacturers have faced a number of high-profile class actions related to side effects of female contraception. Male contraceptives could pose an even greater risk for the industry, given defence lawyers would not have access to the argument that the product in question was at least less risky than an unwanted pregnancy.

Another obvious uncertainty for the industry is the size of the market. How many men would be prepared to accept hormonal manipulation (or gold-plated testes) in order to control their fertility?

A 2005 study of more than 9000 men across four continents found that just over half said they would be prepared to take hormonal medication to suppress sperm production, though the results varied widely.

From the nine countries surveyed, Spanish men were the most willing to take the pill (71%) and Indonesian men the least (29%). The authors also cited an Australian survey from around the same time which found that around 75% of men would consider it.

US researcher Gregory Kopf believes the world may finally be ready for male contraception.

“What is different now compared with 50 years ago is that it’s very easy to determine paternity,” he told JAMA.

Dr John Amory’s research is partly motivated by the desire to ensure his two young sons will be able to control their own reproductive capacity.

“My dream is to send them off to college with a 5-year reversible, male contraceptive implant,” he told Bloomberg. “[But] I have an eighth-grader now, so I’m not sure I’m going to make that deadline.”

Jane McCredie is a Sydney-based health and science writer.

 

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One thought on “What price a male contraceptive? So far, too much

  1. steve says:

    Fine thoughts on an important topic …. but missing one vital element:
    I am a man, and the issue at hand is fertility control. In most fertility-risk pairings most of the time (married or otherwise), it is the female who bears the bulk of the impost of an untimely pregnancy (also true of a planned pregnancy, of course).
    I have (female) friends who have chosen surgical infertility in order to end that risk for themselves, regardless of future changes, as pregnancy has been so burdensome (painful, etc), or in fact so unwanted at any time.
    I trust there are also men who would choose infertility, to avoid similar implications for their partner(s). I have chosen it after 5 planned and beautiful children. However, that does not help those women who (fairly and freely) engage in most contraception – I would not, if it were to be me pregnant, care to rely on the partner’s promise that they were infertile!
    For these reasons, it is plain that the money will be in female fertility control – indeed, for those who can tolerate the side effects, there is also the benefit of cyclic control and vastly improved predictability …. this appears to be an issue irrelevant to men experiencing reversible fertility control (if it were available).
    Finally, the article also fails to mention that abstinence is an acceptable option, exercised by many, advised by few. Males can and do choose to not compromise their female friends with untimely pregnancy the way which has always been available and cheap …. regardless of the name-calling that says men cannot, or will not, do so.

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