Family Forum / Parenting / Parenting / July 2004

http://seattlepi.nwsource.com/local/96391_malepill20.shtml

this article appeared in Nov. 2002

Male birth-control pill studied

By KATHY GEORGE
SEATTLE POST-INTELLIGENCER REPORTER

"Don't worry, honey, I'm on the pill."

Some day soon, that could be a man speaking.

Doctors at the University of Washington are renewing long-stymied efforts to
develop a birth-control pill for men, who haven't had a new contraceptive
product since the condom's invention centuries ago.

The UW researchers plan to recruit about 50 men to test a tablet that, like
the female pill that spawned the sexual revolution of the 1960s,

uses hormones to trick the body.

But instead of suppressing a woman's egg once a month, this new pill would
block millions of sperm produced by a man each day.

"It actually is somewhat harder, biologically, to turn off the production of
all sperm," said Dr. William Bremner, director of the UW's Male
Contraception Research Center, just created with a $9.5 million, five-year
federal grant.

Bremner has been working on male contraceptives for 25 years. Research in
the field has moved slowly, he said, because society as a whole -- and the
American pharmaceutical industry -- still believe that preventing pregnancy
"is really a female issue."

"I just do not see pharmaceutical companies in general stepping up to fund
this kind of research," Bremner said. "The American companies -- it's hard
to get them to talk to you."

It boils down to this: If a safe and effective pill is marketed, will men
buy it?

Zach Beck, 19, thinks so. He's been taking a birth-control pill every day --
and receiving weekly hormone injections -- as part of a preliminary,
month-long UW study of hormone levels that will help guide future studies.

"I really don't mind it. It's really safe," said Beck, a UW sophomore who is
being paid $300 for his participation.

"Just using condoms, they break," he said. "It's a big hassle, trying to get
24-hour emergency contraception . . . I'd so much rather take a pill every
day, just for that extra assurance."

Bremner and his colleagues agree men want alternatives.

"They just don't have a lot of options," said Dr. John Amory, one of the
principal investigators at the new center.

As it is, men account for just 30 percent of contraceptive use in the United
States. Half of that is condoms, the other half vasectomies. Both have
drawbacks.

For one thing, condoms aren't cheap. And many men dislike them because they
decrease sensation and can spoil the mood, Amory and Bremner said.

They also fail frequently. A couple relying exclusively on condoms for a
year has a 10 percent to 15 percent chance of pregnancy, Amory said.

Vasectomies, on the other hand, guarantee infertility, but some men are
squeamish about the surgery.

A male birth-control pill would allow men better control over their own
fertility, Amory said. It also would take some of the birth-control burden
off of women.

That's where the social implications loom large.

"It is a little bit of a tricky concept that a male would take a pill to
prevent a health risk (pregnancy) in a female," Bremner said.

Amory added, "The question I get asked at cocktail parties is: 'Would women
trust men to use it?' "

Beck, the student, said he wouldn't expect that.

The pill "would be for my assurance, not for my partner's."

Chris Charbonneau, president of Planned Parenthood of Western Washington,
welcomes a male pill, saying men would benefit from having more say over
pregnancy risks.

But birth control, if not seen as a woman's domain, still may be viewed as
fundamentally wrong in some quarters.

Sharon Park, director of the Washington State Catholic Conference, said,
"The church's position hasn't changed. We oppose the use of artificial
contraceptives. It wouldn't matter if it was male or female.

"We believe that sexual intercourse should only take place in marriage,"
which should be open to procreation, she said.

Partly because of religious and social concerns, male contraceptive research
has been neglected, Bremner said.

Only two companies, both in Europe, have been funding the research. Without
the $9.5 million grant from the National Institutes of Health, the UW's male
contraceptive work would have stopped, he said. The grant decision was
scientific, not political, he added. After Congress directed the institutes
to create contraceptive centers, Bremner applied for a grant and scientists
approved it, he said.

One company, Holland-based Organon, paid for some of Bremner's previous work
and claims it can bring a hormone-based injection for men to the market
within three to four years, Bremner said.

Long-term safety data is lacking for the male birth-control shots. But
short-term studies show they prevent pregnancy about 97 percent of the time,
making them about as effective as the female pill, the UW doctor said.

The UW researchers hope to develop a male pill that's as effective as the
shots, Amory said, and are trying to determine why the pill reduces but does
not stop sperm production in some men.

Here's how the pill should work.

"The testicle makes two things -- testosterone and sperm," Amory explained.
The pill uses external testosterone to shut down the brain's signals to the
testicle, which stops making sperm and internal testosterone. "It leaves the
guys with a healthy amount of testosterone so that they feel fine," the
doctor added.

Adding progestin has improved the male pill's effectiveness to about 95
percent, still a little short of the injection's prevention rate, Amory
said.

The UW's newly funded work goes beyond the pill. Researchers at the UW and
Washington State University are studying what controls sperm production,
hoping to identify an agent in the testis that -- unlike testosterone -- has
no other function.

Normally, testosterone travels through the man's body, stimulating muscle
mass, beard growth, sexual interest and prostate growth as well as sperm
production. Birth control would have fewer side effects if it used an agent
more specific to sperm production, Bremner explained.

The shorter-term goal, however, is a pill that stops sperm production but
keeps behavior, sexual function and metabolism normal and reduces the risk
of prostate disease.

With adequate research support, it can be done, Bremner said. And it should
be done.

"The burden of reversible contraception falls heavily on the female," he
said. "It's hard to justify that there haven't been any new male methods."

Charbonneau agrees.

"Women have always said, 'When is it going to be the man's turn?' "

P-I reporter Kathy George can be reached at kathygeorge@seattlepi.com