What is the male pill, and how effective is it?

Authored by

Dr Adam Williams

30 May 2022

Reviewed by

Dr Sameer Nakedar

MBBS (London), MRCGP, PGCert

What is the male pill, and how effective is it? - welzo

What’s covered?

Birth control pills will be available for men soon.

Why go for a male contraceptive pill?

Who might be interested?

Is a male birth control pill available?

Why is no male pill available?

Vitamin A inhibitors

Dimethandrolone Undecanoate (DMAU)

What are some more optimistic options for male contraception?

Way forward

Birth control pills will be available for men soon.

Why go for a male contraceptive pill?

Traditionally, women are responsible for contraception. They have to bear several side effects of hormonal and non-hormonal contraceptives. The male contraceptive initiative was started to divide the burden of contraception equally between men and women.

Who might be interested?

Are you a loving partner and interested in sharing the responsibility of contraception with your partner? If so, you might be interested to know about male contraceptives. What type of birth control mechanisms are available for men? Are there any safe and reliable birth control pills for men?

Currently, only two options are available to men for contraception,

Male condom
Vasectomy

Male condoms have high failure rates (up to 13%). Similarly, vasectomy is permanent surgical sterilisation that you may not like. So, are you looking for a pill equivalent to the female birth control pill? If so, these lines are for you. How safe would this pill be?

Is a male birth control pill available?

You will be disappointed to know that no such oral contraceptive pill has yet been approved for men like a female birth control pill despite decades of research. Why?

Why is no male pill available?

Most of the experimental oral contraceptive pills target the male sex hormone testosterone. The problem is that testosterone also has various other functions in the body. Therefore, targeting it can cause other disadvantages, e.g., increased bad cholesterol 'LDL,' increased body weight, depression, etc.

So, the focus of scientific research has shifted from hormonal to non-hormonal contraceptives. Let's know some contraceptive options that can be used for men in the future. Remember that no contraceptive will protect you from sexually transmitted infections (STIs). You have to follow the guidelines for safe sex.

Vitamin A inhibitors

The role of vitamin A for fertility and sperm production is very well known. This is because your body has receptor proteins which receive vitamin A. Some scientific investigations are targeting these receptors of vitamin A. For example, the researchers in a study used the compound YCT529 in mice for a month. The results were very astonishing. The sperm counts in the male mice decreased significantly.

However, in contrast to other methods, this treatment was reversible. As the treatment was stopped, the mice gradually became virile. The compound showed 99% efficacy in preventing pregnancy in mice.

To monitor your Vitamin A levels, order the Welzo at-home Vitamin A Blood Test.

Can it be used for humans in the future?

Recommending this pill for human use is a far cry. Human trials are not yet possible; it has to pass through animal trials, toxicology trials and human population studies. Humans and mice are very different creatures.

According to experts, the reproductive functions of humans and mice are also different, and it is hard to imagine how these compounds will work in humans. However, its clinical trials are expected to start in 2022.

Dimethandrolone Undecanoate (DMAU)

This candidate has passed safety trials. Its daily dose suppresses testosterone production, luteinizing hormone (L.H.) and follicle-stimulating hormone (F.S.H.). These effects are produced without the unwanted symptoms of progesterone deficiency.

A 2019 study published in the Journal of Clinical Endocrinology and metabolism evaluated its safety and efficacy. The study group consisted of 82 men aged 18-50 years. Three doses of DMAU were given. It was found that the levels of testosterone, LH and FSH were lowest in the people who received the highest dose of 400mg per day.

Side effects and future direction

The study confirmed the effects on hormones, but more studies are needed to observe its effects on sperm and sperm count. In addition, some participants noted side effects, e.g., weight gain, reduced libido, tiredness, erection problems, headaches, acne etc.

Further studies are required to observe its long-term effects on reproductive health and to see whether the side effects of female pills, e.g., blood clotting and depression are present or not.

What are some more optimistic options for male contraception?

Besides these candidates, research is ongoing to discover some more mechanisms of male contraception, which may be available in future.

Reversible inhibition of sperms under guidance (RISUG)

It is a non-surgical vasectomy procedure which is under investigation in India. It involves the injection of a gel in the sperm-storing tubes of the penis. The studies on animal models are promising, but a commercial product for humans is a far cry.

NES/T (Nestorone/ Testosterone) contraceptive gel

A Clinical trial is funded by the National Institute of Health (NIH) to test a contraceptive gel NES/T. It would be applied by men on their upper arms and shoulders daily. This gel is currently in phase II clinical trials. They plan to enrol 420 couples in the next phase of clinical trials. It is a hormonal gel. The experts are optimistic that this gel may be approved commercially within five years.

Male 'IUD'

What! How can a man use an intrauterine device (IUD) without having a uterus? It's an injectable hydrogel injected into the vas deferens, the tube transporting the sperm from the testes into the penis. So, it will act as a male version of an IUD. A single injection will be enough for a year. It is awaiting Clinical trials by a Virginia-based biotechnology firm, Contraline.

Way forward

The community is changing its previous opinion that women are only responsible for contraception. While a female pill will prevent pregnancy by preventing the release of egg and fertilisation, a male pill will influence sperm formation. The final result will be the same. A safe, reliable and reversible pill may be a decade away from us, but it will be a reality soon. It has created a hope that contraception will no longer be the responsibility of women only.