Toward a Male Contraceptive Pill

Men and women can never be equal until men are able to control their fertility as easily and confidentially as can women.  Currently, it’s not even close.  Women have a welter of safe, effective and inexpensive contraceptive methods, plus the “morning after” pill should fertilization occur.  Abortion rights mean that, as a practical matter, no woman need bear a child unless she so desires.  In the event she does, the adoption laws of most states allow her to bypass the father and hand off responsibility for the child to others.

Men?  Not so much.  Vasectomy is costly as is reversal which, in any case, may not be effective.  Condoms aren’t reliable enough to be a long-term solution, plus, they can’t be used confidentially.  And that’s important.  If Jane tells John she’s on the pill, so there’s no need for a condom, he’s faced with a dilemma.  If he uses one anyway, he’s telling her he doesn’t trust her; if he doesn’t, he increases his risks of fathering a child he plainly doesn’t want.  Dad’s right to place his child for adoption entirely depends on Mom’s acquiescence.

Therefore, men need a safe, effective and inexpensive contraceptive method whose use they alone control.  That’s what women have, so simple equality demands it.  More importantly, effective contraception for both sexes, could dramatically reduce the chances of unwanted pregnancies and those that remain will be more likely to be desired, not just by Jane, but John too.

So I’m interested in the progress of science regarding safe, effective and cheap male contraception.  Here’s a new development.

Now, I’m no biologist and so have questions about exactly how this particular method works and what its side effects may be, but for now, suffice it to say that a lab at the University of Minnesota headed by chemist Gunda Georg has produced (along with graduate student Md Abdullah Al Noman) a non-hormonal medication that’s been 99% effective at preventing conception in laboratory animals.  They plan to begin human trials in the third or fourth quarter of this year.

How does it work?

To develop a non-hormonal drug, Noman, who works in the lab of Professor Gunda Georg, targeted a protein called "retinoic acid receptor (RAR) alpha".

Inside the body, vitamin A is converted into different forms, including retinoic acid, which plays important roles in cell growth, sperm formation, and embryo development.

Retinoic acid needs to interact with RAR-alpha to perform these functions, and lab experiments have shown mice without the gene that creates RAR-alpha are sterile.

For their work, Noman and Georg developed a compound that blocks the action of RAR-alpha.

Hence, my concern.  If retinoic acid “plays important roles” in cell growth and “needs to interact with RAR-alpha” to do so, then it seems to this ignorant lay person that interrupting the ability of receptors to interact with retinoic acid damages the body’s ability to grow new cells.  That looks like a problem.   I’ve emailed the organization Male Contraceptive Initiative with my inquiry, and received this prompt reply:

Hi Robert - Thanks very much for your email. One of the innovations of this molecule is that it's highly specific for the isoform RAR-alpha, which is associated with infertility in men. The other RAR isoforms, beta and gamma, compensate in other tissues, and the inhibitor has a much, much lower affinity for these isoforms. For more information, feel free to check out this review from the UMN group, and do let me know if you have any questions!

I take that to mean that other structures of RAR make up for whatever damage this particular molecule would otherwise cause.  Whatever the case, Noman and Georg think this approach to male contraception shows promise.

"There is no guarantee that it will work...but I would really be surprised if we didn't see an effect in humans as well," she added.

The mice have shown no apparent side effects and, a month after discontinuing the medication, are again able to sire pups.

Meanwhile, no article on male fertility would be complete without some slam like this:

A persistent question about future male contraceptive pills has been whether women will trust men to use them.

Yes, that shoe really pinches when it’s on the other foot, doesn’t it?  Ever since the introduction of the female contraceptive pill, men have wondered if she’s telling the truth when she says she’s “on the pill.”  That’s because, too often, she’s not.  Plus, the law imposes on her no duty to tell the truth, so men take quite a chance when having sex.  The great majority of women are honest about the matter, but that doesn’t matter a tinker’s “damn” if your partner happens to be one who isn’t.  And how’s a man to know?

It's not as if the phenomenon of “unintended pregnancies” is rare.  Amazingly, almost half of pregnancies are reported by women to be “unintended.”  What that means exactly is anyone’s guess, but there’s no way that a female contraceptive pill that’s 99% effective when used properly and 91% effective on average produces a 46% “unintended” rate.  Other hormonal methods have essentially the same efficacy.

I’ll continue to track the development (or not) of male contraceptives.  It’s one of the most important issues men face.

 

7 comments

Lenona

And…given what’s happening right now in Washington, DC, isn’t it time for the men and women who support reproductive rights to WORK together and demand more contraceptive freedom in general, regardless of whether any of them supports abortion rights, per se?

I mean, does anyone here seriously believe that the 26 states or so that can’t wait to ban abortion are going to do the logical thing and make it easier for the poor, especially, to get safe, effective contraceptives? Or to get sterilized if they want to? Fat chance.

From a 2014 interview with Katha Pollitt:

“I saw an op-ed by Dana Milbank, who writes for the Washington Post. And he was saying, a pox on both your houses. He wrote that what both sides really needed was lots of birth control. And reading this, I’m thinking [sarcastically], ‘Yes, Planned Parenthood, why DON’T you provide birth control for people??’ I mean, what planet is this man living on? Abortion opponents are the main reason it’s hard to get birth control in this country. And abortion supporters are the people who WANT to blanket the country in birth control.”

See also the recent Esquire article: “They’re Coming for Griswold, and Obergefell, and Lawrence, and Loving.” (By Charles P. Pierce.)

Excerpt:

“…What Alito’s reassurance does remind me of is the claim within the decision in Bush v. Gore that it was ‘limited to the present circumstances.’ As ProPublica pointed out two years ago, Bush v. Gore has been cited as precedent in nearly 200 cases. Even if I had a scintilla of trust in Alito’s reassurance…he wouldn’t be able to follow through on it if a state, say, wanted to outlaw gay marriage, or restrict the sale of contraception…

“Remarkably, this blockbuster came at the end of a day that began with a story in the Washington Post about how the anti-choice forces in Congress were already planning to propose a nationwide ban on abortion should the Republicans carry the midterm elections this fall. That’s for any of you who believe that Alito and the apparent majority are sincere about letting the states make up their own minds.”

Lenona

Zeuszoos, I covered that when I said “whether you’re male or female, if YOU’RE the one who doesn’t want a pregnancy, it’s YOUR job to make sure at least two or three BC methods are being used.”

Other than that, I don’t know what you mean. Unless you’re complaining about the lack of male birth control. Well, as it happens, one would think that male rock stars and famous athletes would be dying to get their hands on invisible methods of male birth control – but last I heard, the Parsemus Foundation, which is working to make Vasalgel available in the U.S., is still struggling financially. So that would suggest that those rich men are not that eager to get it or to help anyone else to get it. As MRA Bernard Chapin once said about male birth control: “condoms already work pretty well…it sounds like a solution in search of a problem to me.” (He’s changed his tune somewhat, since – but obviously, most men haven’t. Also, Marc Rudov, who appears on Fox News, now and then, has made it pretty clear that he resents the idea that any man in a long-term relationship should have ANY responsibility for birth control. Plus, the MRAs at A Voice for Men who claim they can’t wait for better male BC to arrive seldom or never say THEY will use it; they just want hordes of OTHER men to use it and put women into a panic. Fat chance.)

And while a MARRIED woman might con her husband into unwanted fatherhood, time and again, there is no epidemic of single women lying about birth control. (Yes, lots of women are unwed mothers, but that hardly means female dishonesty was necessarily involved.) Also, as one MRA wrote, years ago – I can’t find it right now – as a rule, it isn’t the middle-class, educated, self-described feminists who are desperate for babies, it’s the uneducated and the poor, typically because they have little else to look forward to. (A similar phenomenon can be seen with those men who take practically take pride in having babies with multiple women.) Not to mention that, again, accidents happen.

So unless PARENTS start pushing their teenage sons to change their ways, big-time, single men will just continue to rely on condoms (typically because women don’t want to catch STIs), and men in long-term relationships will continue to trust the women they’re with – usually for good reason. But if they don’t trust them, they can just point out what I did – that using just one contraceptive is playing roulette, and that “I love you too much, honey, to put you at risk for having an unwanted pregnancy, so that’s why we’re still using condoms.”

Yes, I know that sounds kind of implausible to a woman, given men’s hatred of condoms. All the more reason for men to get out their wallets and help Parsemus and other medical organizations.

Bottom line:

“Don’t Expect a Supply Without a Visible Demand.”

Zeuszoos

Lenona,

Now try reading your first comment, slowly and reversing the sexes when you do so. What do you think the reaction would be?

IM0, you should read everything you write that way before sending it.

Lenona

Dr. Fiamengo, just so you know, even men’s rights activists, as a rule, do NOT accuse feminists or feminist organizations of trying to stop single men from getting vasectomies. My point is that if feminists were opposed to men’s right to male contraception, they would already have been going after those male patients – and they haven’t. (Married patients are something of a different case, since doctors obviously don’t want to be sued by the patients’ angry spouses. But, when Dr. Warren Farrell complained of the hoops that married men have to jump through to get themselves sterilized, even HE didn’t claim that female patients – married or single – have it any easier.)

But, that still leaves the question of whether male methods of BC will really be useful to any man who is not in a long-term relationship. That is, no doctor wants to see condom use go down, for good reasons, and how many men will be willing to use two male methods at once – and pay for both? Not to mention that doctors will be somewhat reluctant to tamper with any growing boy’s body. (But at least, if doctors make that refusal, fathers could truthfully tell their daughters that any teen boy who tries to argue that condoms aren’t necessary because he’s on the pill, is lying.)

Because of all that, I might recommend that a father teach his son to use a male method but not TELL anyone about it. That way, he can’t be accused of lying about it, and if he can be convinced to use condoms as well, he’ll know right away that a woman is lying when she says she’s pregnant by him. (There’s a classic 2007 Craigslist story you may know, titled “Vasectomy: $400. Speechless look on her face: priceless.” Who knows if it’s true or not.)

Aside from that, he’d have to tell her about it once she gets tired of using condoms – and they decide to get tested for diseases.

Lenona

“Amazingly, almost half of pregnancies are reported by women to be ‘unintended.’ What that means exactly is anyone’s guess, but there’s no way that a female contraceptive pill that’s 99% effective when used properly and 91% effective on average produces a 46% ‘unintended’ rate.”

There’s nothing “amazing” about it, and the next sentence was very misleading.

People just don’t do the math. What I mean is: a woman has about 30 years of fertility. So, even if she only has sex 12 times a year, on average (ha!), but only wants two children (typical for American women), that’s still well over 300 times that she has to PREVENT pregnancy, with or without help from the man. Not to mention that typically, the Pill has to be taken at the same time Every Day, so every day, there’s a chance for error. (Never mind all the women who can’t use hormonal methods, for medical reasons – such as women who smoke.) With that in mind, it’s kind of surprising that ONLY half of all pregnancies are unplanned. Because of those numbers, one could argue that a woman who tells her doctor “I planned this pregnancy” is more likely to be lying, out of pure embarrassment, than a woman who says “I didn’t want this to happen.”

Bottom line: 30 years is a very long time to go without at least SEVERAL slip-ups. Also, just how often do sex-ed teachers tell their students, loudly and clearly, that using the Pill alone is not enough, if you’re serious about contraception? If they emphasized that more, it just might help. Parents need to tell their kids the same thing. While they’re at it, they can tell them that, whether you’re male or female, if YOU’RE the one who doesn’t want a pregnancy, it’s YOUR job to make sure at least two or three BC methods are being used. Always. (It helps not to sleep with near-strangers – or anyone who’s just dumb.)

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