The document discusses the lack of a widely available male contraceptive pill. While female contraception like the pill has been available since the 1950s, a male equivalent has proven more difficult to develop due to physiological differences between male and female reproduction. Several potential male contraceptive methods have been studied, including Gossypol and RISUG, but all have faced barriers like side effects or lack of funding. The responsibility of contraception is also seen as an impediment, as women may not trust their partners to take a male pill consistently. Overall, the document examines the challenges surrounding the development of an effective, reversible male contraceptive.

1. Arianna Toledo
Markham College
Scientific Research
02 December 2021
Why Don't We Have a Male Contraceptive Pill Yet?
“It makes more sense to take the bullets out of the gun than wear a bulletproof vest”, says the American
comedian, Greg Travis (Majumdar, 2018).1 Although meant as a joke, the truth is that male contraception would
be an attractive option in the future to reduce the responsibility of contraception from women. Historically,
contraception for men has been less optimal: abstention, which is not a solution; withdrawal, an ineffective
method; condoms, which are not always effective; and a vasectomy, which is a permanent solution, and daunting
for many people (Bakare, 2019).2 Thus, the question arises: why don’t we have a male contraceptive pill yet?
Contraception has existed since around 1850 BC, yet the pill, a more modern invention, was just introduced in
the 1950s, facing large opposition, even in the 21st century, from governments and religions. However, it is visible
how the birth control pill has revolutionized countless lives of women. Today, we debate the male birth control
pill: its intricacies and difficulties. Unfortunately, research on hormonal and non-hormonal treatments has been
conducted for decades, yet the side effects, on-going drug trials, and the conception of shared contraceptive
responsibility, pose important barriers to male birth control.
CONTEXT
1 Majumdar, M., 2018. Safe, Effective Male Contraceptive Pill - The Long Wait. [online] Medindia. Available at:
<https://www.medindia.net/patients/patientinfo/safe-effective-male-contraceptive-pill-the-long-wait.htm> [Accessed 2
December 2021].
2 Bakare, T., 2019. ‘The pill’ for guys: Male birth control option passes safety tests: UT Southwestern - MedBlog.
[online] Utswmed.org. Available at: <https://utswmed.org/medblog/pill-guys-male-birth-control-option-passes-safety-tests/>
[Accessed 2 December 2021].

2. 2
Birth control is a method of preventing pregnancy, also known as contraception. There are various types
of contraception, such as, preventing sperm from reaching the eggs, stopping ovulation, thickening the cervical
mucus preventing sperm entering the uterus (Rinkunas, 2016),3 and sterilization, which impedes a woman getting
pregnant (Birth Control | Contraception | Contraceptives | MedlinePlus, 2021).4 Each of these methods suits
different people, situations, and preferences. However, the main drawback of these contraceptives is that they are
mainly for women, and the few that are intended for men are less effective.
Female vs. Male Contraception
If there are so many birth control methods for women, then why not the same for men? The exponential
difference, which separates the population into two, seemingly unequal markets, is a fairly basic physiological
difference: birth control pills trick the ovaries with hormones to make them believe a woman is pregnant so
ovulation will stop, whilst there is no similar situation for male sperm production, as it never stops, the way
ovulation does (Rinkunas, 2016).5 Unfortunately, such a key difference interrupts the mirroring of a similar
contraceptive for men, and leaves researchers and scientists to find alternative options to aid prevent pregnancies.
Moreover, another clear difference between the classes would be that as women usually release one egg
every month, men produce 1,000 sperm per second, and even if new sperm production is obstructed, men could
still impregnate women for three months. Additionally, as men are fertile for much longer than women,6 and
contraception proves to be a continuous issue for them, reversible birth control for sperm-wielders would take
3 Rinkunas, S., 2016. The Reason We Don't Have Male Birth Control Is Simpler Than You Think. [online] The Cut.
Available at: <https://www.thecut.com/2016/07/real-reason-we-dont-have-male-birth-control.html> [Accessed 2 December
2021].
4 Medlineplus.gov. 2021. Birth Control | Contraception | Contraceptives | MedlinePlus. [online] Available at:
<https://medlineplus.gov/birthcontrol.html> [Accessed 2 December 2021].
5 Rinkunas, S., 2016. The Reason We Don't Have Male Birth Control Is Simpler Than You Think. [online] The Cut.
Available at: <https://www.thecut.com/2016/07/real-reason-we-dont-have-male-birth-control.html> [Accessed 2 December
2021].
6 https://www.nichd.nih.gov/. 2021. How common is infertility?. [online] Available at:
<https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common> [Accessed 2 December 2021].

3. 3
longer to manufacture for the physiological differences between these alone, notwithstanding the side effects and
funding issues that present simultaneously (How common is infertility?, 2021).
DRUG TRIALS
Considering the anatomy of the male reproductive system, researchers seek different pathways to
implement and manufacture a male birth control pill. As the differences between the female and male reproductive
organs are prominent and key into this discussion, alternatives to the pill are also being manufactured, with the
same intent: serving as male birth control. Below, the essay will explore the first male contraceptive: Gossypol;
RISUG, a more current alternative; 11-beta-MNTC, a hormone contraceptive initiative; and Vasalgel, a sperm
blocking gel.
Side Effects
An important aspect of male contraception methods are the side effects that these may present. Like the
female birth control pill, a key aspect of it is that the effects are efficient, but most importantly reversible. Whether
the male pill would lower testosterone levels, sperm swimming capabilities, or sperm production numbers, it is
essential that the pill produced can obtain easy reversal and allow regular sperm production in the future, seeking
to prevent unintended pregnancies, yet not sterilize men and lower birth rates. Furthermore, another side effect
considered is lowered sex drive and erectile dysfunction. Some male contraceptives that are no longer utilized,
seeked to lower testosterone levels and thus, sperm production, however, blocking these hormones to the extent
necessary could result in these unintended consequences.
Gossypol

4. 4
One of the first avenues to non-hormonal male contraception was Gossypol. During the late 1970s,
Chinese researchers began extensive studies and clinical trials on the consumption of gossypol, a derivative of
cotton plant, as a male contraceptive, which reduced fertility. Two large phase III studies involving more than
8000 men concluded that gossypol reduced both sperm production and sperm motility (Meriggiola and Gemzell-
Danielsson, n.d.),7 and reported high efficacy, reversibility, and few side effects (Gossypol, 2018).8 The promising
compound, with 90% efficacy, unfortunately was largely abandoned as it caused troubling hypokalemia, and
around 20% of men did not have a return of fertility (Meriggiola and Gemzell-Danielsson, n.d.).9
RISUG
The Reversible Inhibition of Sperm Under Guidance (RISUG), is an injectable compound gel currently
under phase III clinical trial in India. It is a no-scalpel technique which provides contraception for at least 8 to 10
years (Thakur, Choudhary, Mehta and Kumar, 2013).10 RISUG is administered into the vas deferens, which is the
duct that conveys the sperm from the testicle to the urethra, and as it comes into contact with the spermatozoa
(sperm) it causes and imbalance on the sperm membrane, causing it to swell and rupture the acrosome (head) and
leak enzymes necessary for fertilization (Thakur, Choudhary, Mehta and Kumar, 2013).11 The membrane
disruption and release of enzymes can be seen in Figure 1. Although studies are continuously being conducted,
these are not yet approved for human trials and thus, even the effectiveness of RISUG and its simple reversal
qualities are yet to be further investigated.
7 Meriggiola, M. and Gemzell-Danielsson, K., n.d. Female and Male Contraception.
8 ScienceDirect. 2018. Gossypol. [online] Available at: <https://www.sciencedirect.com/topics/agricultural-and-
biological-sciences/gossypol>[Accessed 2December 2021].
9 Meriggiola, M. and Gemzell-Danielsson, K., n.d. Female and Male Contraception.
10 Thakur, V., Choudhary, M., Mehta, V. and Kumar, D., 2013. RISUG: A new perspective in non–hormonal male
contraception. [online] ScienceDirect. Available at:
<https://www.sciencedirect.com/science/article/pii/S2305050013601384> [Accessed 2 December 2021].
11 Thakur, V., Choudhary, M., Mehta, V. and Kumar, D., 2013. RISUG: A new perspective in non–hormonal male
contraception. [online] ScienceDirect. Available at:
<https://www.sciencedirect.com/science/article/pii/S2305050013601384> [Accessed 2 December 2021].

5. 5
Figure 1.
Membrane disruption due to RISUG interaction
Source: Thakur, V., et al., 2013. RISUG: A new perspective in non–hormonal male contraception. [online]
11-beta-MNTDC
The new phase I trial male pill, led by researchers at the University of Washington School of Medicine
along with UCLA, in the US, has seen positive results. There were 40 men included in the study, though at least
60 to 90 days are required to affect sperm production levels, and the side effects: mild fatigue, acne and headache,
would be reversible after stopping treatment (Phase I trial of 11-beta-MNTDC reveals positive results, 2021).12 It
works by mimicking testosterone, and for the 30 who took the experimental drug, showed that the levels of
hormones needed for sperm production dropped significantly compared to those taking the placebo, and then
returned to normal levels after the trials (Male pill - why are we still waiting?, 2021).13
12 Clinicaltrialsarena.com. 2021. Phase I trial of 11-beta-MNTDC reveals positive results. [online] Available at:
<https://www.clinicaltrialsarena.com/news/trial-11-beta-mntdc/> [Accessed 2 December 2021].
13 BBC News. 2021. Male pill - why are we still waiting?. [online] Available at:
<https://www.bbc.com/news/health-47691567> [Accessed 2 December 2021].

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Vasalgel
The new male contraceptive under development is called Vasalgel, a polymer (molecular structure of
similar units bonded together) that when administered into the vas deferens, it sets as a gel, blocking the flow of
sperm (Vasalgel - Revolution Contraceptives, 2021).14 Like a female IUD, it is expected to have a long-acting
effect, and be removed once future fertility is desired. Recent rabbit studies suggest and depict a rapid restoration
of sperm flow after flushing the vas deferens (Vasalgel - Revolution Contraceptives, 2021).15 Nonetheless, more
clinical testing is still required to determine the years the effect of Vasalgel will last.
SHARED CONTRACEPTIVE RESPONSIBILITY
A major impediment to the male contraceptive pill is the responsibility. In a relationship, or a casual
situation, it is fairly dubious whether the woman would trust the man would actually take the pill. Subsequently,
the woman would continue to take plan B, and thus decrease the importance or demand of male birth control, not
being a good quality for the market and to gain funding. Actually, a poll done by the University of Teesside
showed that while men would welcome it, their partners did not believe they could be trusted to take the
contraceptive pill regularly, and even a portion of men said they would not trust themselves to take the pill
everyday, possibly leading to unintended pregnancies (Can men be trusted to take male contraceptive pill?,
2021).16
CONCLUSION
14 Revolution Contraceptives. 2021. Vasalgel - Revolution Contraceptives. [online] Available at:
<https://www.revolutioncontraceptives.com/vasalgel/#1519942596148-cf1108da-58bd> [Accessed 2 December 2021].
15 Revolution Contraceptives. 2021. Vasalgel - Revolution Contraceptives. [online] Available at:
<https://www.revolutioncontraceptives.com/vasalgel/#1519942596148-cf1108da-58bd> [Accessed 2 December 2021].
16 Science Daily. 2021. Can men be trusted to take male contraceptive pill?. [online] Available at:
<https://www.sciencedaily.com/releases/2010/01/100128110227.htm> [Accessed 2 December 2021].

7. 7
Today, the aforementioned contraceptives (and others) are under extensive research and development.
However, the adversities that most of the pharmaceutical companies producing these products face, as discussed
above, could potentially halt the investigations, especially considering how this research began in the 1970s, and
an effective pill for men is yet to be concluded, or presented. The lack of funding for research is an important
consideration for the issue, yet the most substantial impediment are the side effects that the current hormonal and
non-hormonal methods are trying to reduce and prevent to achieve a, truly, reversible birth control.

8. 8
REFERENCES
Bakare, T., 2019. ‘The pill’ for guys: Male birth control option passes safety tests: UT Southwestern -
MedBlog. [online] Utswmed.org. Available at: <https://utswmed.org/medblog/pill-guys-male-
birth-control-option-passes-safety-tests/> [Accessed 2 December 2021].
BBC News. 2021. Male pill - why are we still waiting?. [online] Available at:
<https://www.bbc.com/news/health-47691567> [Accessed 2 December 2021].
Clinicaltrialsarena.com. 2021. Phase I trial of 11-beta-MNTDC reveals positive results. [online]
Available at: <https://www.clinicaltrialsarena.com/news/trial-11-beta-mntdc/> [Accessed 2
December 2021].
Majumdar, M., 2018. Safe, Effective Male Contraceptive Pill - The Long Wait. [online] Medindia.
Available at: <https://www.medindia.net/patients/patientinfo/safe-effective-male-contraceptive-
pill-the-long-wait.htm> [Accessed 2 December 2021].
Medlineplus.gov. 2021. Birth Control | Contraception | Contraceptives | MedlinePlus. [online]
Available at: <https://medlineplus.gov/birthcontrol.html> [Accessed 2 December 2021].
Meriggiola, M. and Gemzell-Danielsson, K., n.d. Female and Male Contraception.
Revolution Contraceptives. 2021. Vasalgel - Revolution Contraceptives. [online] Available at:
<https://www.revolutioncontraceptives.com/vasalgel/#1519942596148-cf1108da-58bd>
[Accessed 2 December 2021].
Rinkunas, S., 2016. The Reason We Don't Have Male Birth Control Is Simpler Than You Think. [online]
The Cut. Available at: <https://www.thecut.com/2016/07/real-reason-we-dont-have-male-birth-
control.html> [Accessed 2 December 2021].

9. 9
ScienceDirect. 2018. Gossypol. [online] Available at:
<https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/gossypol>
[Accessed 2 December 2021].
Science Daily. 2021. Can men be trusted to take male contraceptive pill?. [online] Available at:
<https://www.sciencedaily.com/releases/2010/01/100128110227.htm> [Accessed 2 December
2021].
Thakur, V., Choudhary, M., Mehta, V. and Kumar, D., 2013. RISUG: A new perspective in non–
hormonal male contraception. [online] ScienceDirect. Available at:
<https://www.sciencedirect.com/science/article/pii/S2305050013601384> [Accessed 2
December 2021].