For men, the only do-it-at-home option around is the condom, which is about 85% effective at preventing pregnancies. But starting this summer, men may be headed towards their very first widely-available birth control rub. This one won't come with the castration-like side effects of a recent male birth control pill trial that lowered men's testosterone levels (to at or below boyhood concentrations), either.
Doctors in six countries around the world are readying a year-long birth control trial the alcohol-based shoulder rub that participants can administer themselves, once a day. The researchers are hoping to enroll their first couples in US trials starting in July.
"They just do a pump, rub it in their two hands, and then rub it on their shoulders," Dr. Stephanie Page, who studies male reproduction at the University of Washington and is heading up the study in the US, told Business Insider.
The drug works like this: Men plop a nickel-sized amount of the drug (a mix of testosterone and progestin steroids) on their skin once a day, and then wash their hands. Steroids are lypophyllic, which means they're easily absorbed into the skin.
"About 9 to 14% of the steroid in the gel applied is available to the body," the researchers wrote on ClinicalTrials.gov.
Usually after about eight to 12 weeks of gel applications, the hormone therapy lowers the man's sperm count to levels that are effective as birth control. By that point, the testosterone the men are getting in daily gel applications provides most of the body with its proper dose of sex hormones. In tandem with the progestin (Nestorone) in the gel, the testosterone also prevents men from producing their own viable, mature sperm, by interrupting normal hormone production processes in the testicles.
Page has already done smaller six-month studies of the gel in men and shown that roughly 90% of participants suppress their sperm concentrations to levels that are contraceptive. In the forthcoming study, men's sperm counts will be monitored before they start using the gel as standalone contraception, so couples won't start relying on the gel as birth control until a man's sperm count is confirmed to be low.
If the thought of getting your partner to rub you down with testosterone every day sounds appealing, Page says not so fast.
"No, no, no, no, no! That's not the idea," she said.
Because the testosterone can be absorbed into anyone's skin, it's important for women and children not to touch the gel, and to avoid skin-to-skin contact with a man's shoulders for about four hours after he puts on the alcohol-based rub. Men should also carefully wash their hands after administering their daily dose.
Page said the gel can be passed on to others in small amounts — if people vigorously rub their arms together after administering the gel or shake hands for an extended period of time — but those transfer levels aren't high enough to be dangerous for people.
Potential rubbing risks aside, there are clear benefits to using a gel instead of a pill. Since the drug is not delivered orally, it doesn't pass through the liver. That means doctors worry less about effects on cholesterol or liver damage, which have been issues in past male birth control trials.
Page says the only adverse side effects she's seen so far have been mild. In shorter trials of testosterone gels, she's most commonly seen mild to moderate acne, which affected roughly one in five men. A few people complained about headaches, and there were several cases of insomnia reported.
It will take some more time to know for sure if the male birth control might have more serious, long-term complications, but these early results look promising.
Women have been dealing with birth control side effects ever since "The Pill" was introduced in the 1960s. Today, women have a variety of options, each with their own unique cocktail of side effects attached, from weight gain and severe cramping to mood changes and decreased libido. Taking oral contraceptives, for example, can heighten a woman's risk of developing breast and cervical cancer, increase risk of depression, and cause blood pressure to rise.
"The goal of the whole field of male contraceptive development is to try and create choices for men and for families," Page told Business Insider earlier this year. "A lot of women can't use contraceptives, and men want to share the burden of contraception."
She says if you're in a heterosexual couple and you'd like to be a part of her study, she's still looking for volunteers. If the 400-person worldwide trial is a success, the study results would need to be replicated again with several thousand people, and likely need to secure additional funding from a pharmaceutical company, before the Food and Drug Administration would give this gel the green light to be sold on pharmacy shelves.
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