F or Pierre Colin, 72, was the search for a viable male contraceptive for life. As with the female hormone pill first prescribed on the NHS in 1961 (for married women only), the development of male contraception is long and complicated.
Following her release, the pill was equated with a revolution in sexual freedom. When it was made available regardless of marital status in the UK in 1
While female contraceptives containing pill, intrauterine devices (the spiral), implants and spermicides have grown, there are two options for men: condoms or a vasectomy. Between 2006 and 2016, the number of vasectomies in the UK dropped 64%, making condoms by far the most popular method.
In the US, trials with an injectable hormone mix of testosterone and progestogens began in the US to halt sperm production and showed promising results. In the early 1990s, the World Health Organization recruited 271 couples from seven countries to participate in a similar study. The results were encouraging again and only led to pregnancy. However, the pharmaceutical companies were unwilling to provide the $ 1 billion (£ 770 million) drug required for the development of a bulk drug, citing the unsafe and unexamined male market.
In the meantime, Colin had developed a natural male contraception method with a local doctor. In the "temperature method", a jockstrap is worn with an opening to push through the testicles, obviously raising the temperature from 34 ° C to 37 ° C – enough to stop sperm production. Users must wear the machine for 15 hours a day, and it takes three months for the temperature to rise reliably.
Colin estimates that more than 200 pairs have been sold. Now there is also a plastic ring that has the same effect. "People are very interested in the thermal method because there are no hormones," he says. "Many women reject the pill because of the side effects, so we wanted to take a different route."
This method can cause squeamishness, but regardless of whether it arrives, it is symptomatic of male contraception.
"There is a joke in our industry that a viable contraceptive for men has been 10 years away in the last 40 years," says Dr. Logan Nickels. As Director of Operations at the Male Contraceptive Initiative (MCI) in North Carolina, Nickels was at the forefront of recent efforts to launch a male contraceptive. As a nonprofit research sponsor, MCI develops non-hormonal methods, such as a reversible injectable polymer that blocks the vas deferens (the channel that delivers sperm from the testicles to the urethra), and plant compounds, including a plant derived from the plant Justica Gendarussa . "For the past five years – and more so in the past 18 months – I have really felt that the way male contraceptives are addressed in the public domain has changed enormously," says Nickels. "This is largely due to younger generations who asked why these contraceptives were not developed yet – they want to be much more involved in the family planning discussion."
This feeling is mirrored by Aaron Lockhart Jr, who is doing this as part of a year-long global study of a hormonal gel contraceptive for men conducted by the University of Washington, Seattle. "I have watched my wife for several years in various ways of birth control and she can play chaos with the female body," he says. "She's constantly negotiating what hormones might work, so I thought it was time to take some responsibility."
Studies with the male pill proved to be difficult, as the hormones in men and women vary in severity metabolism hopes for this gel, which is already used in the US for the treatment of testosterone deficiency. The alcohol-based solution is self-applied on a daily basis, making it significantly more accessible than injectable methods requiring medical monitoring. "The demand for recruiting in this study was very high," says Lockhart: There were thousands of applicants for just 40 jobs. "There should be more pressure on men to do so, to eliminate their fears about their masculinity and masculinity, even though it has nothing to do with it."
The settings seem to be changing. A January YouGov survey showed that one-third of British men would be willing to take a pill – the same proportion of women taking hormonal contraception – while nearly 80% of adults surveyed consider co-responsibility for contraception to be a positive development , A global survey of 9,000 men from 2012 found that 55% of respondents were willing to "try a new form of hormonal contraception".
"In reality, 40% of pregnancies worldwide are unplanned and this causes tremendous economic and societal burden," says Dr. Seattle-based lead study Stephanie Page estimated an estimated 25 million insecure abortions taking place each year. "By not giving men options, we exclude half of the population from helping to solve this important problem. A man can cause many pregnancies, so this could be very effective. "
For men and women, the choice of contraceptives is critically important, say scientists – whether gels, pills or underwear. "There will not be a perfect contraceptive for all men, and there will not be one single contraceptive for a man's life," says Nickels.
The options for men could include Colin's fitted underwear, which was recently patented. "The thermal method is actually a studied phenomenon, and if you can maintain that temperature long enough, it offers a reversible method of contraception," says Nickels. "But we need to develop contraceptives that make as few barriers as possible and make it easy and fun. These kinds of things should not affect your daily life or be difficult to use. "
But without the interest of pharmaceutical companies, it could take decades for a viable product to hit the market. "When women use contraceptives, they prevent a potentially life-threatening condition: a pregnancy," says Page. "However, when men use contraceptives, the risk-benefit equation is different because there is not necessarily an individual risk to the man. Studies show that men are ready to take new contraceptives, but pharmaceutical companies still see a risk in their potential market. "
Historically, however, sexist male attitudes have helped stop the progress of contraceptive attempts. In the 1970s, hormone tests were discontinued in Brazil because patients' potassium levels had dropped. The problem was solved, but no further attempts were made, and the research director, dr. Elsimar Coutinho later suggested that men "are very afraid of losing masculinity". In 2016, an injectable hormone study was discontinued after 20 men left the group due to increased libido, acne and depression – common side effects of the female pill. This led to charges of hypocrisy in men.
At MCI, Nickels uses crowdfunding and grants to bypass pharmaceutical companies' reliance on initial funding. "We hope that by using funding models such as philanthropy and other private investors, we can find new ways to bring these products to market, while ensuring that they remain exposed and scientifically sound," he says. Last year, MCI brought in $ 1.8 million; He hopes that he will be able to pass on his findings for further studies on pharmaceuticals with sufficient preliminary testing resources.
Significant developments are being made despite the lack of funding. A month-long study of a hormonal pill in March by the US National Institute for Child Health and Human Development prevented pregnancies and did not show any significant side effects. "I hope this exam is a turning point," says Dr. Diana Blythe, head of the program. "We had a tremendous amount of interest, since there has been no change in male prevention for 50 years, and now things are evolving."
The next steps will involve lengthy trials with a larger group of men to review sperm reduction, then the recruitment of couples to use the pill as the only contraceptive method. Like many drug trials, the process will be lengthy, expensive and likely to face regulatory challenges. The cost of the final product is still far away. "I always have to push everyone down by saying that if this works really well – which we'll know in three to four years – the third phase will have to be three to four times bigger," says Blythe. "This whole process would take at least a decade, but every step forward is all the more important."
The participants in the study hope that their efforts will serve future generations. Nickels thinks he often thinks of his five-month-old son: "The timetable for these options means he will be one of the first users to have options on the market. I hope that I can set the stage for him and that his relationships will be empathetic, where he can really engage with his partner in a key element of any relationship: to decide if and when to have children.  However, Lockhart may be forced to make a decision earlier. "I'd like to stick to this method if it works," he says, "but I know it's still a long way off, so we'll probably have our kids in about five years and then, once our family gets there is ready, I will get only the snippet. "Colin regrets that there were no vasectomies after the birth of his two children in the 1970s, as science for contraceptives for men had progressed far more slowly than he had expected. "I'm too old now," he says. "The contraceptives will apply to my grandchildren."