Jelmer Raaijmakers
We think it is self-evident that women make sure that they do not get pregnant, but is that a rational way of thinking? We might have been conditioned to think in that manner. It could be because women get pregnant, women give birth, and women use contraceptives. However, is it not weird and illogical to think of it that way? Might men be able to play a role in this?
Women carry the burden of carrying the (unborn) child; there is nothing we can do to change that. However, what we can do is change our perception on the matter. Together couples get pregnant, and together couples should ensure that it does not happen when they do not want to be pregnant. Currently, it is almost entirely up to females to use contraceptives [1]. Only the provision of non-medicinal alternatives, such as condoms, is a responsibility for both. Nevertheless, what if a male contraceptive becomes available? Men should not think badly of it.
The birth control pill is a well-known contraceptive. There is only one problem: many young women cannot take hormonal contraceptives [2]. For women who cannot take any hormonal contraceptives: is there no other alternative? The most obvious option is not to have coitus, but where is the fun in that? Existing options include copper-based spirals, the use of a condom and sterilisation. We should discuss the male counterpart of the pill: there are alternatives for men currently being researched.
Ever since the female birth control pill was developed in 1950, male contraception has been of scientific interest [1]. In 1972, Professor E.M. Coutinho tested a promising male contraceptive, gossypol, on a large scale: over 10,000 men participated [3]. Although gossypol was extremely effective, serious side-effects were of great concern: many men became infertile [3]. The holy grail of male contraception has not been found after decades of research, yet. Male contraceptives might seem to be a focus of the past, but nothing else than the opposite is more true.
The currently developed drug, the male counterpart of birth control, is a gel that must be applied to the back and shoulders. This might sound a bit odd for such medicines, but there are examples of drugs that are absorbed by the skin, such as painkillers and nicotine. Maybe more interesting: what is the mechanism of action? NES/T is the name of the male contraceptive gel that is currently under development [2]. It uses two main active compounds: the hormones ’segesterone acetate’ and ‘testosterone’. Segesterone acetate can completely block testosterone production by the testicles, thus suppressing spermatogenesis [2]. However, testosterone contributes to important functions in the body, such as muscle gain, facial hair growth and sex drive. Men do not want to lose that. Therefore, testosterone is added to provide normal serum concentrations. Current research focuses on the effectiveness and safety of the gel. If it is effective, it is the first practical medicine men can use to prevent pregnancies.
In the future, a wide range of men will be able to use male contraception: from young to old, if the female cannot take hormonal contraceptives, or ‘just to be sure’. A male contraceptive gel is a lifesaver for many. Contraceptives enable couples to responsibly decide about offspring while enjoying sex without the risk of unwanted children. By bringing this drug onto the market, men will be encouraged more to participate in family planning and use contraception where necessary. In the future, it might become a realistic option and when so, men should play a role in avoiding pregnancy.
References:
[1] Wenk, M. & Nieschlag, E. Male contraception: a realistic option? The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception11, 69-80 (2006).
[2] Ilani, N., et al. A New Combination of Testosterone and Nestorone Transdermal Gels for Male Hormonal Contraception. The Journal of Clinical Endocrinology & Metabolism 97, 3476-3486 (2012).
[3] Dodou, K. Investigations on gossypol: past and present developments. Expert Opinion on Investigational Drugs 14, 1419-1434 (2005).
