Thank you,
Sam

Finally, a male birth control pill, right? Unfortunately, not just yet. There are several methods of "male-directed" contraception being developed and tested in trials; however none are currently available to the general public. Clinical trials are underway and men surveyed in countries throughout the world have expressed their interest in male-directed contraception. The road is being paved, but men may have to wait several years before any viable methods reach the market place.

In the meantime, the possible mechanisms for male-directed birth control seem nearly endless. You can find detailed information about all methods at malecontraceptives.org, an organization whose mission is to "speed the development of safe, effective and convenient contraceptives for men." Consider a few of the methods currently being researched, as discussed at malecontraceptives.org:

• Hormonal pills, implants, and/or shots. These methods would work by using male hormones to stop sperm production. They are similar in theory to female hormonal contraception.
• "Heat" methods. Have you heard that tighty-whitey's can lower a man's sperm count? Well, there's something to the idea that heat reduces fertility.... Heat methods would allow men to systematically bathe their boys in heat (most likely water baths) to diminish sperm production.
• Non-hormonal pills. Certain pill-based drugs may limit sperm production and/or ejaculation in a variety of ways. One is nicknamed the 'dry orgasm' pill, which, as unappetizing as the name sounds, is simply a way to alter muscular contractions in the penis so that sperm does not enter the semen.
• Vas deferens-blocking methods. These methods are basically a temporary version of a vasectomy. They work by plugging the Vas deferens so that sperm cannot enter the semen, however unlike vasectomy they are reversible.

So, what's taking so long? For one thing, scientists have found it challenging to control the male reproductive system. Women have a reproductive system regulated by a menstrual cycle, and are fertile for about 48-hours a month. (However, at exactly what point that 48-hour period of fertility will be during the month is unknown.) Scientists were able to develop the birth control pill, also known as oral contraceptives (OCs), based on the regularity of menstruation. Unlike women, men produce sperm 24/7, through a process called spermatogenesis, at a rate of one-half billion sperm each day. Because men are constantly fertile, developing an effective and reversible hormonal contraceptive, such as a male birth control pill, continues to challenge researchers.

In these studies, at least five different approaches to temporarily decrease or cease sperm production and function have been considered. They include:

In a man:

• preventing sperm production
• interfering with sperm function
• interrupting sperm transport

In a woman:

• preventing effective sperm deposit
• blocking sperm-egg interaction

Of these strategies, decreasing or preventing sperm production by using testosterone, the primary male sex hormone, either alone or in combination with another type of sex hormone called progestin, have shown the most promising results. European men may have access to some form of hormonal male contraception that prevents sperm production within the next five years.

Of course, another consideration is whether men will actually use these methods as they become available. Even though a male birth control pill may seem like a great innovation, not all men agree. Some are nervous about the possible side effects that have resulted from a few of these clinical trials, which have included:

• mood swings
• aggressiveness
• lack of libido
• acne
• weight gain
• lowered high density lipoprotein (HDL, the good cholesterol) levels
• impotence
• long-term infertility

Additionally, an effective male contraceptive could put more of the responsibility for contraception on men, which may or may not fit well into a man's (or woman's) beliefs and values. And as with female-directed methods, factors such as cost, convenience, and ease of use will likely play a role in overall acceptance. Finally, none of the methods being researched would provide protection against sexually transmitted infections (STIs). Even when new male-directed contraceptive methods are available, condoms will still be essential in preventing STIs.

Men who are concerned with preventing pregnancy currently have the two old stand-bys: condoms and vasectomy. Of course, vasectomy is not a good choice for men who would like to have kids in the future, so for many men the only male-directed contraceptive choice is condoms. Men with female partners can also discuss any birth control methods she may be willing to use, and can even contribute money to help off-set the cost. However, it seems it will be a number of years before men have access to reversible contraceptive methods, other than condoms, of their own.

Alice

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