This article was taken from the November 2013 issue of Wired magazine. Be the first to read Wired's articles in print before they're posted online, and get your hands on loads of additional content by subscribing online.
Condoms and coitus interruptus are the only means of reversible birth control in men -- and will remain so because the problem is not scientific, but economic. Scientifically, we know how to create a male Pill. Yet despite much clinical research, the top 20 pharmaceutical companies have shown zero interest in taking such a product to market. Aside from big pharma's focus on older people (a resounding "yes" on treatment for erectile function, an equally resounding "no" for contraception), the biggest problem is the fact that a young man's reproductive span is two to three times longer than a 20-year-old woman's.
A young woman will not ask whether continued use of her Pill would affect her fertility at 45 or 50, whereas many 20-year-old men would require a guaranteed answer. To provide an epidemiologically valid answer to a young man would be expensive, time-consuming (thus cannibalising most of the potential patent life) and open to lawsuits, since men may blame their Pill for age-related erectile dysfunction and prostate-gland problems.
I'm a firm believer in men assuming more responsibility for birth control, but have been so pessimistic about the prospects of a male Pill that I made the following prediction in my 1979 book
The Politics of Contraception: "Every post-pubescent American female reading this in 1979 will be past the menopause before she can depend on her sexual partner to use his Pill."
In several hundred lectures on advances in female contraception, I have frequently encountered aggrieved feminist critics asking: "Why is there no Pill for men instead of the Pill for women?" A male feminist such as me (who sees a liberated woman as a person in charge of her own fertility) would respond that under such circumstances, most decision-making power about a woman's pregnancy would still remain in men's hands.
The more apt question is "Why is there no Pill for men in addition to the Pill for women?" More recently, I've addressed that issue in my "science-in-fiction" as case histories: in my writing I smuggle such information into the reader's mind in the guise of engaging fictional plots.
My novels Menachem's Seed and NO concentrate on male reproductive biology. In Menachem's Seed, a male reproductive biologist addresses the female director of a foundation backing research in reproduction and contraception: "Could you support a project of mine?" "I could arrange an expedited review -" "I'm sure you could... but to be frank, I'd rather not have the competition see what we've got up our sleeves. You know how small a community male reproductive biology is. Your panel must be full of -" "OK," she interrupted. "So what's so hot about your project?" "It's a new approach to impotence..." "Are you trying to cause it or cure it?" "Be serious. We're trying to cure it." "That's all you men ever think of. What about prevention rather than performance? In other words, pay some attention to contraception. We get so few applications for contraceptive research. And virtually none for male birth control. All the reproductive fraternity is interested in is impotence or infertility."
She then outlines some promising novel approaches to male contraception, many of which have worked in actual clinical studies, but which no large pharmaceutical company will pursue.
Scientists and pharma are not interested in male contraception, but rather in the more "glamorous" topic of impotence, thus the capitalised NO in my title. To a chemist, NO is nitric oxide - the causative agent for penile erection and the basis through which Viagra and related drugs operate.
In 1951, Carl Djerassi synthesised the molecule norethisterone, a feat which led to the development of the oral contraceptive. He is emeritus professor of chemistry at Stanford University and author of many books and plays.
This article was originally published by WIRED UK
