Why are we still waiting for the male pill?

Despite decades of promising research, the many men who want their own contraceptive pill still have nothing. One of them, Andy Extance, looks at the obstacles – practical, political, economic – and meets the people hoping to make male birth control a reality.

Had there been a male contraceptive pill in 1976, I probably wouldn’t be here to write this. That was the year when, after my mum – may she rest in peace – had been on the pill for 12 years, health worries made her doctor tell her to come off it. “She said to the doctor, ‘I’ll get pregnant’,” my dad recalls. “And within a very short while, she was.” He explains, much to my discomfort, that although my parents switched to condoms, I was conceived because “sometimes you feel reckless”. But if a male pill had existed, my dad says, he’d definitely have used it.

So why didn’t it exist? It certainly wasn’t because of a lack of scientific interest. Gregory Pincus, who co-invented the female contraceptive pill, first tested the same hormonal approach on men in 1957, and various hormonal and non-hormonal methods have been explored since. And although attitudes among those who might use a male pill were once thought to be a daunting obstacle, it’s now clear that many men want a new option.

Despite this, we’re still waiting. Developing a method that men would accept has brought decades of frustration, yet researchers are as confident as they can be that they’re close to overcoming the scientific barriers. But, crucially, drug makers’ commitment to contraceptives has always been tentative, particularly when it comes to products for men – and today, the whole contraceptive industry is struggling. Now, the multimillion-dollar question seems to be: Who is actually going to make the male pill happen?

Reference:

• Jonathan Eig’s The Birth of the Pill, which looks at the history behind the development of the female contraceptive pill.
• A 2002 paper by Elsimar Coutinho outlining the effects of gossypol.
• The 2005 German study that asked over 9,000 men whether they’d use a contraceptive method “capable of preventing sperm production”.
• Susan Walker’s 2011 paper that looked at both male and female attitudes towards a male contraceptive pill in the UK.
• Richard Anderson and colleagues’ study of attitudes towards hormonal male contraception in Edinburgh, Cape Town, Shanghai and Hong Kong.
• The 2008 paper outlining the Organon–Schering hormonal contraceptive clinical trial.
• The press release outlining the early end of the WHO–CONRAD progestogen–testosterone trial.