Since the Middle Ages, condoms have been used to prevent pregnancies. They have become more comfortable to use over time.
Birth control pills and IUDs in the 1960s changed the way humans control reproduction. Women were able to get a range of pills, patches and implants. The only approved form of contraception for men is a stretchy sheath that protects the penis.
Researchers are looking into contraceptives for spermbearers. The hope is that contraceptives will be seen as a shared responsibility.
The University of Washington wants to create a menu of options similar to what women have.
This story refers to the medications as "male contraception" and their target demographic as "men" since people of other genders can produce sperm.
A clinical trial is being conducted by Dr. Page's lab along with researchers at 15 other sites around the world, testing out a new product that a man applies to his shoulders every day. The brain uses synthetic hormones to lower testosterone levels in the body. Testes produce less and less sperm when testosterone is needed.
Dr. Page's study enrolls 450 couples around the world. She's taking on consent as well as him, and they're both participants, according to Page.
There are phases in the trial. The man applies the gel every day but the couple still use another form of contraception when they have sex. Researchers keep an eye on the man's sperm count. When the count is low enough to prevent pregnancies, the couple stops using other contraceptive methods and the man uses the gel daily.
Researchers begin to monitor the man's sperm count after he stops using the gel in the third and final phase. The researchers hope that their results will show that the effect on fertility is not permanent.
Brian Nguyen, an Ob-Gyn and professor at the University of Southern California, who is also researching male contraception, says he is encouraged by what he is hearing from some of the men in the gel trial.
He says that he hears stories about how men are tired of hearing about their partner's side effects from contraceptives. They would like to do something.
Page's lab is trying to develop an injection solution for hormones that would work the same as the gel.
The World Health Organization sponsored trials for male contraceptives in the 1990s, but they never made it to the market. They weren't effective enough to sell and there were serious side effects, including toxicity for the heart, liver and kidneys.
The gels and pills being tested do not have the same risks, according to the University of Washington'sStephanie Page.
"We have worked really hard to develop methods that don't impact those other parameters," says Page.
Weight gain, changes in libido, and mood swings are reported by some participants. She points out that those are very similar to the contraceptives that some women use.
Specific points in the sperm's life cycle are being targeted by another area of research. The non-hormonal contraceptives are more precise than the hormonal ones according to the research director of the MaleContraceptive Initiative.
If you were to break that link, there wouldn't be any other bodily functions to interrupt. He says that someone using these methods would probably experience few to no side effects.
If you take out any of the hundreds of links in the male reproductive system, you will end up with infertile men.
Another non-hormonal method being tested in Australia is a gel that's injected into the vas deferens and blocks the transport of sperm. It could be similar to a vasectomy in that it could be done again.
It will be at least seven to ten years before any of these new methods can be sold. Women have to shoulder a lot of the responsibility for contraception.
Page says that women bear the burden of pregnancy. The initial energy was used to make sure that women had control of their own reproduction.
Developing male contraception is more difficult. An egg can be released for a couple of months. Men produce millions of sperm a day, and a single ejaculation can hold up to 200 million. The researchers had to figure out how to prevent pregnancies. It needs to be less than 1 million sperm per liter of semen.
The FDA's criteria for approving male contraceptives is not clear.
Data from trials is used by the FDA and the pharmaceutical industry to make decisions. The risk calculation should be different in this case.
What are we doing to keep the man safe? Female contraception protects the woman from the risk of having a baby and of having an abortion. Men use contraceptives to protect their partners. There should be no risks if we just think about the man as a single unit. She says that we need to think about couples as a dyad.
The rate of efficacy is one of the reasons why male contraceptives are hard to bring to market. Birth control pills are effective and contraceptive implants and IUDs are effective. Male contraceptives might have to be just as effective at preventing pregnancies as females.
"Drug companies invest millions and millions and millions of dollars into a drug before they ever see a dime of profit." He says that when they take calculated risks, they try to make sure that they see their money at the end.
There is optimism that a male contraceptive will come to market in the next decade.
The first product to hit the market will be either the non-hormonal gel or the hormonal gel.
It's important for men to be aware of what women go through in order to succeed in male contraception.
Men are rarely discussed about menstruation, labor, and infertility. Most men don't have to think about contraceptives because they don't have to. The only way to fix that is by having more and more open conversations with men about reproduction and their responsibility in a process that is not just a women's issue.
For a long time, women have been waiting for that change. Even if it doesn't happen immediately for most heterosexual men, the freedom to skip the sheath will be motivation enough.
Ab Levine fact-checked the audio produced by Rebecca Ramirez. He was the audio engineer
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