Health Science Reviews

by Pheziwe Luleka Mshunqwane

Men, know your current and future options. Save you and your partner from the trouble of unplanned pregnancy.

Despite the fact that female contraceptives are very successful at preventing unwanted pregnancies, they have proven to be unsafe for certain women who suffer from other health conditions, leaving some couples without access to reliable contraception. This opened a great need for the development of male contraceptives to ensure the prevention of unplanned pregnancies that is estimated to account for approximately half of all pregnancies, totalling to 121 million each year throughout the world, according to the State of World Population 2022 report, published by UNFPA, the United Nations sexual and reproductive health agency.

In addition, a lot of men have shown interest in actively participating in family planning. Condoms and vasectomy are currently the only two reliable male contraceptive methods, while neither is ideal for all men and present with shortcomings which continue to lead to unintended pregnancies in the presence of its use.

Therefore, research and development are being done on innovative male contraceptives. The pros and cons of condoms and vasectomies will be briefly discussed in this blog, followed by an insight into the newly invented male contraceptives under experiment.

CURRENTLY AVAILABLE METHODS:

Vasectomy is a surgical procedure wherein, the vas deferens is physically cut on both sides through a minor scrotal incision. This contraceptive method is currently the most effective for males, with a failure rate of less than 1% and few severe side effects. The main disadvantage of vasectomy is the 3–4-month delay in the start of the azoospermia. Though reversable through vasovasostomy surgery, vasectomy is advised for men with no plans of becoming fertile in the future.

Condoms have been the commonly used male contraceptives for many centuries. The main advantage of these condoms, they offer protection from a wide range of STDs, including the HIV virus and they present with less side effects. However, one of its major disadvantages is its minimal contraceptive effectiveness, which is primarily due to poor use or breakage, which happens in up to 4% of cases, resulting in unintended pregnancy accounting for about 15-20% annually.

EXPERIMENTAL METHODS:

Male contraception methods involve the intake of exogenous testosterone which causes the reduction of sperm production. This method does this by decreasing the release of LH and FSH through negative feedback at the pituitary and hypothalamus. After 8–12 weeks of testosterone therapy, low FSH and LH levels in most men cause a noticeable decrease in sperm production. Sperm counts revert to pre-treatment levels around 3 to 6 months after testosterone use is stopped.

Nonhormonal male contraception is a form of male contraception that does not include the administration of testosterone or substances that inhibit the secretion or activity of testosterone. Therefore, this form of contraception does not affect the testosterone levels or sextual function compared to hormonal methods. Furthermore, these contraceptives may be easier to dose orally than most steroid preparations, which tend to deteriorate quickly because testosterone undergoes considerable first-pass metabolism in the liver and intestinal wall.

In summary, to avoid unwanted pregnancies, contraception is crucial. Currently, condoms and vasectomy are the male contraceptive methods used by more than 30% of couples. Limitations of these presently used methods have necessitated the invention of the new emerging male contraceptives. However, despite considerable clinical testing, hormonal-based male contraception procedures have been observed to have unidentified long-term side effect profiles and only partially reduce spermatogenesis in all men. In pre-clinical investigations, nonhormonal treatments under development show promise; nevertheless, substantial testing of these strategies is still necessary before human studies can be conducted to ascertain their effectiveness in preventing unwanted pregnancy.

References

Amory, J. K. (2016). Male contraception. Fertility and sterility, 106(6), 1303-1309.

Amory, J. K. (2020). Development of novel male contraceptives. Clinical and Translational Science, 13(2), 228-237.