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Do We Finally Have A Male Contraceptive Pill On our Hands? NO

Photo Credit: NYPost 3 mins read

Can the responsibility of contraception now be shared? Can men finally disregard  latex in all its “98% safety” glory? No, alas this is not the case, maybe someday.

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The publication by The Guardian on the 29th of March 2019 may have gotten your attention. And we would certainly like to reiterate – the article titled, “Male Contraceptive Pills Declared Safe To Use” suggests an oversimplification of a more complex issue and is prematurely raising hopes too high! Yes, we said that!


Generally, condoms, pills, injections and IUCDs (intrauterine contraceptive devices) are the more mainstream contraceptive methods. Other methods include the calendar approach which involves complete abstinence from sexual activity during a woman’s fertile periods and coitus interruptus (i.e withdrawal method) during sexual activity. However, it is quite evident that the majority of these methods place the burden of contraception on the woman, save the male condom. Hence, in most cases, women are responsible for searching for a favourable method. 

Contraception & Fertilization

Contraception and fertilization are two sides of the metaphorical reproductive coin. Hence, to understand the former, we shall delve into the latter. Firstly, you ought to know ovaries run a monthly shift. Yes, the pair take turns in producing an ovum (egg) on a monthly basis. Then, said ovum is fertilized by a male sperm during intercourse. These hormonal contraceptives essentially work by preventing this process from taking place; thus leading to effective birth control. 

Secondly, you ought to know about spermatogenesis. This process alluding to the production of sperm is regulated by hormones in three-tier stages; two of these occur at the level of the brain and one within the testes. Within the brain, it is initiated with the release of gonadotropin-releasing hormone (GnRH) which triggers the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These two hormones go further to act on two sets of cells within the testes. Finally, the “seed” sperms become mature consequent on the action by the hormone we all know, testosterone.


Enter, the male contraceptive pill

They employ a pyramid strategy of attack. The rationale is to ensure the sperms never mature. This is achieved at the level of the brain, opposing the initiating hormone(s) which directly affects the production of the final hormone, testosterone. In this way, the final step of maturing seed sperms is totally blocked. This should be easy right? An oversimplification, as there are some challenges to carrying these actions out. The major ones are:

  1. Incomplete suppression of spermatogenesis;
  2. Lack of a long-duration androgen preparation(i.e artificial forms of testosterone and its sister hormones);
  3. The metabolic consequences (side effects) of androgen administration, which researchers have not fully yet understood.

Generally, spermatogenesis is regulated by testosterone working above a certain limit. This is achieved by turning off the production of the initiating hormone(s). This system is known as negative feedback in physiology. 

Male contraceptive hormones make use of this system by administering artificial testosterone together with another opposing agent(s) to these hormones to achieve an extreme reduction or complete suppression of sperm production.

Image courtesy of Family Planning Dashboard

From lab to pharmacy

Generally, drugs or medication produced in a lab go through a rigorous vetting process before they are safe for use. These stages are briefly summarised in this illustration:

However, 11-beta-MNTDC – the drug in question, is still at the experimental stage. In fact, it just passed through phase 1 of its trial. From the graphic above, it is evident that the drug still has three more stages; before final approval by the regulating authorities. It is worth noting that this does not apply only to this particular drug at the moment. For example, a hormonal contraceptive gel is also undergoing phase II trials as of now.

Conclusion:

Having explored the challenges associated with this new wave contraceptive method in men, it is presumptuous to already brand it ‘safe’. We must first take into account the outcome of clinical trials of this contraceptive method. More so, the side effects of this contraceptive method are still yet to be fully established by medical authorities.

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