The Male Pill

July 26, 2013

By Medical Discovery News

“Birth control pills should be made for men. It makes more sense to unload a gun than shoot at a bulletproof vest.” While the first person to post the comment is unknown, it has since been posted on many a Facebook wall, Pinterest board, and Twitter feed. But science has long been working on such a pill, which is now undergoing clinical trials.

While more than 100 million women take the pill for contraception, it remains a topic of controversy in the realms of religion and politics. It works by using synthetic estrogen and progesterone hormones to prevent ovulation, the production of an egg. No egg equals no possibility of pregnancy.

The male pill that is currently being evaluated as a contraceptive also relies on hormones, a combination of progesterone and testosterone (or an equivalent). Progesterone lowers the levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Both are essential for stem cells to develop into sperm and mature, a process called spermatogenesis. Just as no pregnancy can occur without an egg, likewise pregnancy cannot occur without mature sperm to fertilize the egg.

So far, one version of the male pill has been tried in limited studies of about 50 men with 100 percent effectiveness. However, it comes with some side effects. Since LH reduces testosterone levels, a man taking the male birth control pill must also take extra testosterone. Low testosterone causes low sex drive, depression, infertility, and hair loss.

However, new research has developed a non-hormonal approach to male birth control that appears to have great promise. Scientists at Baylor College of Medicine and Harvard University have identified a small molecule called JQ1 that sticks to a protein in immature sperm cells called BRDT. Normally, BRDT allows sperm to become fully mature by binding to specific areas in the genome and causing genes to activate. But JQ1 binds to BRDT and prevents it from effectively interacting with the genome, so genes are not turned on and the sperm cells do not develop. So far, these experiments have only been performed in mice, but their sperm count was reduced by 90 percent and the motility of the remaining sperm was reduced by 75 percent.  When male mice are on this treatment, they are essentially sterile. 

Furthermore, there were no observable side effects; in fact, testosterone levels remained the same. And when JQ1 treatment was stopped, sperm development and fertility returned to normal. Currently, JQ1 is injected, so an oral pill form would need to be developed for widespread acceptance. The next step is to begin clinical trials to test safety, efficacy, and long-term effects in humans.

While this treatment requires further research, in the future it may take some of the pressure to swallow “the pill” off women, especially since female birth control comes with its own set of side effects and long-term health issues. A male birth control pill may even shift the responsibility to prevent pregnancy and take an active role in family planning to men, which may then be met with a sigh of relief from the other half of the population.

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