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The Future of Male Contraception in a Post-Roe Society

On June 24, 2022, the Supreme Court of the United States overruled Roe v. Wade, the famous 1973 court case recognizing the Constitutional right to abortion [1]. The ruling has sparked changes across the nation with several states tightening their abortion regulations in accordance with the Supreme Court, making abortion less accessible for those who may need it.


With safe abortions no longer serving as an option for pregnancy termination, greater stress has been placed on the need for safe and effective contraception. Contraception currently exists in many forms, but numerous studies show that most forms of effective female contraception can be very dangerous to users.


The most well-known and commonly used contraceptive today is the oral birth control pill. In fact, the NIH finds that “approximately 25% of women aged 15 to 44 who currently use contraception reported using the pill as their method of choice” [2]. The oral pill is a hormone-driven contraceptive, typically containing estrogen and progesterone, that is designed for females and taken daily. Studies show that it is about 93% effective [3], but it results in a number of concerning side effects. According to Paula Cohen, professor of genetics at the College of Veterinary Medicine at Cornell University, the oral pill may result in blood clots, cardiovascular issues, and an increased risk of developing breast cancer [4]. Additionally, the oral pill, like most other common forms of effective contraception, is often controversial because it places the burden of preventing pregnancy on women and limits male responsibility [5].


It’s time for society to focus its attention on male contraception.


Male contraception offers an up-and-coming, safe alternative to current birth control methods. Although an understudied field, male contraception has begun to show promising results for pregnancy prevention.


Researchers with the American Chemical Society have developed a non-hormonal contraceptive pill that targets the retinoic acid receptor alpha (RAR-α), a protein involved in sperm formation, in mice. The pill contains a compound called YCT529 that has an inhibitory role on RAR-α. Through veterinary clinical trials, the researchers found that YCT529, when ingested orally for four weeks, dramatically reduced sperm counts and was 99% effective in preventing pregnancy. No side effects were presented, and the mice were able to reproduce again 4-6 weeks after discontinuing the treatment [5]. In light of these positive results in mice, the researchers are in the process of beginning human clinical trials to future test the prospective contraceptive.


Another male contraceptive with recent, promising results is called Nestorone®/Testosterone gel, or NES/T. NES/T is a hormone-based product in the form of a clear gel that minimizes sperm production. The user would apply the gel on each shoulder blade daily. If a user stops using the gel, their sperm levels will return to normal in about four months [6]. The gel has proven effective and safe in Phase 2 of the study, and researchers are hopeful that it will continue to produce results that will allow a Phase 3 study [6].


Researchers at Cornell University ​​are also working on developing a form of male contraception that targets sperm production. Currently, they are identifying the genes that control meiosis in mouse models. [4] With this information, the researchers intend to install a reliable and reversible “on/off switch” on the mice genes using genome-editing technology [4] which would have the ability to successfully regulate spermatogenesis. The research study is in Phase 2, and researchers are optimistic about the data to come, including results regarding the side effects of the contraceptive, if they exist.


In a post-Roe world, it is more important than ever that individuals have access to contraceptives if they choose to engage in sexual activity. It is also critical that women are not left to carry the responsibility of preventing pregnancy and suffer the side effects of common contraceptives on the market. Male contraception has the potential to integrate a greater sense of fairness in society and ensure the well-being of all of the individuals in a relationship. Great innovation is to come in the field of male contraception.


References

  1. Supreme Court Case: Dobbs v. Jackson Women’s Health Organization. (n.d.). Center for Reproductive Rights. Retrieved November 20, 2022, from https://reproductiverights.org/case/scotus-mississippi-abortion-ban/

  2. Cooper, D.B., Patel, P., Mahdy, H. (2022, September 6). Oral Contraceptive Pills. Statpearls - NCBI Bookshelf. Retrieved November 21, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK430882/

  3. Planned Parenthood. (n.d.). Are birth control pills effective?: Do birth control pills work? Planned Parenthood. Retrieved November 20, 2022, from https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/how-effective-is-the-birth-control-pill#:~:text=If%20you%20use%20it%20perfectly,users%20get%20pregnant%20each%20year

  4. Nutt, D. (2022, September 15). Male contraception offers promise in post-Roe v. Wade Era. Cornell Chronicle. Retrieved November 20, 2022, from https://news.cornell.edu/stories/2022/09/male-contraception-offers-promise-post-roe-v-wade-era

  5. ACS Newsroom (2022, March 23) A non-hormonal pill could soon expand men's birth control options. American Chemical Society. Retrieved November 20, 2022, from https://www.acs.org/content/acs/en/pressroom/newsreleases/2022/march/non-hormonal-pill-could-soon-expand-mens-birth-control-options.html

  6. Office of Communications. (2022, August 2). Spotlight: One Year and counting: Male birth control study reaches milestone. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved November 20, 2022, from https://www.nichd.nih.gov/newsroom/news/080222-NEST#



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