Are We On The Brink Of A Contraceptive Revolution?
Gone are the days when condoms and pills were the only options for birth control—the last few years have proven to be a golden age of contraceptive science. From male pills to IUDs, here are a few safe and effective alternatives that are in the works.
It's 2022 and conversation around safe sex is at an all-time high. Accessible, safe and effective modes of protection and contraceptives is indispensable for optimal global healthcare, especially since women (or people with a uterus) have not only faced the pressure of being on birth control and family planning, but also have their bodily autonomy encroached by unaccommodating laws and expensive resources. Putting aside major surgical options like hysterectomy or tubal ligation, even hormonal pills or injections are known to have both physical and mental side effects. In fact, a 2020 study of 24 women (published in the European Journal of Contraception and Reproductive Health Care) concluded that the negative impact of hormones on their mental health reduced their sexual drive as well as made them reluctant to try that method again.
On the other hand, male contraceptives have either been sidelined or provided very few options—single-use methods like condoms or surgical procedures like vasectomies. This is where ongoing research steps in—remarkable improvements have been made in the last few years in terms of hormonal and non-hormonal birth control across all sexes. These methods need to be safe, effective, controllable and easily available. The following are a few instances of such developments, accessibility of which could further help prevent unwanted pregnancies, UTIs, STIs and promote safe sex among youngsters with reduced stigma and risk.
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1. Non-hormonal antibodies can immobilise sperm before it reaches the egg: So far, most contraceptives for people with a uterus target reduction of ovulation or thickening of the mucus lining of the uterus to prevent sperm entry. However, what if there was a way to immobilise the sperm right in its track? According to a 2021 study published in the Science Translational Medicine journal, scientists at the University of North Carolina at Chapel Hill (USA) may be on to something. As per their animal testing, monoclonal antibodies (known for their ability to fight invading germs—from cancer to COVID-19) can be used to immobilise sperm before it reaches the egg and render it ineffective. Further clinical trials are imminent, but a contraceptive based on these engineered antibodies could be a huge breakthrough in terms of highly effective and non-hormonal birth control.
2. Long-term, safe and reversible mode of birth control for men: Penile contraceptives have long been limited to condoms (single-use) or vasectomies. However, the American Chemical Society has published their research in a 2021 Nano Letters paper, which might be the ticket to a long-term, safe and reversible mode of birth control for men (or people with a penis). Research suggests that elevated temperatures around the testes can reduce sperm count, thereby reducing fertility. Taking this into account, scientists are aiming to create magnetic nanoparticles that can be injected into the bloodstream, guided to the testes and heated to prevent spermatogenesis. This procedure is biodegradable and reversible, as the materials are eliminated from the body within a month or two. So far, mice trials have reaped promising results for the future.
3. Oral Contraceptive Pills may reduce the risk of type 2 diabetes for PCOS patients: Polycystic Ovary Syndrome (PCOS) is a chronic metabolic disorder that is one of the commonest ailments affecting women (and people with a uterus) globally. It is a hormonal disorder associated with a plethora of physical and mental side effects—including irregular menstruation, hirsutism (excessive hair growth), hyperpigmentation, acne, weight gain, depression and twice the risk of type 2 diabetes. This is a concerning statistic, which is why a study published in Diabetes Care by a team from the University of Birmingham is a ray of hope. Through their research, it was concluded that combined oral contraceptive pills may reduce the odds of diabetes risk in people with PCOS by 26 percent. Since PCOS isn't curable per se, discoveries like these hold the key for highly reducing the distress of comorbidities in patients and providing better global healthcare.
Related story: Polycystic Ovarian Syndrome—Traits, Types and Treatment
4. IUDs are just as effective as tubal ligation: When it comes to irreversible and surgical modes of birth control, tubal ligation has long been held at a pedestal for folks with a uterus. It involves tying off of the fallopian tubes, through which the egg travels from the ovary to the uterus. A 2022 paper published in the Journal of General Internal Medicine says otherwise. According to scientists at the University of California (USA), hormonal intrauterine devices (IUD) have proven to be more effective than tubal ligation in preventing unwanted pregnancies, while copper IUDs are at least just as effective. Bonus points to IUDs for causing lesser side effects says the team of researchers. With over 83,000 patients and 6 years of study, they think that reversible but long-term processes like IUDs (each can last from 3 to 5 years) must be broached before permanent and major surgeries like tubal ligation.
5. This male contraceptive gel does not cause other symptoms of low-T: To reduce the burden of birth control on women and to broaden the horizons of options for people with a penis, the University of Utah (USA) has developed a hormonal contraceptive gel that is reversible and non-invasive (it is applied daily on the shoulders). This gel is made of a synthetic progesterone and replacement testosterone, thereby reducing sperm levels while maintaining sex drive and other testosterone-dependent functions. Supported by the National Institutes of Health, a clinical trial of 12 couples will monitor the participants for two years to determine the changes in sperm count levels due to the long-term use of the gel. If the trial proves to be successful, it will open up doors for a more equal participation in terms of safe sex.
6. A male hormonal pill may soon be available: In a similar vein as the contraceptive gel, more studies and innovations are cropping up to increase accessible and reversible modes of birth control for men/people with a penis. If data from The Journal of Clinical Endocrinology and Metabolism is noted, the first hormonal oral contraceptive pill for men/people with a penis just passed safety options. Named Dimethandrolone undecanoate (DMAU), the daily pill reduces two male hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — therefore reducing testosterone and sperm levels without causing other symptoms of low testosterone (low-T). As with current hormonal pills, minor side effects may include acne, fatigue, headaches and further studies will provide a more concrete view of how the drug impacts the body. What makes this option revolutionary is that it helps people share accountability and opt for a milder option than vasectomy, which is a surgical procedure and reversal is not always guaranteed.