A Male Contraceptive Pill Could Be On Shelves Very Soon

Whether it’s an IUD, a shot, an implant, or a daily pill, birth control has become a regular part of many women’s lives. In the United States, about 40% of pregnancies are unplanned, with women unfairly being made responsible for pregnancy prevention and family planning.

With a range of side effects, including headaches, breast tenderness, increased risk of blood clots, and even increased blood pressure, scientists have been searching for a solution that could take the sole onus of pregnancy prevention away from women. The result? A possible contraceptive pill for men. 

Why Has The Male Contraceptive Pill Taken So Long?

In 2019, a male birth control pill passed its first round of clinical testing, which gave hope for a non-permanent contraceptive that would level the playing field of pregnancy prevention. However, this didn’t materialize.

The search for a male contraceptive pill has been going on for years with little to no positive results. Scientists have explained that it is biologically harder to produce a contraceptive for men, calling it “a numbers game.” Women produce an egg a month, while men produce millions of sperm on a daily basis. This has made the process a longer one, with experts exploring various aspects of the male reproductive organs in conjunction with the whole body.

However, with recent developments, it seems as though a solution may have been found.

TDI-11861 

According to research published in the Nature Communication journal last month, researchers at Weill Cornell Medicine have discovered an experimental drug that could be a promising find in the search for a male contraceptive pill.

Known as TDI-11861, this drug works by temporarily disabling sAC (soluble adenylyl cyclase), an enzyme that is not only responsible for sperm maturation but also triggers sperm cells to swim, ensuring that semen will contain no sperm. These are the most promising findings in the contraceptive pill search, allowing men to “make day-to-day decisions about their fertility.”

Does It Impact Overall Fertility?

This drug doesn’t damage or kill the sperm, it just immobilizes it for a few hours through a “sperm-swim” switch. With the idea that it would take about an hour before engaging in sexual intercourse, this “on-demand” drug would block the fertility protein for about 24 hours.

Dr. Melanie Balbach, the lead author of the study, says “our inhibitor works within 30 minutes to an hour,” further explaining that “the compound wore off three hours later, and males recovered their fertility.” The perfect way to describe it is a “reversible, easy-to-use contraceptive”.

What About Side Effects?

Unlike the female contraceptive, this new drug does not involve hormones, meaning that it will not affect testosterone or have any hormonal-related side effects. TDI-11861 has been proven not to be toxic to sperm, with it blocking the bicarbonate-induced increase in flagella beat frequency in sperm.

The flagellum of the sperm gives it a “whip-like” movement to propel it forward, so this effect will prevent sperm from being able to move forward, which increases the chances of the fertilization of an egg taking place. 

The Latest Development, Not a New One

This isn’t the first breakthrough in the search for non-permanent contraceptive options for men. However,  it seems to be the most convenient and viable.

Prof Allan Pacey, professor of andrology at the University of Sheffield, said: “There is a pressing need for an effective, reversible, oral contraceptive for men and although many different approaches have been tested over the years, none has yet reached the market.”

In 2022, the American Chemical Society presented YCT529, a chemical shown to cause a significant reduction in sperm counts a month after consistent use. Unlike TDI-11861, this would require a month of pre-treatment before full effectiveness is achieved. Also, regaining full fertility is a process that would require weeks. 

Two More Pills In Development 

Tamar Jacobsohn, B.S., a researcher in the Contraceptive Development Program, mentions that there are two other pills in development, with studies indicating that they may “provide an acceptable balance of efficacy and tolerability.”

Known as dimethandrolene undeccanoate (DMAU) and 11b-methyl-19-nortestosterone-17b-dodecyl carbonate (11b-MNTDC), these bifunctional prodrugs with androgenic and progestogenic effects are designed to be cleaved after ingestion, so the active hormones do so over 24 hours, thus allowing once-a-day dosing. 

Chinese Herb Alternative

Another option that has been explored is Triptonide, a herb that was originally identified from Chinese folklore.

This herb was found to cause sperm deformation in non-human primates and mice, not only leading to infertility in these animals but also inhibiting the epididymal peptidase inhibitor (EPPN), which blocks sperm functions in non-human primates. 

The Most Promising Pharmaceutical Development

There is no indication that this drug will be available anytime soon. While human trials still need to be conducted, this is the most promising development pharmaceuticals have seen in this regard. While female contraceptive pills are relatively safe, they carry a wide range of side effects that are unpleasant.

With the proposed pill for men not carrying any reported side effects, this could be extremely beneficial to both men and women. Couples would be able to implement this, helping women not experience any complications (which are rare, but possible and serious), including heart attacks, strokes, and blood clots. Frankly, many women may be reluctant to place this total trust in their partners to take this pill consistently to ensure efficiency. However, only time is sure to tell how successful this venture will be. 

Reference

• Reynolds-Wright, J.J. and Anderson, R.A., 2019. Male contraception: where are we going and where have we been?. BMJ sexual & reproductive health, 45(4), pp.236-242.

• Tan, Z. and Garcia, T.X., 2023. SLO3 in the fast lane: The latest male contraceptive target with a promising small-molecule inhibitor. Proceedings of the National Academy of Sciences, 120(8), p.e2221758120.

• Long, J.E., Lee, M.S. and Blithe, D.L., 2021. Update on novel hormonal and nonhormonal male contraceptive development. The Journal of Clinical Endocrinology & Metabolism, 106(6), pp.e2381-e2392.