– We are always hearing about breakthroughs in male birth control but I never seem to hear about it again. Why is this? Is there a reason why multiple different forms of male birth control never seem to materialize for sale?
In: Biology
The simple answer is it’s much easier to block 1 egg produced monthly than millions of sperm produced continuously.
It takes on average 10-15 years for a drug to go from initial discovery to getting on market. You hear the positive press releases from preliminary findings, but even then there is a long way to go.
The Gel that people referenced here has only been studied in a little over 200 people and it had only been studied in terms of sperm count reduction – after 12 weeks, 86% achieved a predetermined sperm count of 1 million per mL of semen. It hasn’t been studied for decreasing the risk of pregnancy yet and is going to need to be in a much larger study to do so that will take multiple years. If that fails, the company isn’t going to put out a press release stating it didn’t reduce pregnancy rates to a satisfying degree, it’ll just fizzle out and you won’t hear about it again.
In general, it is because there are real and significant risks of pregnancy in women—so the risks of contraceptives are less than the risks of pregnancy. There are exceptions, like when a doctor tells a patient that a certain method of contraception is not appropriate, but in general, no amount of weight gain, low level blood clot risk, etc is going to be more than the risks of pregnancy. The same cannot be said for men. So when they encounter a risk the drug ends up being much much harder to get though FDA approval.
[It comes down to funding](https://www.nbcnews.com/health/mens-health/male-birth-control-gel-results-promising-rcna153349)
Because female birth control has been so successful, and women bare the brunt of fertility ramifications, male BC has lacked funding. IMO now that women are speaking up more about the intensive side effects, and more men want control of their own fertility other than barriers, more men are interested in a product for themselves thus pushing the market forward
Male birth control has been, right there, but it’s taking forever to come out. It’s because they have to make sure it’s safe and effective. Guys don’t have to deal with pregnancy directly, so they’re not gonna accept any side effects. On top of that, they don’t put enough money into research, so it’s slow going. But hey, there’s some cool stuff in the works, like hormonal gels and non-hormonal pills. Maybe one day, man, we’ll finally have male birth control.
They aren’t allowed to consider the emotional and financial burden of fatherhood or being a non-consensual sperm donor. As such any side effects have no benefits to offset them. They need to change how drug benefits are measured or make an exception.
Which is why it’s really kind of demeaning when it’s phrased as “haha men won’t tolerate the same side effects women put up with”. It’s likely true to some extent, particularly given the [rates of female sterilization vs male sterilization](https://oss.jomh.org/files/article/20230928-93/pdf/JOMH2022122401.pdf)
https://www.malecontraceptive.org/blog/shared-risk-addressing-the-ethics-of-male-contraception
https://www.bioethicsproject.org/ethics-of-male-birth-control/
https://www.bbc.com/future/article/20230216-the-weird-reasons-male-birth-control-pills-are-scorned
That and the media is so overhyped.
A cervical and ovarian cancer blood test has been “just around the corner” for 20 years
A vaccine for dental cavities has been in the works for about that long. Almost got into a trial once. That and living bacteriophages to kill the bacteria that cause cavities
And they’re always just months away from a “new pancreas” for diabetics.
The way I’ve heard it explained and why male birth control is hard is that unlike the female body that naturally has measures to prevent pregnancy that birth control tries to artificially induce, there is no natural mechanic to stop sperm. And considering the body produces *hundreds of millions* of spermatozoa daily, trying to disrupt that presumably involves some pretty serious measures
With female hormonal birth control, we “trick” the body into not accepting pregnancy by changing the hormone levels to something like “already pregnant” – a natural state for the body.
This has both positive and negative health effects (many use them for milder period pain, less bleeding etc, unrelated to the birth control function) and last I read about this, the average health effects were net positive. All in all, a fairly natural trick, low risk, even beneficial in most cases, easy to invent.
With male birth control, we are somehow trying to poison or disable one of the body’s highly prioritized functions – producing viable sperm, which has no natural cycle or method of shutting down or taking breaks that can be exploited – it just keeps functioning until it breaks.
Producing an agent that will shut down or damage viable sperm production enough is fairly easy – administering it so it doesn’t damage anything else in the body and making sure the production can recover fully afterwards is likely very, very hard. Even harder, it must not affect the “potency” which the whole function is tied to.
I would guess the most likely successful methods would be local injections into the scrotum (but who wants that?) or some sort of sticker/salve for local application, but that gets messy or could fall/sweat off etc. Just eating a pill would be SO much harder for it to not cause side effects elsewhere.
So to your question;
“*We are always hearing about breakthroughs in male birth control but I never seem to hear about it again. Why is this*?”
The best explanation is likely a combination of the difficulties described above, and the same reason that much of the cancer research you hear about in the news never materializes; it is fairly easy to produce an agent that disables sperm production or kills any type of cancer, and to get funding you shout from the rooftops that you have invented this wonder drug and it looks promising! … But the challenges of delivering it to an actual human without causing dangerous side effects prove too great and the project gets shut down.
Entire industries benefit from unwanted pregnancies and a lot of people benefit from men being stuck with no choice.
If men were suddenly able to prevent most unwanted pregnancies themselves it would shake shit up a lot.
I’ve read several times now that it was because when time came for human trials, the men couldn’t handle the side effects. You know, the same ones women on birth control have to deal with.
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