Sex Question Friday: How Close Are We To Having A Male Version Of “The Pill?”

Every Friday on the blog, I answer readers’ sex questions. This week, we’re talking about contraception. As you know, there are many forms of birth control available for women: the pill, the patch, the NuvaRing, hormone shots, IUDs, and so on. But what about guys? Is there anything they can do to reduce the risk of pregnancy during sex aside from the old standards (i.e., condoms and vasectomies)? Unfortunately, it’s much more difficult to biologically regulate male fertility than female fertility. Just think about it—is it easier to try and stop one egg per month from being released, or to try and stop up to a half billion sperm from being released per ejaculation? Despite the inherent difficultly of creating the male equivalent of “the pill,” some scientists have been hard at work and their research has yielded some promising new developments.

Are there any forms of male birth control being developed now?

For the past few decades, there have really only been two options for guys who want to ensure they don’t accidentally get a woman pregnant: use a condom or get a vasectomy. Unfortunately, these options represent two extreme ends of the spectrum. Condoms must be used correctly and consistently during each sex act and some guys complain of dulled sexual sensation. Vasectomies eliminate these concerns because after the surgery, there are no special precautions to take and no loss in sensation. The downside of vasectomies, though, is that not only are they expensive, but they are not guaranteed to be reversible. Thus, if a guy thinks he might want to father children in the future, he’s probably better off sticking with condoms. So is there any way to get the best of both worlds? Is there something that neither reduces sexual sensation nor runs the risk of creating permanent infertility?

I’ve recently read about two new procedures that have such potential. The first of these is something that has been reported in the media as the “testicular zap,” in which a specialized ultrasound is performed on the testicles. A recent study tested this out on rats and found that two 15-minute ultrasounds administered two days apart had the effect of significantly reducing sperm count [1]. It is yet to be determined whether this would have the same effect in humans, how often it would need to be performed, and whether normal sperm production would eventually resume, but this technique is promising for its non-invasive nature.

The other procedure I’ve read about involves injecting a polymer into the vas deferens (the sperm-carrying tube). This polymer stays in place and disables sperm as they pass by. It is known as RISUG [2], which stands for Reversible Inhibition of Sperm Under Guidance (a rather unfortunate name and acronym, if you ask me—although I must admit it sounds more pleasant than the testicular “zap”). This procedure does not affect sperm production; rather, it just serves to immobilize sperm before they can exit the body. It is supposedly reversible simply by flushing the polymer out of the vas deferens. RISUG is currently undergoing clinical trials in India and, if successful, could be administered widely in that country soon after. You can read more about RISUG here (but be warned, this webpage contains a video of the actual procedure being performed, which may not be safe for work or for those who are squeamish).

Before you get all excited about having your scrotums zapped and injected, I should warn you that we’re probably a long way off from either of these methods becoming widespread in the United States. We just don’t have enough evidence of the effectiveness of these procedures and their potential long-term side effects to start performing them routinely any time soon. For the time being, you’ll probably want to keep that condom drawer fully stocked.

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[1] Tsuruta, J. K., Dayton, P. A., Gallippi, C. M., O’Rand, M. G., Streicker, M. A., Gessner, R. C., … Sokal, D. C. (in press).Therapeutic ultrasound as a potential male contraceptive: Power, frequency and temperature required to deplete rat testes of meiotic cells and epididymides of sperm determined using a commercially available system. Reproductive Biology and Endocrinology. doi: 10.1186/1477-7827-10-7

[2] Sharma, U., Chaudhury, K., Jagannathan, N. R., & Guha, S. K. (2001). A proton NMR study of the effect of a new intravasal injectable male contraceptive RISUG on seminal plasma metabolites. Reproduction, 122, 431-436.

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