[sickbadthing]

Men on "the pill"? Doctors say it's no dream

By Carol M. Ostrom

Seattle Times health reporter

At a conference of researchers looking at the future of male contraception, some nagging concerns poke through the fog of scientific jargon.

First: The male machinery that produces sperm — at a rate of 1,000 per heartbeat — is incredibly hard to disable.

Second: Would a man really trust some researcher to tinker with his testosterone? And would any woman believe a man who says, "I'm on the pill?"

Third: Men on the pill — are these researchers nuts?

As it happens, these concerns are not new to the doctors and scientists gathering at the University of Washington today and Friday, many of whom have slogged through years of research on hormones, devices and treatments.

Yes, the sperm-production mechanism is hardy. Yes, attitudes of men and women will be key.

But no, these researchers are not nuts. There is good evidence, including some large international studies, that a good percentage of men would use a new male contraceptive.

Now, if these researchers could only produce one.

"Demand is the smallest hurdle," says Elaine Lissner of the Male Contraception Information Project, part of Our Bodies Ourselves, a Boston-area women's health-education organization. "Basically a majority in pretty much every country is interested in male contraception."

In some cases, Lissner says, male enthusiasm for a new method may well be linked to the hope of getting more sex. Some men want alternatives because the female pill affects their partner's libido, or because she's already abandoned contraception because of side effects. Some worry that women will forget or lie about contraception. Some just want to share the burden.

At this point, hormone-based methods, including pills and injections that last three to six months, are the furthest along in the research process, have the best chance of drug-company funding and are what men say they'd prefer, says Dr. William Bremner, a UW endocrinologist.

Bremner, chairman of the UW School of Medicine, is host of the conference, which is sponsored by the university, the National Institutes of Health, the World Health Organization and the Contraceptive Research and Development Program, an international consortium.

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He says he and colleagues at the UW's Male Contraception Research Center have already made "significant advances" toward a hormone-based "male pill."

But researchers have had a long, bumpy record with women's hormones. Why would men trust them with theirs?

"I think that's a fair question," Bremner responds. Researchers are shooting for a "normal range" of hormones, and working hard to eliminate any side effects. "It's a tall order," he says.

And Lissner says women often tell her: "I wouldn't trust a guy in a bar who says he's on the pill."

Her response: "If it's a guy in a bar, you should be using a condom. End of story. This is not about the guy in the bar. This is about your boyfriend of four years, your fiancé, your husband."

Bremner says many men join his studies because their female partners have had to give up their contraception. Using condoms "becomes burdensome," he says, and vasectomy is usually irreversible. Even so, those male-based methods now account for a third of contraception used among stable couples in the U.S. and Europe, he says.

So how long before a male "pill" becomes available?

"I've been saying 'five to seven years' for about 20 years," Bremner admits. "I will again say 'five to seven years.' I just want to give you a dose of reality."

Not all researchers are putting their eggs in the hormone basket.

Other headliners at the conference ******* something called the Intra Vas Device, a set of tiny implants that block the flow of sperm on its way out.

With this method, as with others, the concern is whether fertility can be reliably restored if desired.

Other researchers are looking at the effects of heat on male fertility, which have been known for centuries. In the 1940s, a doctor reported that sitting in a shallow, hot bath 45 minutes a day for three weeks caused six months of sterility.

A small study is also looking at ultrasound, Lissner said.

So far, heat-based methods haven't proved "adequately and reliably effective," Bremner says.

In addition, Lissner says, low-tech methods may not attract sufficient funding.

Another product now in late-stage clinical trials in India is called RISUG, an injectable compound that partially blocks the tubes carrying sperm.

"The goal in all this research is to give people a full range of choices," says Bremner, who said he just saw the movie "Knocked Up," about a couple facing a pregnancy after a one-night stand. "It's a major issue for both people involved."