The World’s First Injectable Male Contraceptive Is Ready — Are Men?
Until now, the conversation around male birth control has been hypothetical: If the methods existed, would men be keen on sharing the burden of contraception equally with women? Will women trust men with this responsibility? Currently, society puts the onus of preventing planned pregnancies on women, not only because it affects them almost entirely, but also because family planning and controlled sexual
But researchers at the Indian Medical Research Council have recently completed clinical trials for the world’s first injectable male contraceptive, which they claim is 97.3% effective and has zero long-term side effects. The procedure requires a trained medical practitioner to administer an injection near the testicles into the vas deferens — the male reproductive tubes that carry sperm from the testes to the urethra — when the patient is under local anesthesia.
The injection, first developed by Dr. Sujoy Guha, a biomedical engineer in the 1970s, is made up of a synthetic polymer containing two different chemical compounds: styrene maleic anhydride (SMA) dissolved in dimethyl sulphoxide (DMSO). When injected together, this solution creates a blockage in the vas deferens, so the sperm is not able to pass through to the urethra during ejaculation. The injection lasts up to 13 years, after which the person regains their fertility, and it can be reversed easily at any time. For this reason, it’s been termed RISUG, short for Reversible Inhibition of Sperm Under Guidance.
Dr. Radhey Shyam Sharma, a New Delhi reproductive biologist who leads the research, published the findings of the clinical trials in the Indian Journal for Medical Research, in which he explains that until now, surgical vasectomies were the only 100% effective, long-term contraceptive option available to men, and even though vasectomies are technically reversible, the surgery can be complicated. This new injection is not only less invasive than a vasectomy, but it is also easily reversible by simply flushing out the chemical blockages from the vas deferens.
“The product is ready, with only regulatory approvals pending with [India’s drug regulatory body]. The product can safely be called the world’s first male contraceptive,” Radhey Shyam Sharma, a New Delhi reproductive biologist who leads the research, told the Hindustan Times.
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If this is true, the Indian invention could possibly solve the problem of almost half of pregnancies worldwide being unplanned. Given how currently men only have three viable options when it comes to birth control — condoms, which in one survey, almost 95% of Indian men said they found cumbersome and said they didn’t use; vasectomies, which men are reluctant to avail of due to misinformation and misguided notions of masculinity, which prevent them from availing this option; or ‘pulling out,’ which is completely unreliable — ultimately, men tend to leave birth control to their female partners.
But, according to some researchers, making a long-term contraceptive available to men could lead to the number of unplanned pregnancies drastically reducing. This is the reason behind the growing impetus to manufacture male contraception — currently, a gel, an oral contraceptive (pills), and another injectible are also being developed, though they are very far away from reaching the market.
Now that a near-fully effective birth control for men is one step away from hitting the markets, the choices in front of men seem a little less hypothetical. Are men really willing to bear the responsibility of birth control? Especially, since it involves a needle to the groin?
According to an informal poll put out by The Swaddle journalists on multiple social media platforms asking men if they’d want to get the injection, 62 of 116 men surveyed said they were not willing to undergo the procedure for several reasons. Some common responses included that 13 years was too long to stick to a decision in case they changed their minds about having children; that it was too soon to decide on the safety of the injection so they’d rather err on the side of caution and say no — “what if my balls stop functioning?” said one respondent; and, that an injection to the balls sounded unnecessarily painful and invasive — “an injection to the balls is a bit much, don’t you think?” responded another man. (It’s worth noting several birth control options for women, such as IUDs and diaphragms, are as or more invasive.) Five men went on to explain that if their two options were RISUG and abstention to prevent unplanned pregnancies, they’d rather stop having sex.
For all practical purposes, as of now, RISUG is the most affordable, minimally-invasive, easily-reversible option available, but upon taking a closer look at the trials’ published findings, perhaps men have good reason to be hesitant about the procedure. In the study, of the 133 men who took one shot of RISUG, none got their wives pregnant despite having unprotected sex. However, the researchers noted that “mild scrotal enlargement,” scrotal pain and presence of nodules at the site of the injection were common — but these effects resolved themselves within the six-month duration of the study. Two men, however, experienced “fluid collection” around their scrotums — which according to Vox‘s interview with Michael Skinner, a reproductive biologist who studies male contraceptives at Washington State University, is “concerning” and needs longer and bigger studies to understand its true impact.
A 2018 paper by researchers at the University of Virginia School raised similar concerns about RISUG’s safety. They cited earlier clinical trials and studies in animals that showed RISUG may damage sperm and tissues in the male reproductive organs. They also noted that “there has been no data reported on the reversibility of RISUG in humans.” That aspect has only been tested on animals.
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Still, as valid as that is for any new product waiting to be approved after testing, RISUG reveals society’s and the medical community’s double standard: While the researchers have completed trials on RISUG after almost 20 years of studying the procedure and have concluded there are no long-term side effects, more and more versions of birth control pills, on the other hand, have inundated the market as a contraceptive staple in women’s lives — despite official trials listing side effects such as mood disorders, acne, spotting, weight gain, nausea, and even liver tumors, in some cases.
Yet, there is also a positive takeaway here: 46.6% of men surveyed by The Swaddle team said they would want to get this procedure done simply because it was time men stepped up and took on the responsibility of birth control equally.
As one of the respondents said, “It’d be a nice change in pace. Contraceptive and emergency pills can really mess up someone’s hormonal balance and body, both in the long and short term. Women are going through more than enough shit as it is. So, [with] a combination of the [male] condom and this injection, women can stop worrying too much. It will be really nice to see them not worry so much. It’s high time we, as the laziest gender, take a more active role in preventing unwanted pregnancies.”
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