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Science Technology

Why We Can't Have the Male Pill (bloomberg.com) 347

Reader joshtops shares a report: For years, headlines have promised an imminent breakthrough in male contraception. Time and again, these efforts have fallen short. Last October, for instance, researchers reported that a hormone cocktail they'd been testing curbed sperm production and prevented pregnancies. But they'd had to halt the study early because men were reporting troubling side effects, including mood changes and depression. "The joke in the field is that the male contraceptive has been five years away for the last 40 years," says John Amory, a research physician at the University of Washington School of Medicine who has been working on the challenge for two decades. A new form of male birth control would be a public-health triumph and could snag a significant piece of the contraceptive market -- which is expected to surpass $33 billion by 2023, according to research firm Global Market Insights Inc -- or possibly expand it further. In a 2002 German survey of 9,000 men in nine countries, including Brazil, France, Germany, Mexico, and the U.S., more than 55 percent of the respondents said they'd be willing to use a new form of male birth control. A later study by Johns Hopkins University estimated that the demand could yield 44 million customers in those nine countries alone. And yet major pharmaceutical companies have mostly abandoned the chase.
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Why We Can't Have the Male Pill

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  • by Penguinisto ( 415985 ) on Friday August 04, 2017 @11:57AM (#54941127) Journal

    The Pill generally works for most women (and in some cases helps them stay 'regular'), a not-insubstantial number cannot go near the things without causing massive problems (irritability, fertility issues later down the road, etc). That said, it's fairly predictable, and you're not introducing anything more than just more hormones at the right times.

    It's tougher with men, since we don't have predictable cycles to monkey with (sperm production is more or less constant until the guy is well past old age), unlike eggs (which are already present at birth), sperm is made on-demand, and various hormonal interdependencies with brain chemistry is likely way more complex.

    • by Anonymous Coward on Friday August 04, 2017 @12:01PM (#54941155)

      We don't really need a pill that blocks sperm, we just need a pill that alters your DNA enough to make you fail a paternity test.

      • by penandpaper ( 2463226 ) on Friday August 04, 2017 @12:26PM (#54941345) Journal

        Funny that, you don't have to be the biological father to pay child support. http://clementlaw.com/child-su... [clementlaw.com]

        Even if the woman lies about birth control you are still liable. http://www.kidspot.com.au/birt... [kidspot.com.au]?

        • Re: (Score:2, Informative)

          by Pascoea ( 968200 )

          Funny that, you don't have to be the biological father to pay child support.

          While I don't disagree it sucks for the dude involved, being forced to pay for a child that is not his, I want to point out a couple of things about this case: Based on the court doc, they were married in 96, under two years later the kid was born, they weren't divorced until 2001. That would lead me to believe that for 3 years he raised the child as his own. The 2001 divorce filings "incorporated a revised marital settlement agreement acknowledging Richard as the father of the couple’s minor child

      • by rtb61 ( 674572 )

        No way dude. You want 100% guaranteed birth control, you create an inhaler that can simulate orgasm. One snort and you are orgasming long and hard, no muss, no fuss, the end of STDs and rape. Of course getting people to stop using it might be a bit trickier ;D.

    • The reason that male contraceptives cause depression is easily understood - both sexes need a sufficient quantity of one or the other of the sex steroid hormones - either testosterone or estrogen. This is why drugs such as dutasteride (to treat prostate cancer by dropping endogenous testosterone) come with warnings because they can cause depression and suicidal ideation.

      One option is for the woman to sneak sufficient quantities of estrogen in the man's food (known as medical or chemical castration), same

    • There's also the fact the consequences of pregnancy hit women more immediately and personally, so they're wiling to put up with more to get birth control.

  • by IMathGood ( 2722541 ) on Friday August 04, 2017 @12:01PM (#54941159)
    Women have a natural state where they no longer ovulate (pregnant or breast feeding) and female birth control works by tricking their bodies into going into that natural state. The big problem with male birth control is that there is no natural state where men don't produce viable sperm. All hormonal based male birth controls force the male body into some sort of unnatural state, which always leads to unacceptable side effects. Now physical barrier based male birth control might work better but its not as profitable because those methods are typically long lasting and more permanent, so the drug companies don't get a regular kickback as you don't have to buy pills every month.
    • Yeah it's also cost/benefit.

      If you get pregnant you're in a risky medical condition. The pill might put you at risk, but you're avoiding a different risk. For the male pill you're taking someone who is in a perfectly safe medical condition and putting them in a risky medical condition with no direct benefit to the individual.

      It's a stickier ethics question than the slam dunk case for female contraceptive pills.

  • by Anonymous Coward on Friday August 04, 2017 @12:02PM (#54941165)

    A pill doesn't solve all the problems with sex, just birth control.
    A condom isn't perfect, but it's a heck of a lot better than a non-existant pill with the added benefit of preventing STDs.

    I'm disappointed that the male contraceptive that basically glued the vas deferens closed but could be dissolved by another solvent hasn't taken off: https://wired.com/2011/04/ff_vasectomy/

    • by thewolfkin ( 2790519 ) on Friday August 04, 2017 @12:13PM (#54941253) Homepage Journal

      A pill doesn't solve all the problems with sex, just birth control. A condom isn't perfect, but it's a heck of a lot better than a non-existant pill with the added benefit of preventing STDs.

      I'm disappointed that the male contraceptive that basically glued the vas deferens closed but could be dissolved by another solvent hasn't taken off: https://wired.com/2011/04/ff_v... [wired.com]

      Birth control is not just for one night stands. Sometimes wedded couples decide they have enough kids at whatever number they have and would like birth control that doesn't make the wife throw up and allows them to have sex. A LOT of married men would gladly take birth control over expensive constant buying of condoms.

      • by ranton ( 36917 ) on Friday August 04, 2017 @12:21PM (#54941297)

        Birth control is not just for one night stands. Sometimes wedded couples decide they have enough kids at whatever number they have and would like birth control that doesn't make the wife throw up and allows them to have sex. A LOT of married men would gladly take birth control over expensive constant buying of condoms.

        And they all have that option already: a vasectomy.

        • For me at least, the ability to change my mind is why I am partial to the idea of male BC. When I am a little older or at least certain on the permanency of no children then a vasectomy makes more sense.

      • by Shotgun ( 30919 )

        A LOT of married men would gladly take birth control over expensive constant buying of condoms.

        Married men have sex enough that the purchase of condoms is constant and expensive. Whahaha!!!

        Seriously, though. It takes a day at the doctor's office and a weekend of holding frozen peas in your crotch. I made the decision after two.

    • Re: (Score:3, Insightful)

      I'm guessing that for a man who is circumcised, and who already lost most of his sensitivity, a condom doesn't make much difference, but for me the condom cuts far too much sexual pleasure. I prefer masturbation (and obviously a blow job) to having sex with a condom.

      Of course, the best solution would be for society to realize that it's women who get pregnant, not men, and that it's obviously their body, their choice, and therefore their responsibility, but society doesn't like the idea that women should be

      • Of course, the best solution would be for society to realize that it's women who get pregnant, not men, and that it's obviously their body, their choice, and therefore their responsibility, but society doesn't like the idea that women should be responsible for their body.

        I know you're just trolling... but for the record. Damn right, if you get someone pregnant you're 50% responsible and better be prepared to take ownership of that child.

        If a woman tricks you into getting her pregnant that would suck really bad. I'd much rather have control over my own destiny than leave it up to someone else.

    • by 914 ( 88354 )

      Vasagel ( https://www.parsemus.org/proje [parsemus.org]... [parsemus.org] ) is pretty far along, with human trials expected in 2018. It's shown good efficacy and reversibility in animal studies already.

      RISUG, which uses a different polymer, has been in human trials in India for more than a decade, with good results and no serious side effects. It's currently in Phase II trials there, which is the last step before being available by prescription.

      Most of the information on RISUG is either very superficial or very dense, but

    • I'm disappointed that the male contraceptive that basically glued the vas deferens closed but could be dissolved by another solvent hasn't taken off

      Is that because you've never heard of retrograde ejaculation? Personally, I would be happy if that never happened to me again.

  • Let's do the math (Score:2, Interesting)

    by Anonymous Coward

    I would think it's far more prudent (and effective) to kill one egg than a gazillion sperm.

  • by ArylAkamov ( 4036877 ) on Friday August 04, 2017 @12:04PM (#54941177)

    Sounds about the same as the female pill regarding mood swings and depression, or altered personality. Anyone who has been with someone before and after they started taking birth control will know what I'm talking about.

  • by Anonymous Coward

    "Vasectomies cost about $350 to $1000 — far less than surgery to sterilize a woman — and many insurance companies will cover the procedure."

    How much profit do they think they'll make off these pills?

    • by crow ( 16139 )

      Yes, but currently they're not 100% reversible. So they're not a good option for people who aren't done having kids.

  • Woman have a valid reason for BC. Men would lie because we're stupid.

    • by penandpaper ( 2463226 ) on Friday August 04, 2017 @12:33PM (#54941387) Journal

      Because women don't lie about being on the pill? I got some bad news for you.

      • Because women don't lie about being on the pill? I got some bad news for you.

        A responsible adult (man or woman) should be able to take control of their own birth control. They should never have to rely on the other party doing their part- or be in a position where the other party could be misleading them.

        Doesn't matter if you're man or woman, it's much better to have your destiny in your own hands.

        • Absolutely agree and that is one reason I hope for a day with male BC so that I don't have to make a permanent decision like a vasectomy to take control of my own birth control.

          or be in a position where the other party could be misleading them.

          This is more difficult because it amounts to; "Trust no one". Being in a relationship, a healthy one at least, is built on some level of trust.

    • Woman have a valid reason for BC.

      So do men. No-one wants to be lumbered with 18+ years of child support from a one night stand.

    • Birth control outside of a condom is for people in a dedicated relationship and if you're lying about birth control in that situation your relationship is more fucked up than I care to imagine. I wouldn't want to have unprotected sex with someone I've just recently met. Pregnancy isn't the biggest concern compared to getting some STDs. If someone gets pregnant you can always get an abortion, but there's no easy fix for HIV, hepatitis, or herpes.
  • by roc97007 ( 608802 ) on Friday August 04, 2017 @12:07PM (#54941201) Journal

    "The joke in the field is that the male contraceptive has been five years away for the last 40 years"

    Did anyone else immediately think of nuclear fusion?

    • Did anyone else immediately think of nuclear fusion?

      Yes. Because that is the exact comparison that researcher in the article was making:

      When I was in high school, I thought I was going to become a physicist and work on developing fusion,” Amory says. “Then I started working on this, and now I wonder what we’re going to have first: workable fusion or a male pill?”

      • And AI.
        • At least with AI the initial goals were hit and our definition changed to some degree. "AI will play chess and win!"... "Ok, it can play chess really really well but that's only because it can see every move and choose the best one not because it is intelligent.".

        • Get the AI to design the pill AND fusion and we'll be golden. It's Just That Easy (TM)

      • The answer is our work with nuclear fusion will go horribly awry and sterilize all men. Hooray!
    • "The joke in the field is that the male contraceptive has been five years away for the last 40 years"

      Did anyone else immediately think of nuclear fusion?

      Nuclear Fusion seems a bit heavy handed just to achieve a male contraceptive.

    • I thought of cellulosic ethanol, although It's been 10 years away for the last 25 years.

      People often forget that corn based fuel ethanol was only supposed to be a bridge to cellulosic, but that was passed during the Bush administration, and yet here we are...
    • by sootman ( 158191 )

      I think I first heard that joke about AI, maybe 15-20 years ago, and it was an old joke then.

  • Contraceptive pills for women piggyback on the existing infertile period: pregnancy and lactation.

    If you already have a basic mechanism to stop fertility in place, it's a lot easier to trigger it on command. Specially when it is designed for external control. It is the fetus that signals the mother's body to switch to pregnancy mode. This makes it a lot easier to find and trigger the chemical pathways that will do the trick.

    Males, on the other hand, do not have such mechanism, which makes this much harder to achieve without serious side-effects,

    • Contraceptive pills for women piggyback on the existing infertile period: pregnancy and lactation.

      Lactation? Women (and men!) can lactate independent of pregnancy.

    • by pnutjam ( 523990 )
      Yeah, I tested one that made me blow a dusty cloud out...
      harder to clean up...
  • Keep your pants zipped. I've done it for 47 years. Saves a lot of heartache from shotgun marriages, unwanted children and STDs.
    • Yes, sleep in a separate bed away from the wife... She has cooties ya' know!

      • Yes, sleep in a separate bed away from the wife... She has cooties ya' know!

        That's what my parents did — after my mother slept with the barbers from around the corner.

  • Hate Facts. (Score:3, Funny)

    by x0ra ( 1249540 ) on Friday August 04, 2017 @12:16PM (#54941271)
    <mode type="SJW">
    This article is pure hate fact. We all know the only reason there is no "male" birth control pill is because of the cis-gendered alt-right white nazi patriarchy. Men and women are the same and any differences only exist because of social constructs.
    </mode>

    :-)
  • Perhaps male contraception was a viable issue to address during the boomer generation.

    Today, the divorce rate has never been higher. Infidelity(AshleyMadison/IllicitEncounters) and casual sex(Tinder/Grindr) have been turned from sins into products for the hook-up generation. All of this activity going on in the most dangerous STD landscape that has ever existed.

    Pill contraception is a one-trick pony, and unwanted pregnancy is the least of our fucking concerns now.

  • "He confessed his transgression to the researchers, and follow-up studies confirmed his account: WIN 18,446 didn&rsquo;t mix well with booze. Men who combined the two reported heart palpitations, sweating, nausea, and vomiting. The research was quietly abandoned.".

    As someone who doesn't drink at all, I would quite like this to be researched more. There are a non-trivial number (some millions in the USA alone) of people who don't drink, for one reason or another, and might be interested in a contraceptiv
    • I've never been much of a drinker, and I would absolutely give up the few social drinks I have every year in return for otherwise safe male contraception. Hormone-based birth control gets riskier for women as they get older, and around 35 doctors start advising you might want to try something else. As a middle-aged man I'd be fine taking a pill so women don't have to.

      And though I could live without it, there's also the possibility (I'm ignorant of the chemistry involved, so until someone who knows advises

    • It's a free country, why don't you take on the investment yourself. But I heard that teetotalers are some 2% of the population, so you might find it difficult to profit on such a small market.

      • Way, way higher than 2%.

        http://www.add-resources.org/half-the-worlds-adults-do-not-drink-alcohol-what-should-the-policy-implications-be.5325474-315773.html
        Past year abstainers (lifetime isn't so relevant as you can come off the drug in a day or two).

        Doing more digging comes up with the figure of 28% of of-age males had been alcohol abstinent in the previous year in the united states. That's a damn large market.
    • If it isn't a direct interaction, it means that the slight work the liver had to do on the booze left it unable to deal with the drug. This isn't good... a bigger study would probably then find that taking an advil would result in similar.
      • My limited understanding is it attacked specific enzymatic pathways - not a general 'liver weakening' effect.
  • Sperm #1: "I'm getting tired swimming. How far is the uterus?"

    Sperm #2: "I don't know, We only just passed the tonsils."

  • ...and just how many women would trust a guy saying... "yeah.. I'm totally on the pill"
    • It's not about asking women to trust men, it's about not asking men to trust women.

      If each party can see to it on their own that they're not going to make a baby, then nobody has to take anybody's word that they're handling it on their end, and if they're both taking separate precautions the pregnancy prevention is even more effective anyway.

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