Beyond the Condom: A Foray into Male Birth Control
By Vidhya Pathy, Associate Editor
Discussion on birth control almost always centers around females. Sex education ambiguously describes condoms as birth control without gender specificity — aside from the anatomy. However, much of sex education focuses on explaining pregnancy prevention methods, such as “the pill,” hormone-releasing implants, and intrauterine devices (IUDs). A woman is often pressured to purchase and maintain methods of pregnancy prevention. If she makes a mistake or the condom breaks, the consequences are hers to bear. Levonorgestrel, better known as Plan B, is her last resort. Male birth control rarely receives the attention, only reinforcing the skewed notion that pregnancy prevention is a woman’s job, not a shared responsibility. So, what is male birth control and how does it work?
The two main forms of male birth control are condoms and sterilization. With an 85% effectiveness rate, condoms are the most common form of male birth control. Condoms are thin pouches — usually made of rubber, polyurethane, nitrile, polyisoprene, or lambskin — that cover the penis during sex and catch semen, preventing it from entering the vagina. Male sterilization, called a vasectomy, is also somewhat common, though less so than condoms. Vasectomies are straightforward surgeries performed by doctors, who cut the small tubes that carry sperm. In the United States, 500,o00 vasectomies are performed each year, and about nine percent of men have had the procedure. Though this is the most effective type of birth control, its permanence may partly explain why a low percentage of men have elected to undergo it. Historically, though, condoms and sterilization are not the only options of male birth control.
In De Materia Medica, a text by Dioscorides in 40 A.D., hemp seeds and rue were touted as effective in reducing male sperm count. A study published by the Indian Journal of Urology tested this method of birth control in 2007 and concluded that this method was relatively efficient. However, much like the use of another herb in Persia, Gossypium herbaceum, the results could have undesired permanence in addition to being potentially toxic. Gossypium herbaceum, better known as the cottonseed plant, causes lifelong infertility in up to 20% of its users. The neem tree leaf, a solution for male birth control advocated for in traditional Indian medicine, emerged around the same time. A 1980 study, published in the Journal of Postgraduate Medicine, found this method to be surprisingly effective at reducing male sperm count. Unfortunately, there were still undesirable side effects. Hippocrates took a different approach, advocating for fire instead of herbs. His writing explained a method where a man heats his testicles to inhibit the production of sperm. The drawbacks of this type of male birth control were that it required maintenance and was quite painful.
More recently, researchers have been looking into male birth control pills and gels that could hopefully have the same efficacy without the unpleasant side effects. In 2019, researchers from LABioMed and the University of Washington gave test subjects an androgen-based pill that showed significant results in reducing sperm count. Notably, none of the men on the pill or the placebo reported a lower sex drive. Another promising option for male birth control is body gel. An international trial with men from the United Kingdom took place in 2019 as well. Men would apply this gel to their back and shoulders, where it would be absorbed. The gel uses a hormone called progestin to block testosterone production in the testicles, naturally ending the production of sperm. Testosterone in the gel replaces the lost testosterone to maintain sex drive and other bodily functions. With these viable options approaching the market for the general public relatively soon, the biggest question is popularity. However, among researchers, there is some agreement that if pharmaceutical companies invest adequate resources, male birth control could become its own market—and a lucrative one at that.