Condoms and the Elusive Male Contraceptive Pill

What do you do if you want to avoid having a baby? If you’re a woman, you’ll probably head down to your local doctor. They’ll reel off a smorgasbord of choices. There’s:

• Sterilisation (i.e. tubal ligation)
• Abstinence
• The Female Condom
• Diaphragms
• IUD’s (Mirena)
• Hormonal implants
• Contraceptive injections (Depo Provera)
• The vaginal ring
• The oral contraceptive pill and the list goes on.

Each has its benefits and drawbacks.

If you’re a man, going to your doctor would be a waste of time as the story is very different. Options for male contraception are condoms, withdrawal, vasectomy or abstinence. That’s right, four choices, including doing without.

These choices also have benefits and drawbacks. For example withdrawal or coitus interruptus, is cheap and requires no planning or preparation. This method simply relies on the man leaving the station early so his semen doesn’t enter the vagina. Sounds good, until you read the failure rate that is thought to be up to 25%.

In comparison, a vasectomy offers top notch success rates, with a one in 1,000 chance of falling pregnant. Further adding to its appeal, vasectomy is a permanent birth control solution with no ongoing maintenance required. But, that’s also its biggest drawback. It is permanent. Under local anaesthetic, a doctor cuts the tube that carries sperm from the testicles (where sperm is produced) to the penis, effectively sterilising the man. The operation is usually reversible, but success is not guaranteed.

This brings us to condoms. These little rubber raincoats are between 95% and 99% effective. They protect against pregnancy and lower the risk of contracting a sexually transmitted disease. They’re also relatively cheap. But, to use condoms you need to plan ahead (so you’ve got one on hand) and they have a tendency to disrupt proceedings.

The History of Condoms

The interesting thing about condoms is that they’re one of the oldest forms of contraception. A cave in France contains the earliest known depiction of a condom, thought to be 15,000 years old. Condoms made of linen were used in ancient Egypt, and condoms made of sheep intestine were used in 17^th century England.

The world of condoms remained much the same until the 1830s when Charles Goodyear (of Goodyear tyre fame) discovered a way to vulcanise rubber. This process converts natural rubber (the liquid that drips from a rubber tree when it’s tapped) into a durable material, and paved the way for the birth of the modern, err rubber.

The first rubber condoms were thick and smelt of sulphur. Yep, sulphur famous for smelling like rotten eggs. Surprisingly the smell wasn’t a contraception in itself. Then in the 1920s the first latex condoms were produced.

From here the popularity of this cheap, effective form of contraception slowly grew. Initially driven by the need to have fit, healthy (venereal disease free) soldiers, and continuing through the sexual revolution of the 1960s and the AIDS epidemic of the 1980s.

Today, you can grab one at your local pharmacy, supermarket, from the servo or the dispenser in the loo at the pub. They come in many shapes, sizes, textures and flavours. You can even customise a condom with your photograph (strange but true). If you’re keen, visit ripnroll.com.

What’s Missing from Male Contraception?

An equivalent to The Pill, the revolutionary drug Australian women have been taking for more than 50 years, has proved elusive.

Researchers’ efforts have fallen into two main categories: targeting testosterone to stop the production of sperm, and preventing healthy sperm from reaching the vagina.

One potential solution currently in development is Vasalgel. This contraceptive would block the tubes that are cut in a vasectomy, by injecting a gel. Should the man wish to conceive down the track, another injection would flush out the blockage and restore his fertility.

Clinical trials for Vasalgel are expected to start within 12 months and, if all goes well, the product could be available in the United States as early as 2018. But, this is not the first time headlines have claimed a male contraceptive solution is imminent, and these past attempts to develop one have vanished.

The reason might surprise you. Sure, it’s more difficult to block the thousands of sperm a man produces each minute then it is to block the single egg a woman produces each month. But, this isn’t the biggest stumbling block.

The biggest hurdle has been money. How important is a male pill when there’s already a range of female contraceptives available? How important is a male pill when the money could go to finding a cure for cancer or AIDS?

Also, would men take a pill? Would they remember to take it? Would their female partners trust them to take it? Pharmaceutical companies aren’t investing in research because they don’t believe the market for a male pill will justify the cost.

But, for all these questions one is missing. Do men have effective control of their fertility and reproduction without access to a contraceptive drug?