Saturday 24 February 2018

MIT Technology Review/Emily Mullin: A Contraceptive Gel for Men Is About to Go on Trial


MIT Technology Review

Rewriting Life
A Contraceptive Gel for Men Is About to Go on Trial
It’s expected to deliver hormones more effectively than injections or pills.

    by Emily Mullin December 20, 2017

After more than a decade of work, government researchers in the U.S. are ready to test an unusual birth control method for men—a topical gel that could prevent the production of sperm.

And no, gentlemen, you don’t rub it on your genitals.

The clinical trial, which begins in April and will run for about four years, will be the largest effort in the U.S. to test a hormonal form of birth control for men.

Currently, the most effective options men have for birth control are condoms or a vasectomy. In the last major study of a hormonal male contraceptive, which took place in Europe from 2008 to 2012, participants received injections of hormones every two months. The shots suppressed sperm production and prevented the men’s female partners from getting pregnant, but they also gave men severe mood swings and other serious side effects (see “Why We Still Don’t Have Birth Control Drugs for Men”).

The new gel contains two synthetic hormones, testosterone and a form of progestin. Progestin blocks the testes from making enough testosterone to produce normal levels of sperm. The replacement testosterone is needed to counteract the hormone imbalances the progestin causes but won't make the body produce sperm.

More than 400 couples will participate in the study, which will take place at sites in the U.S., the U.K., Italy, Sweden, Chile, and Kenya. Men in the trial will take home a pump bottle of the gel and rub about half a teaspoon of it on their upper arms and shoulders every day. The gel dries within a minute.
Sign up for Weekend Reads
Stories from our archives that put technology in perspective
Manage your newsletter preferences

“It’s not a lot of effort. It’s just remembering to use it every day,” says Diana Blithe, program director for contraception development at the National Institute of Child Health and Human Development, part of the National Institutes of Health.

The gel can suppress sperm levels for about 72 hours, so if men forget a dose, “there is a bit of forgiveness,” says Régine Sitruk-Ware, distinguished scientist at the Population Council, a nonprofit for reproductive health that is sponsoring the trial alongside the NIH.

Men will use the gel for at least four months while their partners also use some form of female contraception. Researchers will monitor the men’s sperm levels, which need to drop to less than one million per milliliter to effectively prevent pregnancy, according to Blithe. Once the sperm count is low enough, the women will go off their birth control. The couples will then use the contraceptive gel as their only form of daily birth control for a year.
Read Next
Why We Still Don’t Have Birth Control Drugs for Men
Male contraception research is a field littered with failures, but a few promising candidates are in the pipeline.

The method has already been shown to be effective in an initial six-month study. But it involved two types of gels that had to be applied to different parts of the body, so Blithe’s team at NIH worked with researchers at the Population Council to reformulate the hormones and combine them into one gel. She says the gel works better than hormone pills because lab-made testosterone gets cleared from the body rapidly. In gel form, the hormone gets absorbed by the skin and sticks around in the bloodstream longer.

Still, the question is: will men use it?

Historically, there hasn’t been much interest from pharmaceutical companies in a male contraceptive. Running clinical trials takes years and is hugely expensive, so it’s a risky endeavor when lots of options for female contraception already exist.

But researchers like Sitruk-Ware think views are changing, and that men, especially younger men, will be open to using a contraceptive drug. “This is about gender equity,” she says. “Men would also like to be able to regulate their own fertility and not be forced into fatherhood.”

    Do you think men would use a male contraceptive gel, if it were shown to work?
    Tell us in the comments.

Plus, some women can’t use hormonal birth control for medical reasons, so having another option would be helpful to those couples.

Men’s attitudes on their role in contraception vary by country, but a 2010 survey indicated that at least 25 percent of men worldwide would consider using a hormonal contraceptive.

The biggest problem might not be resistance but forgetfulness. In a small 2011 survey conducted in the U.K., 42 percent of respondents worried that men would forget to take a contraceptive pill—and women were more likely than men to say so. Forgetting to take the drug at the same time every day is the top reason why oral contraceptives for women fail. The typical failure rate of those methods is 7 percent, compared with about 13 percent for condoms, according to a recent study.

“I am very confident that if men put the gel on every day and apply it correctly, it will be effective,” says Stephanie Page, a professor of medicine at the University of Washington and a principal investigator in the trial.

Even if the trial is successful, Blithe says it will likely be several years before the gel would be available to the public.

Cut off? Read unlimited articles today.
Become an Insider
Already an Insider? Log in.
Share

Tagged

contraception, family planning, birth control, male contraception, sperm
Emily Mullin

Emily Mullin Associate Editor, Biomedicine

I am MIT Technology Review’s associate editor for biomedicine. I report from Washington, D.C., where I look for stories about how new technology is making us healthier and our medicine better. I am particularly interested in how these advances… More
READ 10 COMMENTS
Related Video

More videos

Rewriting Life
Capturing Our Imagination: The Evolution of Brain-Machine Interfaces 28:35

Rewriting Life
Next-generation Brain Interfaces 29:32

Rewriting Life
Understanding Intelligence 23:23
More from Rewriting Life

Reprogramming our bodies to make us healthier.

    Forecasts of genetic fate just got a lot more accurate

    DNA-based scores are getting better at predicting intelligence, risks for common diseases, and more.

    by Antonio Regalado
    Can’t get new lungs? Try refurbished ones instead.

    Spruced-up human and animal organs could someday be the solution for people needing transplants.

    by Erin Winick
    Why even a moth’s brain is smarter than an AI

    A neural network that simulates the way moths recognize odors also shows how they learn so much faster than machines.

    by Emerging Technology from the arXiv

More from Rewriting Life
From Our Advertisers

    In partnership with Couchbase
    The Customer Engagement Revolution

    In partnership with BMF
    A New Dimension: How a Startup Company Reshaped Precision Manufacturing

    Sponsored by VMware
    Network Virtualization: The Bridge to Digital Transformation

    Presented in partnership with VMware
    The Bridge to Digital Transformation: The Move to a Software-Based Network Strategy

Want more award-winning journalism? Subscribe and become an Insider.

    Insider Plus $79.95/year* Best Value

    Everything included in Insider Basic, plus the digital magazine, extensive archive, ad-free web experience, and discounts to partner offerings and MIT Technology Review events.
    Subscribe

       
    See details+
    Insider Basic $29.95/year*

    Six issues of our award winning print magazine, unlimited online access plus The Download with the top tech stories delivered daily to your inbox.
    Subscribe

       
    See details+
    Insider Online Only $9.99/3 months

    Unlimited online access including articles and video, plus The Download with the top tech stories delivered daily to your inbox.
    Subscribe

       
    See details+

* Prices are for U.S. residents only

See international prices
The Download What's important in technology and innovation, delivered to you every day

Follow us
Twitter Facebook RSS
MIT Technology Review

The mission of MIT Technology Review is to equip its audiences with the intelligence to understand a world shaped by technology.

Browse
International
Editions

    Company
    Your Account
    Customer Support
    More
    Policies

MIT Technology Review © 2018 v.|eiπ|

No comments: