Well, maybe– and maybe not. While it’s an important scientific advance, this is also very early-stage research, the kind that may or may not ever make it to market.
In short, the researchers found a drug called JQ1 that shuts off sperm production in mice– and though it’s just mice, that’s already more advanced than many studies that are reported as big news. Many studies claiming to a big deal basically say “we found a gene/ ion channel/ whatever that is key for sperm production/function. Now if we can just find a drug to affect it! We’re looking hard! And then we’ll need to see what else the drug happens to do to men and whether it’s safe. Check back in 5 or 10 years!”
These researchers, by contrast, are a step ahead: they have already found a drug that works in mice, called JQ1, that they discovered while working on cancer. But not all drugs that work in mice work in humans, as was discovered to great disappointment with another promising male contraceptive lead, Zavesca. And even if it works, it will take many years of testing to determine whether the drug affects anything else in the body besides sperm production. Is it really a magic bullet against sperm production only, or does it just happen to turn your hair green or raise your cholesterol while it’s at it? Only time will tell.
In the meantime, it is important to keep funding contraceptive methods further along the pipeline. Too often, researchers get promising early results like these in mice and then find they can’t get the scale of funding needed to take the work to the finish line. Some methods in this category: Gamendazole and the Clean Sheets Pill, which have already been shown to work in animals; RISUG and Vasalgel, highly-effective methods that can provide hassle-free contraception for more than 10 years; and Gandarusa, a plant-based pill slated to go on the market in Indonesia next year but that has not been pursued at all in the West. New research is important, but we must also finish the jobs we start.
This week researchers from UCLA and the Population Council reported that their combination hormone contraceptive gel lowers sperm count in many of the men who take it. Is this the advance we’ve been waiting for?
MCIP applauds the Population Council’s work on Nestorone, a “designer progestin” that is more pure in its action than current synthetic progestins and could have significant advantages in women’s contraceptives. But we continue to support NON-hormonal male contraceptive research, for two reasons.
First, hormones are not one size fits all. As seen in previous trials, the standard dose of testosterone may be too much for one man (making him aggressive or giving him acne) and too little for another man (making him depressed). The risk of depression is what brought the big recent WHO hormonal trial to a halt.
Second, we have concerns about the long-term effects of progestins in men. Testosterone is pretty well understood, but the progestin, which is added here to make the method more effective, is another matter. As seen with hormone replacement therapy for women, it could be 60 or more years before we begin to understand the health effects of adding a synthetic progestin. And in this case it’s in men, who aren’t normally exposed to the high levels women have during part of their menstrual cycle. It could turn out to be a great thing for health, but progesterone is complicated in men, and we just wouldn’t know for many years. We ran that experiment in the 1960′s and 1970′s with women and the Pill, but by now we should be able to do better.
A final thought: The continuation and effectiveness rates were not great, meaning that this method would be a challenge from a practical standpoint. Fifty-six of the 99 men used it properly and continued for the whole study period, a little more than half. What was the experience of the other 43 men, and why did they quit? Did they forget to use it for too many days? Or did they have side effects? And of the men who kept going, sperm counts reached the desired levels in 88-89% of the men, meaning 1 in 10 didn’t work well enough to be under the sperm cutoff line. By themselves each of these might seem like a small issue, but put together they add up.
We applaud the researchers for carrying this through and getting answers. But we continue to press for development of nonhormonal, more targeted methods- and preferably ones that are long-acting. It’s easy to forget things that have to be done every day– that’s human nature, for men or women. We know from studies of contraceptives in women: the less you have to think about a contraceptive, the more effective it will be.