#LetsTalkSex: Can You Name a Male Contraceptive?

The pill, the patch, the ring, IUD, diaphragm, the female condom, the femcap, sterilization, injections.

Whew. We can rattle of the long list of female contraceptive options, but what’s available for the men?

Err...condoms?

Clearly there was much missing here. From a lack of awareness of the available options (like pills or a vasectomy) to a meager amount of options and a lack of interest.

What Male Birth Control Options Are There Now?

Currently, the research done to find the male contraceptive falls into two categories: hormonal and non-hormonal.

Non-Hormonal Methods

1. Condom: It’s the most readily avai;able and known, but Indian men are not too keen to use it. According to data by Quartz India, although 660 million condoms were distributed nationwide in 2008-09, that figure fell by more than half to 320 million in 2015-16.

Hormonal Methods

The goal of hormonal contraception research is to find a way of temporarily blocking the effects of testosterone so testicles stop producing healthy sperm cells. However, this needs to be achieved without lowering testosterone levels to such an extent that it triggers side effects, such as a loss of sexual desire.

1. The Gel: This is the furthest ahead in research, and once the gel is applied every day for a few weeks and the testosterone reduces, men can rely on only this for 12 months. But, it still has another ten years to go before it hits the markets.
2. The Pill: It’s easy to take and non-invasive but has uncomfortable side-effects, and is still a work in progress.
3. A vasectomy: This is more a long-term surgical solution but is the effective. However, reversing this procedure is complicated and not always possible, so this is seen as a permanent solution.

Could There Be a Solution That Works as Effectively as a Vasectomy but Is Reversible?

Enter Dr Guha, an emeritus of IIT Kharagpur, and his invention RISUG (Reversible inhibition of sperm under guidance).

In early 1970’s, Dr Guha, then an engineering professor at IIT, was out on an assignment to create a compound that kills the bacteria in a hand pump when he realised that the same insight could be used towards creating birth control options for men. He created a gel-like injectible substance that could negate the positive charge of the sperm and make it unable to ferlitise.

After several tests, a medical degree (Guha had a PhD in engineering and needed to do the MBBS to submit a new drug for clinic testing), changing drug regulation laws, extensive scrutiny and years (and years and years – almost 40 to be precise) Guha and his team at ICMR have created a “one-time, low-cost” contraceptive method called RISUG and are very very close to proving it can be reversible as well. RISUG also is localised, solving the problem of affecting the testosterone production in other parts of the body.

“Its reversibility has been tested in 2 species of primates, rabbits and more,” Dr Sharma, senior director general and scientist at ICMR told FIT.

At 78 now, Guha hopes his invention makes it to the public soon as it has life-changing effects on entire populations.

Why Is It so Hard to Create a Male Contraceptive Option?

One of the challenges in creating a male contraceptive is in male biology.

“The male produces hundreds of millions of sperms every day, and when the ejaculate comes out, there are 250 million sperm,” said Michael Skinner, a reproductive biologist who studies male contraceptives at Washington State University. “We could probably get away with a tenth of that and still be fertile.”

Women, by contrast, only produce one or two eggs a month. Shutting down the male system while keeping men healthy is a daunting task on a simple numbers basis.

Plus, it is a challenge to keep the testorone levels balanced when trying to create male contraception.

Besides it being scientifically difficult, male contraceptive research is woefully underfunded.

Then there is the problem of how men will handle the pill. When a small trial of the male pill was done, there were many articles that wrote that men couldn’t handle the depression, the pain, the headaches –all common side-effects of the female pill women deal with every day.

Family Planning Just a Woman’s Issue? NO!

So far, there has been nothing that works as effectively as women’s contraception, and there are a lot of options there – it’s hard for a male option to be the preferred choice as there is a lot of competition to overcome. Now while the women are the ones that physically have the pregnancy, it shouldn’t be this unequal!

The main issue with this is :family planning is still seen as a woman’s proble.

This disparity is called the ‘contraceptive burden’.

The Indian Express reported that in 2018, women accounted for at least 93 per cent of sterilisations in India, and bore more than their share of the burden.

So more male options like RISUG could hold the potential of not just bringing men into the family planning conversation, but also of lifting some of the weight of the women’s shoulders.