Why Hasn’t Big Pharma Pulled Out A Male Contraceptive Pill?

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A pioneering innovation within the reproductive biotech industry was the invention of the first oral contraceptive pill in the 1960s, creating a non-invasive and safe method of preventing pregnancies.

What is a Contraceptive?

Contraceptives are procedures, medications, technologies or behaviours that prevent pregnancies. Throughout history, various methods of contraception have been innovated and utilised. Some common examples include:

When	Contraceptive Method	User
6000BC	Abstinence and Withdrawal	Male and Female
2000BCE	Vaginal poultices and barriers	Female
1885	First rubber condom	Male
1960	The Birth Control Pill	Female
1964	First IUD (the Lippes Loop)	Female
1988	ParaGard Copper IUD	Female
1999	Plan B Emergency Contraception	Female
2000	Mirena (the first hormonal IUD)	Female
2002	Ortho Evra (the first birth control patch)	Female

IUD

Intrauterine device

Hormonal Contraceptives

Contraceptives which influence the homeostasis and hormones (endocrine system) within the body to prevent pregnancies, are known as Hormonal Contraceptives.

Some examples include

• The birth control pill (The Pill)
• Contraceptive skin patches
• Hormone-releasing contraceptive coils (some IUDs)

Hormonal contraceptives prevent pregnancies in various ways. Along with preventing ovulation, some hormonal contraceptives prevent fertilised eggs from implanting into the womb. Additionally, some act by restricting sperm from accessing the cervix by causing mucus barriers. However, hormonal contraceptives are only effective when used according to the drug labelling.

The Birth Control Pill

Studies have shown that the contraceptive pill is the most common form of contraception used by Australian women aged between 18-24, with 60% of participants saying they used the pill.

Although there are over 30 different brands of ‘The Pill’ in Australia, there are two different types of contraceptive pills, both only usable by females

• Estrogen-progesterone (Combined oral contraceptive or COC)
• Progesterone-only pill (POP)

How does hormone signalling look during ovulation?

How does the pill work?

The pill works by influencing the hormone production pathway to ensure ovulation doesn’t occur. Progesterone and estrogen are important hormones in female reproductive health and pregnancy. However, in the pill, progesterone and estrogen are used to influence the hormone production pathway, preventing pregnancy.  

Progesterone’s main method of action is to prevent ovulation by inhibiting follicular development. This is achieved through progesterone-negative feedback mechanisms, recall back to the article ‘Why You Need To Understand Hormones And Homeostasis’. The diagram below shows the basics of how the pill acts to prevent pregnancy.

Why Haven’t Reproductive Scientists Created a Male Equivalent?

Now, someone might ask:

“We know all the science and have a sophisticated understanding of hormones and how the pill works in females, so why haven’t reproductive scientists created a male equivalent to the pill?” – Sam Ruba

Well, the answer is, that they have tried and failed. This is due to numerous reasons; however, I have compiled a list of some prominent reasons.

• The Social Need

The development of a male contraceptive pill or lack thereof, can be seen as a social issue. The availability of many contraceptive methods – even though many are only for women, suggests a ‘if it’s not broken, don’t fix it’ ideology. Therefore, some pharmaceutical companies don’t see the value in a male contraceptive pill

Additionally, the ancient perception that men don’t want to take reproductive responsibility and therefore wouldn’t take the pill has been used as an excuse. However, this is no longer true with the rise in men undergoing vasectomies.

• Effective Alternatives – Vasectomies

Vasectomies are a quick and reversible form of contraception. In the last decade, vasectomies have become increasingly popular amongst men who desire to control their reproductive health. However, this also supports the argument for the need for a male contraceptive pill, as a less invasive form of contraception.

(Vasectomy Reversal)

The success of vasectomy reversal is around 65-95% effective. This means vasectomy reversal doesn’t guarantee that a man will be able to conceive a child.

• The Risk-to-Reward Ratio – Healthwise

Think of any drug or medication you know of. Most likely, it is to treat or prevent an illness or ailment. Pharmaceuticals are predominantly developed to treat or prevent diseases and ailments in individuals; thus, the risk of adverse side effects is worth the reward of better health.  However, a contraceptive pill is used by healthy individuals. Therefore, the risk-to-reward ratio in terms of side effects, is completely different.

(Healthy Individuals)

Contraceptives are also used for numerous reasons other than preventing pregnancies. See for more here

• The Risk-to-Reward Ratio – Business 

The drug development pipeline was explained by Harry in his article ‘Understanding The Drug Development Pipeline‘. A major reason that pharmaceutical companies haven’t developed a male contraceptive pill is that they believe that the price of developing the drug, wouldn’t provide a favourable return on investment (ROI), in terms of time and money.

Where Are We Now?

Although no male birth control pill is on the market, it doesn’t mean there isn’t research being done. Since the development of the female birth control pill, scientists have been trying to find a way to bring a male alternative to the market. However, research can only go so far without significant financial investment.

The ADAM Study – Epworth Health Care by Professor Nathan Lawrentschuk

Aside from contraceptive pills, contraceptive implants are also going under trial in Melbourne. The ADAM study is a world-first study that involves the injection of hydrogel into the vas deferens, blocking sperm from travelling to the testes. This acts like a temporary vasectomy

Next Week, I will talk about another male contraceptive that is in development from EPPIN Pharma.

Take away message…

The female contraceptive pill is a revolutionary biotech innovation. However, there needs to be a shared contraceptive responsibility between males and females.

Although we are not there yet, the development of the male contraceptive pill and its release onto the market would be a significant reproductive biotech innovation.

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Seek help from a doctor if you require medical advice regarding contraceptives