Male contraception: a nasal spray in 2021

Male contraception is at hand. A British team says it will be available in 2021.

The list of effective contraception is long. But it relates almost exclusively women. Besides condoms and vasectomy, no methods target the male. An inequality that may soon disappear.
Several teams are striving to further involve these gentlemen in controlling fertility. One of them announced that on October 25, his strategy will be available in 2021.
Researchers from the University of Wolverhampton (UK) have developed a pill that also comes in the form of a nasal spray.

Developed with a Portuguese team, this method acts directly on sperm motility: it makes immobile, preventing them from reaching the egg to fertilize it. A fully reversible effect since it only lasts a few days. To believe the researchers, the molecule acts quickly. In pill or spray, it should be used just before sex. Its action takes effect after a few minutes.

Double injection hormone
Besides this communication very enthusiastic, male contraception is also talked about in the scientific literature. The Journal of Clinical Endocrinology & Metabolism (1) publishes indeed a clinical phase II trial that assesses safety and efficacy of an intramuscular injection of two hormones – norethisterone (long-acting progesterone) and a form of testosterone . The approach is quite different: it is the time to reduce the number of sperm produced and released during ejaculation.

320 healthy men took part in this test. Aged between 18 and 45, they were to be monogamous with a woman of reproductive age. Throughout the research, they delivered regularly sperm samples.

The first phase consists of a ramp-up: 26 weeks, injections were performed to reduce sperm count below the threshold of one million units per milliliter of ejaculate. Then, two injections were prescribed every eight weeks.

4 pregnancies
It is only after the minimum number of sperm was reached that couples could abandon the emergency contraception. 274 for men, this level was reached after 24 weeks. Thereafter, only 4 pregnancies were reported. This corresponds to a rate of 1.57%. “The contraceptive efficacy is high, especially if compared to other reversible methods in humans; it is comparable to the effectiveness of a female oral contraception, “the authors say.

Not surprisingly, the approach must be further refined as some side effects are heavy. Depression and mood disorders are still too frequent. Others seem easier to live: an increase in libido is possible. The balance sheet remains positive with 75% of participants say they are ready to continue this long-term contraception. “The combination of hormones should be investigated further in order to develop a good balance between safety and efficiency,” admits Mario Reyes Festin Philip, the World Health Organization – which is partially funding this work.

(1) The study was financed by the United Nations Development Programme, the United Nations Population Fund, UNICEF, WHO, the World Bank program for research, development and training in human reproduction, CONRAD program – partially funded by the Bill & Melinda Gates Foundation and the US Agency for International development. The Schering AG has provided injectable hormones.