Wednesday, November 20, 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.
Renee C. Byer / P-I
Connie Pete, a research technician at the University of Washington, carries specimens to analyze while her computer displays a study of morphology.
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."
"Women have always said, 'When is it going to be the man's turn?' "
P-I reporter Kathy George can be reached at email@example.com
Male birth-control pill studied