On the way: Oral contraceptives for men

By KWAMBOKA OYARO

There is excitement in the field of research as scientists work overtime to make a male oral contraceptive a reality. The researchers in a university laboratory in Indonesia are on the verge of making history by presenting the first contraceptive of its kind to the world.

The scientists are humble about their crucial contribution but sometimes the probable impact of their success is overwhelming and one of them shouts, “This is it!” The others smile knowingly. Their raw material, the Justicia gendarussa tree, is widely available as it grows naturally in Indonesia and south East Asia.

Picking the tree for this study was not by chance. For years, the men of Papua, occupants of one of the 17,000 Indonesian islands, have used the tree to avoid pregnancy in pre-nuptial relationships. The Papuans — considered ‘primitive’ compared to other more developed provinces of the country — know that the tree is toxic and boil the leaves for hours to kill the toxins.

They drink the boiled water about 30 minutes before intercourse. Unconfirmed reports (no scientific study to prove this) say the rate of success among the Papuans is 100 per cent.

Indeed, the researchers’ effort to turn these leaves that have worked successfully for the Papuans into male family planning pills has not disappointed them as results of their trials are showing almost 100 per cent success.

The first and second trials have shown that the pill is safe and effective.  Most importantly, the research established the quality, safety and efficacy of the drug.

The experiment has been going on for years. The researchers  used mice to find out the drug’s suitability and after 20 years and convincing results, the researchers were ready to start their first trials on humans in 2008.

Making the drug In the laboratory at the Faculty of Pharmacy in Universitas Airlangga in Surabaya, Indonesia’s second largest city after capital Jakarta, lead researcher or team leader Dr Bambang Prajogo, explains the process of making the drug.

Before it reaches the laboratory, the leaves of the raw material, the Justicia gendarussa tree, are harvested, cleaned and dried for about three days in hygienic conditions before they are crushed into powder form and delivered to the university.

At the bottom of the chain of production are hirelings who harvest the leaves, deliver them to a herbal factory, Sido Jodo, a family-run business on the town’s outskirts.

Once the leaves are received, they are cleaned to remove any physical impurities before they are dried in the sun.

At the laboratory, the dry leaves, now in powder form, are converted to capsules. These capsules are then given to the selected subjects in the trials to take. In the first trial, the results showed 100 per cent success and the subjects reported no side effects.

In the phase two trials that started in 2009 with 120 male subjects, one woman got pregnant and the researchers are looking at what might have happened including whether there was honesty in sticking to just the one method.

The phase three trials, which started last year, are ongoing and so far there is no reported pregnancy. To qualify for the trials, the male subjects must be aged between 21 and 41, married with at least one child and have normal, healthy sperm. They must also commit themselves to use the pill as the only contraceptive during the period of trials which lasts five to six months. During that time, they get health insurance and a stipend.

One of the subjects in the study, Mr Panca Ariansyah, a father of three daughters, says he readily joined the trials because he was desperately looking for an alternative family planning method after his wife conceived even while on contraceptives. His wife supported him.  He took the capsules and used no other family planning method. “My wife and I don’t want any more children. For us, this is the best method as it has no side effects,” says Mr Ariansyah, 38.

In the study, Ariansyah took the capsules for 72 days, the stipulated period for phase two trials. In phase three, the duration was reduced to 30 days.

Better libido Says Dr Prajogo: “From phase one and two findings, we are working on reducing the length of time one can take the pill.”

At the end of the study, they will determine whether someone has to take the pills before or just during the wife’s fertile days. They might just come to the same results the Papuans have always used: Just 30 minutes before sex.

In addition to its effectiveness, some of the subjects in the study have said they have found their libido better during the durations, says Dr Dyan Pramesti, a lecturer in bio-medical science department in the School of Medicine at the university.

The good news for men is that this method is not permanent as fertility returns immediately after one stops taking the pills and it is not a barrier (like the condom) — vasectomy and condoms are the only  family planning methods available to men.

Says Indonesia’s minister of Health Dr Endangy Rahayu Sedyaningsih: “Since men don’t like the two options available for them — vasectomy and condoms  — perhaps a pill will be more welcome.” Globally, Indonesia is the fourth most populous country. It has a population of more than 250 million.

Will the male contraceptive see the number of men increase the uptake of contraceptives? In Indonesia, just like in Kenya, a negligible number of men use contraceptives. In fact, only a tiny percentage has had vasectomy done.

This is the case in other countries too; men believe contraceptives are a woman’s prerogative. It doesn’t help matters that myths associated with family planning and contraceptives are discouraging many from planning their families.

This came out strongly a week ago when a report of Kenya Medical Research Institute indicated that many women don’t use contraceptives due to belief in myths. 

The ball will soon be in the men’s court. Will they take charge of Kenya’s destiny by controlling the population growth or will they sit back and watch as Kenya numbers swell to 70.5 million in 2030?