As a syringe, gel or as a tablet? Scientists have been researching a “pill for men” for decades. The birth control pill revolutionized sex in the 1960s. But the search for the counterpart for men is not making much progress.
A clear majority of people in Germany would welcome such a drug, as a survey by the opinion research institute Yougov on behalf of the German Press Agency shows. A new study in the USA also points to the fact that men could become more involved in contraception.
There are currently two main safe options for men: condoms or vasectomy - a surgical procedure in which the vas deferens is severed. “Vasectomy as an operation scares many people away because they have images of scalpels and blood in their heads,” says psychologist Michael Klein. And it is an invasive procedure, i.e. an intervention in the body.
But the condom, which has replaced the pill as the most popular contraceptive in Germany, is often not well received. Many men rejected the "rubber" because it supposedly affects sensitivity and authenticity of feelings - and can also cause an unpleasant pause during sex.
The “male pill” involves a hormone injection
US scientists are researching a tablet. “The new pill is different from previous ideas,” says Michael Zitzmann. The men's doctor from the Center for Reproductive Medicine and Andrology in Münster is a proven expert. He conducted a study on the topic on behalf of the World Health Organization (WHO) in the 2010s. But it wasn't about a tablet, as the generic term "male pill" suggests, but about a hormone injection. It worked well for most test subjects, but ultimately too many men complained of severe side effects. The study was stopped.
“There were mood swings in 10 to 15 percent of the participants, including depression, weight gain and acne,” Zitzmann told the German Press Agency. The libido was also affected, which sometimes led to couple problems.
“The new US study uses a new substance,” explains Zitzmann. The name: "YCT529", a hormone-free retinoic acid receptor alpha inhibitor (RAR-alpha). "This blocks access to vitamin A with the aim of inhibiting sperm formation in the testicles."
Animal experiments show very high effectiveness
According to the scientists, the contraceptive was 99 percent effective in tests on male mice. There were no side effects and the mice were able to reproduce again four to six weeks after stopping the pill. A phase I clinical trial is now expected to run until June with 18 participants, including men in Great Britain. A first step.
"The world is ready for a male contraceptive, and administering a hormone-free one is the right thing to do, given what we know about the side effects that women have suffered from the pill for decades," says chemist Gunda Georg, co-developer of the contraceptive medication, quoted in a statement.
Zitzmann is skeptical. He expects health problems as a result of blocking the special receptor for vitamin A. "Possible side effects are likely to be vision problems, digestive disorders and problems with urination, and the consequences may be irreversible," he says.
There is great interest in a “pill for men”.
In principle, 70 percent of people in Germany would “definitely” or “somewhat” support it. This was the result of a population-representative online survey by Yougov among 2,032 people.
However, a closer look reveals differences between the genders: among women, approval was significantly higher at around three quarters. At least 63 percent of the men surveyed were in favor of it in principle. But only 37 percent can imagine taking it with certainty. There is still a big gap between attitude and behavior - i.e. acceptance and actual willingness - says psychologist Klein.
This probably also has something to do with cultural history. “We have a long tradition of holding women more responsible for the issue of pregnancy,” says the expert from the Catholic University of North Rhine-Westphalia in Cologne. This was made worse by the pill for women. "The topic of the pill for men has unfortunately remained dormant over the past 60 years, despite all the emancipation and equality." It is pleasing that research is now being carried out on new preparations.
In addition to the US study on tablets, there are other projects. One involves a gel containing Nestorone, a synthetic hormone known as a contraceptive drug, and the sex hormone testosterone. It is applied daily to the man's arms and shoulders. The study is already in phase II, which is no longer just about an initial test of tolerability, but also about effectiveness. Basically, expert Zitzmann is confident. "It now actually looks like it will take a maximum of five years until a drug is developed," he says - only to admit with a smile that he has thought that several times.
There are several hurdles to overcome for success
“Women have to be able to trust the product,” says Zitzmann. But it will probably take a long time before it is introduced for other reasons. There is no larger study yet. In addition, a larger manufacturer would have to be interested.
It could definitely be financially worthwhile, scientists discovered around eight years ago in the journal “Current Obstetrics and Gynecology Reports”. Given an estimated market of ten million men in the USA and 50 million more men worldwide, they calculated a market value of a new contraceptive method of between 40 and 200 billion US dollars, the equivalent of up to 185 billion euros.