The modern birth control pill was conceived in 1950. That year, Margaret Sanger, the founder of Planned Parenthood, asked a doctor named Gregory Pincus to develop an oral contraceptive for women. Pincus succeeded very quickly: He released a contraceptive pill in 1957 as “Enovid,” a menstrual regulator with a “side effect” of preventing pregnancy, and the drug was approved for sale as birth control in 1960.
Pincus also looked into the possibility of hormone-based birth control for men the same year that “Enovid” came out, but he didn’t get very far.
Since then, no one else has gotten very far either. Scientists began testing hormone-based contraception on men in the 1970s, with pills that used testosterone or a combination of testosterone and progestin (the latter is used in the female pill, too). So far, the most promising hormone-based contraceptive is a daily pill called dimethandrolone undecanoate (DMAU), which delivered encouraging results in a recent four-week trial. But researchers are also testing non-hormone options like … poison.
The University of Minnesota is currently experimenting with a non-toxic form of ouabain, a plant extract that is typically extremely poisonous. Before it became an option for male birth control, ouabain was used by African hunters on the tips of their arrows to stop the hearts of their prey—but we won’t know how effective it is for quite a while.
It wasn’t easy for Sanger, Pincus, and their colleagues to develop an effective contraceptive for women in just ten years. Quite often, their methods weren’t safe or ethical, either. As journalist Jonathan Eig recounts in his book, The Birth of the Pill (soon to be a TV drama), Pincus tested the drug on Puerto Rican women who may or may not have been aware that they were participating in a trial. Still, over 50 years have passed since the pill for women came out—so why haven’t we figured out how to make one for men?
In the beginning, there may have simply been too little interest. Eig points out that Sanger and Katherine McCormick, the pill’s financial backer, weren’t very motivated to develop a version for men.
“I think the key for Sanger, in particular, and McCormick was that they couldn’t trust men,” Eig told National Geographicin a 2014 interview. “They felt like if men had any hand in this, it could somehow be subverted, and that if women didn’t have the power to control their own bodies, if they had to rely on men to make it happen, they would never really succeed in gaining equality.”
This didn’t mean that Sanger and McCormick didn’t want someone to develop male birth control. They simply felt it was necessary to develop it for women first, according to Eig, or else “women will never have the opportunities that they should.”
Indeed, the pill did make a remarkable impact on women’s lives by allowing them to control their own reproductive choices. But it also put the burden of preventing unplanned pregnancy primarily on women’s shoulders. The pill, along with other options like intrauterine devices (IUDs) and birth control implants, are all contraceptives that women must obtain. Other than a vasectomy, the only birth control option men have are condoms (though of course, women can buy those too).
After Pincus, others began to look into male birth control. In 1967, the Journal of Marriage and Familyreported that a British scientist, Harold Jackson, was developing a drug that could prevent sperm production, though it wasn’t yet safe for human testing. In 1974, the University of Washington, Seattle, ran a human trial with a hormone-based contraceptive that lowered, but did not stop, sperm production in most of the subjects. And there have been many attempts since.
So why haven’t any of them panned out? Experts working in the field argue that figuring out how to prevent sperm production is technically more difficult than preventing once-a-month ovulation. But it’s also a money issue. Scientists have struggled to get pharmaceutical companies on board to fund FDA trials.
Herjan Coelingh Bennink, the CEO of Pantarhei Bioscience in the Netherlands, described his experience of discussing male contraception with Big Pharma executives: “At board level it was only middle-aged white males,” he told Mosaic. “I tried to explain how important it could be, but they never got further than saying to each other, ‘Would you do it?’ ‘No, I wouldn’t do it.’ It was not considered male behavior to take responsibility for contraception.”
Interest in males birth control, however, may be higher among younger men, and scientists are currently pursuing several types of potential contraceptives. DMAU has generated a lot of media attention because of a trial that showed it can suppress production of three hormones related to sperm production without causing serious side effects. However, more trials are needed to determine whether it can actually lower men’s sperm counts.
If DMAU does prove to be a safe, effective contraceptive, it would take years to complete the trials necessary for FDA approval. This, too, is a reason why scientists were able to develop birth control for women more quickly than they’ll ever be able to design an option for men. Back when the female contraceptive pill was approved, the FDA’s requirements weren’t as strict (hence the unethical testing).
This means that for a male pill to be approved, it will need to be much more rigorously tested than the first pill for women ever was—which is a good thing.