Welcome to the world of equal opportunities. Women try to get more involved in the world of business, sweat, corruption and beer; men in their turn try to interfere in depilation, panties choice and birth control. Is it because men do not trust women in such a life-turning-away area or it is just a step toward more deeper understanding of the common responsibility but the question of male contraception arises more and more often.
Now the only way of commonly used contraception that is available to men is condom, one-way-ticket-step vasectomy or abstinence. But the last one is like the item about best contraception – take some tea together instead of sex - won’t do. Other methods are winning their popularity. Let’s get to know something about their peculiarities.
There are lots of researches to find new form of male contraception: heat methods, vas occlusion methods, hormonal methods and other.
Heat methods – wet heat (external heat) and suspensories. The whole idea is in warming of the testes to or above body temperature. Naturally, the testes are located outside the body in the scrotum; it allows them to keep themselves cooler than the rest of the body. Warming disrupts spermatogenesis. Can men rely upon this methods as a contraceptive – sure not! The researches showed decreased sperm counts of the human and animal participants, and no effect as a contraceptive method. Men, forget about hot water, saunas, incandescent light bulbs and other creative attempts as natural, easy to do methods in order to get contraceptive effect.
Injectable silicone plugs are often used by men in China as a potential alternative to vasectomy. There are two tested types of injected plugs: medical-grade polyurethane (MPU) and medical-grade silicone rubber (MSR). What is the principle of the method? The polymer (special ingredient) is injected directly into the vasa deferentia, the tubes that carry sperm from the testes. Once injected, the polymer solidifies in place, forming a flexible plug. The procedure takes less than 30 minutes under local anesthesia. Is it effective? The method is close to vasectomy, though its proponents believe it is easier to reverse. But small percentage of ineffectiveness of the method is not properly researched by now. As side effects it is 0.85% of complications (by the way, it is lower than no-scalpel vasectomy’s 1.21% and chemical vasectomy’s 1.31% complication rates). How long does it take to reverse? From 2 to 4 years after the reversal procedure.
Intra Vas Device (IVD) is a set of tiny pre-formed, flexible silicone implants (plugs) that are inserted into the vasa deferentia, the tubes carrying sperm from the testes, what blocks the flow of sperm. The researches are held mainly in Canada and US. The method is also close to vasectomy, but it leaves the vasa deferentia intact. Two plugs are inserted with a small space between them in the same vas. So to say double central lock system. If sperm pass around the first plug and enter the space between the two plugs, than the second plug blocks them. In a 1999 study IVD gave the contraception effect to 90% of participants. Mind that the side effect is a small rate of local infection after the procedure (1%), also swelling and tenderness of the epididymis or testes (3-5%) and formation of granulomas (0.02%). What about the reversal? It has not yet been tested in humans, but the study of IVD reversal in primates gives 1 months approximately.
RISUG is an injectable compound that partially blocks the vasa deferentia, and gives effective contraception for up to 10 years per dose. This method has been developed by scientists in India and still under clinical trials.
Male hormonal contraceptives. Of all the potential male contraceptives (for a note – it’s not likely a pill), this method is the closest to market in the US and Europe. The principle of working is again - to block or severely reduce the production of sperm by stopping the secretion of a man's reproductive hormones in the brain and testes. Sperm production slows when the level of testosterone in the testes is low. There was small scale of clinical trials so far to give promising results. Though it gave some notable successes. As there are lots of hormonal methods the effectiveness varies depending on its formulation, delivery method and dosage. Side effects? Be prepared to lean muscle weight gain, increased acne, changes in mood and more others. Good news – it takes near 2 months to reverse.
What about other methods? Nifedipine, “dry orgazm’ pill”, gossypol, Tripterygium wilfordii, immunocontraceptive and enzyme inhibitor pill - all them are true non-hormonal male pills.
Nifedipine is a high blood pressure (hypertension) and migraine medication taken as a daily pill. A man taking the pill produces a normal amount of sperm, but it cannot fertilize an egg. There have been no clinical trials of nifedipine as contraceptives, so there is no certain answer to the question of effectiveness. As well as to the question of side effects. The most common side effects (2-12% of users) include swelling in the extremities (peripheral edema), flushing, lightheadedness and nausea.
How does a “dry orgazm’ pill”(phenoxybenzamine and thioridazine) work? While sexual arousal certain amount of sperm are propelled by smooth muscle contractions (this muscle functions unconsciously with the help of nervous system) along the vas deferens, then vasa meet the urethra where sperm mix with fluids and form the semen. When orgasm comes this semen is also propelled through the urethra by more smooth muscle contractions and ejaculated. The smooth muscle does not contract when vasa deferentia were exposed to phenoxybenzamine or thioridazine and sperm are prevented from mixing with the semen. The side effects are also under the trials but there exists a small danger of infertility in the men taking these medications.
Gossypol. This is a chemical which cotton plants produce for the sake of preventing it’s cotton bolls and seeds from insects. Gossypol slows down the reproduction of the insects. The study has started from 1929 when it was noticed that families that use crude cottonseed oil for cooking were smaller than others. This phenomenon led to large scale testing of gossypol as a male contraceptive in China during that period of time. Among side effects are hypokalemia (low blood potassium - which includes fatigue, muscle weakness and sometimes paralysis) and kidneys. The reversal time is from 1 up to 3 years. The contraception effect is under trials so far.
There is an interesting story about Tripterygium wilfordii (or lei gong teng)also. In traditional Chinese medicine these herbs were used to treat almost everything - fever, carbuncles, rheumatoid arthritis, chronic nephritis, chronic hepatitis, skin disorders. Some patients after taking the T. Wilfordii were not able to conceive children. What a surprising contraceptive effect of a twining vine, known in Chinese medicine for over 2000 years. Some recent studies say that the principal of working is close to nifedipine. Side effects are also under the trials.
Other drugs such as enzyme inhibitor pill and immunocontraceptive are on the first stages of their development. And there are lots of researches of how it will work.
So, men, yes it is pretty complicated to choose the certain contraceptive among all and not to be lost in variety. And perhaps it is more easier way to prefer nice friend condom, or vasectomy (after considering the consequences) or abstinence! And maybe it is really much easier to take some tea instead of sex, but… Think of that, how we, women, would be grateful for your brave step to share common responsibility in controlling the birth.
Valentyna Ant.
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