For decades, the burden of contraception has largely fallen on women, with options such as the pill, intrauterine devices (IUDs), and hormonal injections. But North Carolina-based company Male Contraceptive Initiative (MCI) is working to change that within the next 10 years.
Male contraception has the potential to revolutionize the way we think about family planning, as well as the dynamics of sexual relationships. With male contraception, men could take an active role in preventing unwanted pregnancies, potentially reducing the need for female contraception and decreasing the number of unintended pregnancies worldwide.
A National Institutes of Health study published this year found there may be an on-demand contraceptive pill that could be a safe and effective option for men who don’t want to get their partners pregnant. MCI is funding the company working to develop a compound that could make the dream of an on-demand contraceptive (that’s not a condom) a reality.
“My goal is to make that joke of ‘we’ve been 10 years away from a male contraceptive for the last 50 years’ no longer a joke,” said Lonny R. Levin, a scientist at Cornell University and founder of Sacyl Pharmaceuticals. He said he hopes the drug will be on the market by 2031.
How would male contraception work?
Most female contraceptives work through the use of hormones to manipulate the menstrual cycle, preventing the release and implantation of an egg and making it more difficult for sperm to hit their target. Even if you or your partner doesn’t use female hormonal contraceptives, you’ve probably heard about them.
There are thousands of birth control pills on the market made of various types of hormones and non-daily hormonal options like the IUD, the implant and the ring. What do men have?
- The withdrawal method
While the last option is free (and the only free option), it comes at the cost of knowing your body and your partner really well. Even with perfect use of the withdrawal method, it’s around 80% effective at preventing pregnancy.
Levin’s company, Sacyl Pharmaceuticals, is developing an on-demand contraceptive that inhibits sperm motility and could be used by men and women to accomplish the same goal: keeping sperm from swimming up the cervix and fertilizing a female egg.
This potential contraceptive drug would block Soluble Adenylyl Cyclase (sAC), which research shows does inhibit sperm motility. “Inhibited sperm motility,” in plain terms, means the sperm would be unable to move.
Theoretically how the pill would work is that one (or both) of the partners could take it about 30 minutes prior to sex and engage in unprotected sex without the risk of pregnancy, Levin explained, with the caveat that the compound has not yet been tested on humans, only animals. He said the company hopes to begin human trials in the next two to three years.
The compound would not protect against any STIs, only pregnancy.
The idea to make sAC the focus of a contraceptive was born out of data from two men who presented to a fertility clinic and were found to be infertile. Those men were otherwise healthy aside from their infertility.
While side effects are a big conversation in the male contraceptive space, Sacyl has the potential to be different because not only did the men not have sAC in their reproductive system, it was nowhere else in their body.
This shows, Levin’s explained, that a low or no side effect, reversible male contraceptive could be possible through acting on sAC.
MCI funds non-hormonal options, but there are also hormonal male contraceptives. The problem with male hormonal contraceptives is that they take around two or three months to become effective and about the same amount of time for sperm production to resume.
You’ve probably heard comments like “the male body creates millions of sperm every day.” Yes, it is true that millions of sperm are available for ejaculation every day, but it actually takes way longer than a day to create a sperm cell.
Levin explained that spermatogenesis (the creation of sperm) actually takes around two and a half months from the beginning of the creation of a sperm cell to that cell being ready to be ejaculated.
Hormonal methods that stop spermatogenesis take longer to become effective due to this lead time on sperm production.
So, what’s the holdup on male contraception?
The problem with male contraception, according to MCI founder Heather Vahdat, is that our culture and healthcare industry seems to have forgotten that men can and want to be involved in preventing pregnancy. But she has market research that shows men would take a contraceptive if one was available.
“The joke is that we’ve been 10 years away from a male contraceptive for the last 50 years,” she said, referring to the slow process of funding and marketing a male contraceptive–a process that’s held up by sexism and impatient investors.
Since Roe v. Wade was overturned last summer, Vahdat said they’ve received more messages and calls from men who are looking for ways to shoulder the burden of contraception.
“We have men contact us daily asking about trials, asking if they can drive from out of state to participate in male contraception trials and begging to be allowed to re-enter trials they previously were part of,” Vahdat said. “Men want contraception, and the myth that they don’t or won’t use it just isn’t true.”
Since 2014, the company has funded over $5 million of research and development of reversible, non-hormonal male contraceptives, and is currently the second largest funder of male contraceptive research in America.
Major pharmaceutical companies have not funded research for a male contraceptive since 2007 and haven’t funded any new female contraceptives since the 90s. Why?
Vahdat said the companies think the task of finding and marketing a male contraceptive won’t be worth the investment, but she thinks it could change how we view contraception altogether.
Levin explained male contraception isn’t “worth the risk” for Big Pharma in part because of how men and women experience different societal and physical risks associated with pregnancy. They simply think men won’t use a pill form of a contraceptive.
“The physical consequence and risk of pregnancy for women is a real imbalance, and it explains why women are putting up with more side effects than the world believes men will put up with,” he said. “Men don’t have nearly as much at risk in a physical health sense, so the bar for what side effects a man will put up with is going to be an incredibly high bar to clear.”
The future of male contraception
While the information about Sacyl’s potential drug is exciting, it could be another eight years before it’s on the market.
“We’re hoping that this eventually changes the conversation around sex, because now it becomes a shared responsibility,” Levin said. “I don’t see a reason why a woman wouldn’t have a prescription and why a woman wouldn’t offer it to a man when they’re ready to take their relationship to that level [of sexual intercourse].”