CLEVELAND — The concept of male contraception is not new, but few options ever advance to human trials, mainly because of funding.
However, the latest treatment with promise is a hormonal gel that contains testosterone and a synthetic hormone called nesterone that reduces sperm production, but not sex drive. The gel is rubbed on the shoulder blades and shown to be 86% effective, but it takes time to work.
"This has to be taken every day," Cleveland Clinic urologist Dr. Scott Lundy says. "Whether it's as sensitive to timing as other oral contraceptives for females is unclear, but likely so, and it does need to be taken regularly and it takes several weeks to kick in. So for that first period of time, even if the product works perfectly, there are still plenty of sperm that have to find their way out before the sperm production stops."
The hormonal gel is entering the second half of phase 2 clinical trials, but it still needs to go through phase 3 testing, and that will take time and money.
"This process takes time, and we have to prove that these products are safe and efficacious, and that still remains to be seen," Lundy explained. "And while these recent results are promising, it is fascinating that the degree of sperm production that is allowable in a study like this is actually different than what we allow for a man after a vasectomy. So there's a lot of work left to be done, and while I think this product could be on the horizon, we still have some homework to do."
On average, it can take up to $2 billion to get a product through the FDA approval process and to market. While male contraception may receive some NIH funding and money from other sources, they typically don't have the big-dollar backing of pharmaceutical companies.
There are other male contraception options in development, one being a non-hormonal pill that blocks the Vitamin A receptor important in male fertility. The other is called ADAM, a non-hormonal gel injected into the vas deferens to block sperm without affecting sensation or ejaculation. The blocked sperm degrade become absorbed by the body naturally.
ADAM is being tested in Australia, and U.S. testing may begin next year. The manufacturer hopes to have it approved by 2027.