What are the latest advancements in male contraceptions?

The drawback of surgical approaches (such as vasectomy), especially patient compliance and the low success rates with condoms has spurred research on hormonal contraceptive dosage forms. There is a dearth of investigations in the development of pharmaceutical preparations. Evolving technology in the 21st century as well as improvement in living standards further underline the need for new male contraception approaches, especially those that entail new drug delivery methods.

Here are few areas where male contraception is being researched and used in some countries

Hormonal contraception for men is possible, and we are at the threshold of an important breakthrough. Combined testosterone plus progestin administration is more effective and safer than testosterone alone. Combination of testosterone plus an anti-androgenic progestin has several advantages over other formulations. In combined therapy, single injection formulation may have better compliance. 

Conventional male contraception 
Abstinence (doesn't work well)
Masturbation
Male condom
Vasectomy
There are other methods being developed but not sure they are there yet. But for guys? Their options are stuck in a time warp. If a man wants to take pregnancy prevention into his own hands, his choice basically comes down to condoms, a vasectomy, withdrawal, or abstinence. That s why it's so amazing that scientists are finally developing some real advancements when it comes to male contraception.

Researchers writing in the April issue of the Open Access Journal Contraception published a rundown of the top emerging options. A few hold real promise, particularly a daily or weekly pill that would deliver a dose of artificial hormones to a guy s bloodstream, which would then act on reproductive hormones to stop sperm from being produced. Like the female hormonal pill, the male hormonal pill would be reversible. But also like the female hormonal pill, there appear to be side effects, among them acne, weight gain, and even trickier to work around, changes in testosterone levels that trigger a plunge in libido.

Non-hormonal techniques are also being developed, particularly a vaccine that immunizes men with antibodies to halt sperm production. This so-called male birth-control shot is encouraging, because it targets sperm directly (rather than targeting other hormones in the body) and doesn t have the testosterone-lowering side effects of a hormonal pill. Each injection would last for long intervals (experts aren t yet sure how long), but the pregnancy-preventing effects would be reversible, if and when a guy decides he s ready to be a dad.

So when can you expect to see men rushing out to the pharmacy counter to pick up their new birth control Rx?  I think we may see a novel male contraceptive within 10-12 years, That may seem far off, but hey at least it s finally within sight.

Male Contraception - An Insight!

Contraceptives are generally drugs and devices, which are used to prevent pregnancy. A large number of contraceptives are available which allow the couple to enjoy sex without running the risk of unwanted pregnancies. The general categories of contraceptives are explained below:

Barrier Methods:
i. Male Condom: It is one of the most common forms of contraception. They are worn on the penis before sex is initiated. For safety purpose, a new condom should be used every time the person has sex.

ii. Female Condom: Much like male condoms, these are available at over-the-counter pharmacies without prescription. The condoms can be inserted to the vagina anytime within a period of 8 hours prior to sex.

iii. Diaphragm: This should be coated with a spermicide before sex and placed inside a woman's vagina so that the sperms are prevented from entering the uterus.

iv. Cervical Cap: These are used as replacements for diaphragms because some women may develop bladder infections such as cystitis while using it and these caps have lesser contact with the vagina.

Hormonal Methods:
The main implementation of hormonal changes to provide contraception is the pill. This is the most common form of female contraception available. It comes in two forms:
i. Combined contraceptive pill: Contains a combination of hormones such as progestin and oestrogen.
ii. Mini-pill: Contains only progestin: It is available only with the prescription of the doctor and should be used as per the prescription.

Intrauterine Devices
The intrauterine device (IUD) is a long-acting and reversible form of contraception for women. It is of two types: Copper IUD (contains copper) and Hormone-releasing IUDs (progestin hormone is released into the womb slowly). It is a small device that is fitted inside the womb and it provides contraception by facilitating the prevention of fertilization of the egg.

Sterilization
This is a lifelong option that is available for both men and women. In males, the procedure is known as vasectomy which basically ties and cuts off the tubes that carry the sperm.

In women, two forms of sterilization are available; surgical and non-surgical. Surgically, the fallopian tubes are cut and tied using small cuts in the belly so that the ovaries and uterus are not linked. Non-surgically, coils are inserted into the fallopian tubes so the resultant development of scars leads to complete blockage of the tubes.

Other forms of contraceptives include contraceptive patches, vaginal rings, contraceptive injections, spermicides and contraceptive implants.

Different Types of Contraceptives and Its Uses

Abortion is the process of terminating pregnancy. It is induced, either by the use of medications or by surgical procedure. The term abortion is usually used to denote induced termination. Unsafe sex is one of the major causes of abortion, even though it is legal under a number of circumstances in most countries. 
The term miscarriage is used to denote spontaneous termination of pregnancy before a fetus develops. In other words, miscarriage is denoted as spontaneous abortion in medical terms.

What are the causes of abortion?
Causes of an abortion or miscarriage may be due to fetal or maternal complications. Some of the fetal factors include:
1.  Unwanted pregnancy
2.  Abnormal development of fetus, either due to abnormal chromosomes or teratogenic factors.
3. Immunological factors
4. Problems with implantation
5. Serious health diseases like kidney disease

What are the homeopathic treatments for abortion?
Homeopathic medication system is one of the most popular and widely accepted holistic medication approaches used all over the world. The choice of remedy for any disease is based on individualized symptoms and lifestyle habits using a holistic method. In such a way, a state of complete wellness can be achieved by eliminating all the signs and symptoms that the patient is suffering from. The main objective of homeopathy is not just to manage the adverse effects of abortion. 

Some of the homeopathic remedies that are beneficial in treating abortion or miscarriage are given below:

1.  Aconite Nap: Helpful in treating anxiety, excitement or fear experienced before the procedure.
2.  Apis Mel: Medication used during the 3rd month of pregnancy
3.  Aletris Far: Treats conditions of typical abortion that is done due to anemia or weakness or other conditions affecting the mother
4.  Arnica Montana: To manage abortion that is done after an accident to treat the mother
5.  Baptisia- Used in treating abortion is done due to shock, fever or mental depression. Often used for women under the age of 21.
6. Sepia: Used when there is an abortion during fifth to seventh month of pregnancy.
7. Thuja: Used to treat women who have a history of gonorrhea.
8. Syphilinum: Used for treatment when there the abortion is done due to syphilis.

Homeopathic Management of Abortion - Best Medicines & Remedies 

Most medications are used because of their one particular therapeutic effect. However, invariably, they affect other organs or systems and produce some good and some adverse effects. The same happens with birth control pills (BCPs), which are the most commonly used method of contraception. It is also the most effective method. It contains the female hormones estrogen and progesterone in various combinations and these have an effect on various body functions, so it should come as a surprise that regular use of BCPs leads to a number of side effects.

Read on to know more

Intermenstrual bleeding: This is the most common side effect and occurs in about 90% of the women, but usually subsides within 3 months. They experience bleeding between their regular periods. While mere spotting can be ignored, bleeding for more than 4 to 5 days needs a visit to the doctor.
Missed period: It is very essential to take the pill at the same time daily. Sometimes, a period might be missed or may be very light and this should be reported.
Effect on libido: While some report a decrease in libido, there are others who experience an increased sex drive. This depends on the individual and not consistent.
Vaginal discharge: The amount and type of discharge can change when on the pill. Decreased lubrication may lead to a reduced sex drive, as it might be painful. If the discharge is foul-smelling or looks suspicious for an infection, then a doctor should be consulted.
Mood changes: Changes in mood and prominent mood swings are very common in women using contraceptives, with many feeling depressed often.
Effects on breasts: While it is not yet proven if they increase the risk of breast cancer, most women experience breast enlargement, tenderness, and sometimes pain. This is more common in between their periods.
Headaches and migraine: BCPs are also proven to have worsening effects on migraine and headaches.
Circulatory effects: Oral contraceptives increase the chances of heart attack and stroke, especially in women who are over 35 and are smokers. Most women experience a slight increase in blood pressure and are more prone to form blood clots. It is essential that contraceptives are used under medical guidance only.
Digestive effects: Oral contraceptives can cause loss of appetite, changes in body weight, diarrhea, and nausea. The weight gain is also attributed to increased fluid retention, especially in the hip and breast areas.
Skin: Some women may experience skin rashes and acne and sometimes hair loss due to the increased level of hormones in circulation.
It is very important that the pill is taken at the same time for best results. Any suspicious symptom should be immediately reported to the doctor.

10 Side Effects of Birth Control Pills

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Contraceptive methods of birth control are usually quite successful. By these methods, you can enjoy your life without the worry of pregnancy. Modern technology has led to the formulation of avid techniques of contraception; some are temporary and the others permanent. However, no matter how well these methods work, almost all of them have got a variety of side effects on your body and health.

Here is a list of different modes of contraception and the side effects they may cause:

 Hormonal implants
This long term method of birth control is an effective one. The side effects are:
- a surgery is required where rods are inserted under your skin. This might be risky surgery
- if you want to remove it, again another surgery has to be carried out
- an infection may develop in the area where the thin rods are inserted

Intra uterine device
A device is fitted into the uterus, which does not cause pregnancy. An effective method with the following side effects:
- there is a risk of the device falling off
- this causes puncture in the uterus
- the device made of copper may lead to menstrual cramps and spotting

Depo provera hormonal injection
This mode of contraception involves taking an injection, which restricts pregnancy for a period of three months. The side effects are:
- gaining of extra weight, fatigue
- decrease of bone density
- menstrual bleeding along with spotting takes place

Birth control pills
Birth control pills are one of the most common and most effective ways of birth control or contraception. However, several side effects may be observed.
- causes nausea, headaches and also blood clots in rare cases
- in case you use other prescribed medicines along with birth control pills, severe damage may be inflicted

Vaginal ring
This mode of contraception is very effective. It also helps in making menstrual periods of women much lighter and in continuity. The side effects are:
- may cause nausea and headache
- there is a vast increase in appetite
- there is a risk of blood clot formation.

Diaphragm
A very successful mode of contraception where a diaphragm is inserted and fitted into the vagina. The negatives of this mode are:
- it may get out of place during sex and is likely to cause damage
- the process can be a mess
- causes urinary infections

All modes of contraception irrespective of their effectiveness have got some side effects on your health. Hence, you must choose them wisely.

Comparison of Side Effects of Different Contraceptive Methods

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