Birth control methods – any real news?

When I first started in this business in 1982, there were few contraceptive methods for men in the West aside from condoms and vasectomy (unless you count withdrawal).  The newer methods for women over the years tended to be hormonal.  Proponents of birth control cheered when they became aware of a Chinese method for men developed in the 1970s – gossypol – derived from cotton seeds.  The downside of this method was explained in 2002.  “The only concern at present appears to be lack of reversibility in over 20% of subjects.  Gossypol should be prescribed preferably to men who… would accept permanent infertility after a few years of use.” (http://www.ncbi.nlm.nih.gov/pubmed/12020773).

In the 1980s, we were excited at the news of another Chinese development, plugs injected into the vas deferens; but again, there were problems: “concern about potential toxicity of a chemical component…”  It also took time to be effective.  The plugs “rupture the vasa deferentia, and it is the slow formation of scar tissue that eventually blocks the flow of sperm.”  (http://malecontraceptives.org/index.php.)

Yikes.

In 2011, this article on birth control innovations hit the popular press: http://www.everydayhealth.com/sexual-health/birth-control-innovations-you-could-see-soon.aspx.  Sadly, in the section on male methods, they said, “it may be decades before male hormonal birth control is available (http://www.everydayhealth.com/sexual-health/male-pill-still-a-ways-off.aspx).

Fast forward to January 2015.  A news story entitled “6 Innovative Ways We’re Reinventing Birth Control” (http://mashable.com/2014/09/10/new-birth-control/?utm_cid=mash-com-Tw-main-link&utm_source=twitter&utm_medium=tweet&utm_content=futurebc&utm_campaign=healthtwitter) came across my Twitter feed.  Again, my hopes rose – and then flagged.  You be the judge.

Microchips – a remote-controlled, implanted microchip that can deliver drugs beneath your skin – including hormonal birth control. It’s designed to last up to 16 years, and can be controlled by wirelessly opening and closing a reservoir that releases the hormone levonorgestrel over a course of 30 days.  They are working to get FDA approval for pre-clinical trials in 2015, with a view to going on the market by 2018.

 The woman shuts off the chip with a remote when she wants to get pregnant.  Seriously?  My esteemed colleague, Abby Lippman wrote, “Everything that can go wrong with remote-controlled devices could happen with this device. There really is no foolproof way to ensure that only ‘registered’ people will have access to control the electric current needed to open the seal on the device to release the daily doses. Nor can there be guarantees that hackers won’t be able to access either the device itself or some interconnected computerized information or devices…” (http://rhrealitycheck.org/article/2014/07/16/im-skeptical-remote-controlled-birth-control-chip/)

For more on levonorgestrel, see below.

Oregami condoms – California-based company, Origami Condoms, redesigned the prophylactic so the wearer feels it even more. It isn’t available commercially yet, but pending regulatory approvals, the Origami Male Condom is expected to reach the market in early 2015.

One question:  What about the other partner?  What sensations do they feel vaginally or anally?

L. Condoms – L. is changing the way condoms are manufactured and marketed. They are made from sustainably tapped, locally sourced, biodegradable latex – without irritating additives often associated with typical latex – and they’re packaged in discreet, 100% recycled boxes.

I’m liking this a lot.  Here’s the icing on the cake:

For every condom sold, one is donated to a developing country battling the HIV/AIDS epidemic. 

RISUG –Reversible inhibition of sperm under guidance (RISUG).  Vasalgel, is a form of male birth control.   One shot of polymer, or gel, is injected into the vas deferens, creating a semi-solid plug that blocks sperm in a 15-minute procedure.  100% effective, low-cost, reversible, and can last between 10 and 15 years.  So far, they are testing the polymer with baboons and plan to start clinical trials in humans in 2015.

Looking good.

Sino implant (II)

Here we go again.  Will they never learn?

The Sino-implant (II) is a subdermal implant made of two thin, flexible rods containing levonorgestrel. Hormonal contraceptive implants were introduced more than 30 years ago – but the Sino-implant (II) is designed for “resource-limited settings.”  (The term they use is “ideal” for those settings, aka poor countries.)  While other implants can cost $20 or more per unit, the Sino-implant (II) is priced at $8 per unit. 

Levonorgestrel is the hormone that was used in Norplant.  Class action lawsuits included complaints of severe headaches, anxiety and panic attacks, depression, acne, weight gain of 60 to 100 pounds, excess growth or loss of hair, ovarian cysts, breast pain, skin discoloration, infection at the implant site or numbness in the arm, as well as a variety of menstrual disorders.  What would follow-up look like in a developing country?

Next.

Caya contoured diaphragm

Lea’s Shield, a silicone rubber diaphragm, was introduced in 2002 but discontinued in 2008.  It was a laudable innovation, but clunky to use.

The Caya-brand contoured diaphragm is a redesigned, single-size diaphragm that ensures increased comfort and ease of use.  It can also aid in the delivery of gels that can prevent HIV and STIs.  The contoured diaphragm was approved by the U.S. Food and Drug Administration in September, 2014.

Like older designs, it has to stay inside the vagina for six hours.  For every act of intercourse you need to reinsert gel with an applicator.  Presumably, one needs access to clean water to use it.  You can use Caya up to two years, which is a bargain in the world of birth control.  The gel (Contragel) can be costly depending on frequency of use.  It does not contain nonoxynol-9 which can irritate mucous membranes.

Health advocates who promote non-hormonal methods will be pleased; but some of the drawbacks are similar to the old diaphragm.  It can slip out.  It takes time to insert.  You have to buy gel and reapply.  You have to wash it after use.

To be honest, the only innovations that get my thumbs twitching upwards are the two male methods, the L. condom and RISUG.  How about you?

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