safe sex

Next-gen contraceptives are coming

By Sophie Morlin-Yron 15 January 2018
Summary

Male pills, smartphone apps, and condoms like you've never seen. There are even unisex options.

The Pill has been deemed one of the greatest liberators of modern times.

Women pop one a day and gone are the woes of unwanted pregnancy.

Now, it’s about to get competition.

From graphene condoms, to algorithms and rub-on gel for men, we take a look at what the future holds for contraceptives…

The male ‘pill’

Globally, the majority of women rely on some form of contraceptive today. But not everyone’s a fan.

One side effect is it can mess with your mood because most options – beyond the condom and copper IUD – involve tampering with the female sex hormones estrogen and progesterone, which are linked to mood swings, weight gain and even depression.

Vasalgel will be injected into the testes for a long-acting contraceptive. Image: Vasalgel

Enter the male contraceptive.

After decades of research and broken promises, it’s finally looking bright, with the injection Vasalgel set to be clinically trialled ‘soon’. 

It’s not unlike the reversible vasectomy, explains Richard Anderson, Professor of Clinical Reproductive Science at the University of Edinburgh. 

This gel, which forms a flexible barrier to block the passage of sperm, has already been tested on primates in the US and a similar substance is sold now under the brand name RISUG in India.

If you’re not a fan of genital injections, that’s no problem. Clinical trials of a hormonal rub-on-gel that reduces sperm count are also due to kick off this year. (It goes on the upper body, people – not down there).

 A combination of the hormones progestogen and testosterone, it’s yet to be seen what the side effects will be.

“This is the first one that men will actually be able to give themselves, rather than having to go to the doctor to get,” explains Anderson.

“You cause the hormones, that normally stimulate the gonads from the brain, to switch off, and the gonads then stop producing the hormones for reproduction.” 

“You’re not damaging, or directly affecting the testes you are just switching off the drive to it.”

These new methods could drastically cut into the global markets for condoms and female contraceptives, (valued at $3.2 billion and $10 billion per annum), with research in the field backed by large NGOs like the Bill and Melinda Gates Foundation (which recently donated $600,000)

Elina Berglund Scherwitzl co-founded Natural Cycles together with her husband, Raol.

The algorithmic method

Understandably, some women may not want to hand over control over whether they fall pregnant.

But a growing number of women are shunning contraceptive pills in favour of fertility predicting smartphone apps. 

Frustrated with the lack of non-hormonal options out there, Swedish physicist Elina Berglund Scherwitzl, decided to found Natural Cycles – which claims to have the perfect algorithm for predicting ovulation.

This requires users to spend around two minutes a day taking their temperature and entering this data into the app. The app can then tell you whether it’s safe to have unprotected sex.

Natural Cycles only launched last year, but it already has 600,000 users worldwide and was the first app to be certified in Europe. Indeed, pharmacies in Sweden are already promoting the app.

“What many women don’t know is that they are actually only fertile maximally six days per menstrual cycle,” Berglund Scherwitzl told The Memo.

“I hope we will soon enter a new era in which women are much more in control of their bodies than before.”

The past years have seen a boom in fertility apps like Natural Cycles. Image: Natural Cycles

Vatican Roulette

Natural Cycles is not the only algorithmic option either. Thousands of fertility apps have entered the market in recent years with reportedly some 200 million users around the globe.  

Rivals include Clue, Fertility Friend, Ovia, and Ava – a bracelet that tracks your temperature at night to predict ovulation. 

They might sound high-tech, but all of these are actually based on traditional methods, explains Mary Jane Minkin, gynaecologist and clinical professor of obstetrics, gynaecology and reproductive sciences at Yale School of Medicine.

“These apps are really just fancy modifications of the rhythm method, which gynaecologists for years have referred to, among other names, as ‘Vatican roulette’ – as the only method of contraception that the church would allow,” she says.

She doesn’t see them taking over the market anytime soon, but points out that they are a great option for couples for whom getting pregnant wouldn’t be a disaster.

“The problem is that we cannot predict ovulation that far in advance, and if a woman happens to have unprotected intercourse three days in advance of ovulation, those sperm can hang around for several days, and then ‘ambush’ an egg as it is produced out of the ovary to get someone pregnant.”

And, no app can prevent STDs (yet!).

The launch of the 'Hex' in 2016 was backed by Charlie Sheen. Image: Lelo

Revamping an old friend

It’s with STDs in mind that a number of leaders have focused their efforts on giving the old condom a makeover.

The mythical graphene condom is being researched, and new arrivals to the market include Hex, an ultra-thin condom with a clever hexagonal pattern for that ultimate snug fit, launched by sex-toy retailer Lelo and celebrity ambassador Charlie Sheen.

“Our goal was to rattle the cages of the condom industry, which had been suffering from inertia for many years,” says brand manager Stuart Nugen.

“There had been no major innovation for decades. The last essential change to the condom was the addition of the reservoir tip, and that was around 70 years ago.”

Others are targeting women specifically.

The British company Hanx, for example, have developed a fair-traded vegan condom (condoms may contain the animal byproduct casein) which comes in purse-friendly boxes.

Birth control circa 2028: the plant-based molecular ‘condom’

But one invention stands particularly tall in the race to find the ultimate contraceptive that ticks all the boxes, so to speak.

US scientists are working on a plant-based potentially unisex method, based on the substances lupeol and pristimerin (found in dandelions and aloe vera) which blocks fertilization.

Also used in Chinese medicine, it prevents sperm from catching eggs and fertilizing them by turning strong swimmers weak.

It’s early days, but if planned trials are successful, it could hit the shelves as pills or patches in the next 10 years, say the researchers – both to prevent pregnancy or as an emergency contraceptive.

“The beauty of pristimerin is that it is not a steroid hormone (but a triterpenoid),” says Nadja Mannowetz, assistant project scientist at the Department of Molecular and Cell Biology, University of California, Berkeley.

Early studies on rats and isolated human sperm cells are showing a potentially glowing future for the drug.

“We are looking at a compound that is non-hormonal, non-toxic and effective in very small concentrations. Too good to be true, right?” Mannowetz adds. 

We’ve got our fingers, toes – and reproductive organs – crossed.