So close, yet so far: Why “the pill” for men isn’t right around the corner

Author: Ashley Melnick
Editors: Stephanie Hamilton, Christina Vallianatos

Family planning is an important component in many relationships; this includes preparing for planned pregnancies and navigating ways to prevent unplanned pregnancies. Since prescription-based birth control hit the market, women have mainly been responsible for taking “the pill” and utilizing other methods of pregnancy prevention, such as cycle monitoring, rings, and patches. In December 2018, the CDC released data indicating the pill was the most commonly used form of birth control (12.6%) after sterilization (18.6%), with long-acting reversible contraceptives (LARCs) like intrauterine devices (IUDs) trailing closely behind (10.3%), followed by male condoms (8.7%). With new advances in reproductive health research, a similar breadth of contraceptives is becoming available for men, which will soon give men more family-planning options. Western societies have recently pushed men to take larger roles in raising a family, ranging from paternity leave to being stay-at-home dads, and others beyond and in between. Developing additional options for male contraceptives will give men and women, both in relationships and as singles, more options when it comes to planning for children or preventing pregnancies.

There are a few commonly used contraceptive options designed to manage male fertility. One option is an invasive surgery called a vasectomy. In a vasectomy, the vas deferens, the tube that carries sperm to the ejaculatory duct, is cut, stopping sperm from entering the semen. Reversal of this procedure is tricky, having a success rate of 40-70%. A second, and reversible, option is condoms which are 98% effective when used correctly, but that number drops to 85% with typical use. Improved options for male contraceptives would alleviate these issues of convenience, invasiveness, and reversibility.

“Many men say they would prefer a daily pill as a reversible contraceptive,” says Dr. Stephanie Paige, a lead researcher at the University of Washington. She is part of a team developing a new pill being tested to regulate testosterone levels in men. Testosterone is an important hormone involved in the sperm production process. Dimethandrolone undecanoate, or DMAU for short, is a modified version of testosterone. When introduced to the body in certain dosages, it lowers the level of a hormone essential for testosterone production and consequently lowers sperm production in men. This trial pill is a remarkable step in the field of male contraceptives, not just because it seems to be effective and in a convenient form, but because it is also easily reversible.

DMAU sounds like a promising option for a male contraceptive, so why haven’t we seen it at our local pharmacies yet?

 

male-contraception-v1
From mouse models, gene editing, and drug development, research on male contraceptives is challenging. Illustration by Catherine Redmond.

First, the small study size of 83 men does not provide enough data to draw strong conclusions about DMAU’s effectiveness in men of different ages or ethnicities. It also does not allow researchers to confirm what dosages of the drug are the most safe and effective. A larger study is being planned by the same research team. Other male contraceptives in development include a hormone-based shot and a hormone-based gel, but, like many drugs, they come with their own side effects.

Along with reversibility, safety and effectiveness are additional aspects to consider when developing a contraceptive. Researchers need the pill to have as few effects as possible, given how widely it could be used. Men reported slight weight gain from DMAU, but this isn’t life threatening, and women commonly experience this side effect from female contraceptives. Men must be mindful that side effects are to be expected when taking any drug that interferes with the normal processing of hormones.

Another factor to consider is whether the male version of “the pill” will affect the sperm formation process long-term. By targeting sperm cells early in their development, sperm may not be produced correctly or at all. This may lead to a reduction in testes size, a physical effect generally unappealing to men. If the pill affects sperm cells later in development, it could target a critical function during fertilization- the sperm’s ability to swim. This means sperm would be produced but be unable to propel themselves to fertilize an egg. As of now, researchers do not know how DMAU impacts sperm formation, an answer that may affect short-term and long-term fertility.

To learn more about sperm development, researchers in Dr. Chen Chen’s lab at Michigan State University are working on a genetic approach to look at sperm production. To do this they use a gene knockout model in male mice. Think of “knockouts” like taking apart a car and then putting the car back together, except for one piece. Would your car function the same? Maybe the wheel would not turn anymore, or the engine would not start? Would a male mouse be fertile after the removal of an essential gene? Mouse genes are relatively similar to human genes, so mice make great models for infertility and human health studies in general. The Chen lab hopes to identify a target for a male contraceptive pill using these genetic models.

Although it may take some time researchers are getting closer to developing oral male contraceptives by taking careful steps in the right direction. Dr. Paige and Dr. Chen are just a few of the researchers advancing the field of male reproduction. Men hold equal importance and responsibility when it comes to fertility control and family planning, so it’s important to have a variety of safe options available for them. A better range of options can help distribute the accountability for outcomes related to reproduction.


MelnickAshleyAshley received her MS degree from Michigan State University studying spermatogenesis and male fertility. She is now a PhD student in the Molecular and Integrative Physiology Department at the University of Michigan, where she hopes to continue her passion for research in reproductive sciences. Outside of the lab, Ashley enjoys playing with her puppy, camping in Northern Michigan, trying out new restaurants, and watching Game of Thrones. Interested in connecting? Find her on Twitter and LinkedIn!

Girls Who Code Emprenden la Semana de Educación en Ciencias Computacionales

Autora: Brooke Wolford
Editores: Zena Lapp y Whit Froehlich
Traducción: Irene Vargas-Salazar, editado por Neykelin Burgos Tirado

Aunque no sea aparente, ¡Una gran parte de programación computacional está trabajando tras bastidores para ayudarte a leer este artículo! De hecho, este tipo de código ocurre frecuentemente en el mundo moderno. Los empleos en computación y matemáticas se encuentran en el número seis entre los 22 grupos ocupacionales de mayor crecimiento en E.U.A. Además, se han proyectado alrededor de 4.3 millones de trabajos para americanos en estas áreas para el 2020.

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Feminine, Masculine, or Androgynous: How Do We Characterize Science?

Author: Kristina Lenn
Editors: Isabel Colon-Bernal, Jessica Cote, and Whit Froehlich

Being confronted with our own biases is a humbling experience. I hate to admit it, but for most of my life, even when I was in college, the images I had of scientists and engineers were typically of men. Growing up, the parochial school I attended taught us that men are supposed to be providers and women are supposed to be nurturers. According to my teachers and pastors, men are more logical and women are more emotional; therefore, men are more reliable for leadership roles. Popular culture at that time, which is unfortunately not very different from today’s, was full of references to dumb blonde women, women’s “excuse to be crazy” once a month, and men’s mistrust of “anything that bleeds for seven days and doesn’t die.”

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 Who owns cells and DNA?  Property rights get messy in biology

Author: Sarah Kearns
Editors: Genesis Rodriguez, Zena Lapp, and Whit Froehlich

Scattered around your house or apartment, lightly coating the surface of your coffee table and lurking in the nooks and crannies of each room, discarded layers of yourself can be found in the form of skin and hair cells. Regardless of how much of clean-freak you are, it’s unlikely you miss the over one million cells you shed per day. One might go so far as to say that they aren’t even yours in the first place as you sweep them up during a spring cleaning before irreverently dumping them in the waste bin. But what if someone came into your house and took them? Continue reading ” Who owns cells and DNA?  Property rights get messy in biology”

Girls Who Code take on Computer Science Education Week

Author: Brooke Wolford. Editors: Zena Lapp and Whit Froehlich

It is not directly apparent, but a lot of computer code is working behind the scenes to allow you to read this article! In fact, computer code runs a lot of the modern world. Computer and mathematical occupations are the sixth-fastest-growing of 22 major occupational groups in the U.S., and are projected to account for 4.3 million American jobs in 2020.

This week (December 3-9 in 2018) is Computer Science Education Week, an effort to encourage K-12 students to take interest in computer science, frequently observed with Hour of Code events. Unfortunately, only 35% of high schools teach computer science. Furthermore, fewer than one-fifth of Computer Science graduates are women, and the gender gap is getting worse. To try to bridge this gender gap, a University of Michigan graduate-student led organization, Girls Who Code at University of Michigan Department of Computational Medicine and Bioinformatics (UM DCMB), pursues computer science education year-long through K-12 educational outreach efforts primarily serving young women. GWC at UM DCMB is a recognized Voluntary Student Organization (VSO) founded by doctoral students in the Bioinformatics graduate program in 2017. The organization, led by an eight-woman Executive Committee, coordinates a weekly Girls Who Code (GWC) Club as well as extensive K-12 educational outreach efforts. Continue reading “Girls Who Code take on Computer Science Education Week”

Las Historias de Ciencia que Nunca Consideramos

Autora: Kristina Lenn

Editores: Christina Vallianatos y Whit Froehlich

Traducido al español por Irene Vargas-Salazar, editado por Paloma Contreras

La primera vez que leí “La Cuchara Desaparecida” fue en el 2012, mientras estaba de regreso a casa durante las vacaciones de mis estudios de doctorado. Como estudiante de ingeniería química, nada me atraía más que un libro sobre la tabla periódica. Y no me refiero a un típico libro de química que discute las diferentes características de los elementos de la tabla, recorriendo sus líneas horizontales y verticales. Éste es un libro que conecta la ciencia, la historia y el impacto que los elementos de Mendeleev tienen no solamente en el mundo, sino también en sus descubridores.

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El Dilema Cuántico

Autora: Kristina Lenn
Editores: Alex Taylor, Zuleirys Santana-Rodríguez, and Whit Froehlich
Traducido al español por Irene Vargas-Salazar

Mi película favorita es El Código Enigma con Benedict Cumberbatch y Kiera Knightley. Me fascina esta película por las siguientes razones:

  1. En toda la película se demuestra que uno no se puede rendir ante las personas pesimistas.
  2. Como química computacional, siento orgullo al ver como mi campo obtuvo mayor visibilidad ante el público.
  3. Y, por supuesto, ¡Benedict Cumberbatch!

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The Mental Health Toll of Graduate Education: How Lack of Support and Work-Life Balance Affect Graduate Students

Author: Isabel D. Colón-Bernal; Editors: Callie Corsa, Zena Lapp and Irene Park

When I first came to the University of Michigan for recruitment weekend back in March of 2015, I was shocked to hear other recruits commenting on how Michigan graduate students seemed more cheery than graduate students at other institutions. I was even more shocked to learn students at other institutions have died by suicide recently; these include but are not limited to Anna Owensby from Scripps Research Institute, Jason Altom from Harvard University, and Han Nguyen from the Massachusetts Institute of Technology. Continue reading “The Mental Health Toll of Graduate Education: How Lack of Support and Work-Life Balance Affect Graduate Students”

Benefits of Nutrition in Cancer Prevention and Survivorship

Author: Lei Wan
Content Editor: Zena Lapp, Kristina Lenn; Senior Editor: Sarah Kearns

Disclaimer: The opinions in this post belong to me. Patients should consult their own physicians about what will work best for their treatment and recovery plan.

When I volunteered in a cooking class for cancer patients and cancer survivors, I was often asked about nutrition and dietary supplement choice. For example, patients with colon cancer would ask if they should take omega-3 fatty acids; patients with prostate cancer were interested in taking lycopene and vitamin E. I pondered the same questions when my mom was diagnosed with breast cancer and when her cancer recurred—would she recover faster if she ate more cruciferous vegetables like broccoli and Brussels sprouts? These questions are also of interest to the public, given increasing evidence supporting the role of nutritional factors in cancer development. Continue reading “Benefits of Nutrition in Cancer Prevention and Survivorship”

The Stories of Science we Never Considered

Author: Kristina Lenn
Editors: Christina Vallianatos and Whit Froehlich

I first read The Disappearing Spoon in 2012 while I was home from grad school on a break. As a chemical engineering student, nothing appealed more to me than a book about the periodic table. And I’m not referring to a typical chemistry textbook that discusses the different trends in the table as you go from left to right or top to bottom. This is a book that weaves together science, history, and the impact that the subjects of Mendeleev’s kingdom have had not only on the world but also on their discoverers.

Sam Kean, the New York Times best-selling author not only of The Disappearing Spoon but also of The Violinist’s Thumb, The Tale of the Dueling Neurosurgeons, and Caesar’s Last Breath, has taken his passions for science, history, and writing and melded them together to create four books that were each Amazon’s top science book of the year. The books cover the periodic table, DNA, neuroscience, and the alchemy of air, respectively – all vastly different from one another yet equally enigmatic.

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