Wednesday October 24, 2018

A New Step Towards Contraception for Men

The responsibility for family planning routinely falls to women, and contraception is not accessible to an estimated 214 million women in developing countries.

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Newer Contraception Tries to Engage Men. VOA
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Newer birth control for men is beginning to fill the gap between the traditional condoms and sterilization. One new technology involves inserting a hypodermic needle into the scrotum. It is said to decrease libido.

For men, contraception had remained fairly stagnant for the past century, primarily limited to condoms (85 percent effective when used correctly) and vasectomy, which is usually permanent. New methods are trying to move beyond centuries-old contraception applications, and some younger men say they are enthusiastic about the prospects.

But they want them to be safe.

“Contraceptives are necessary regardless of which partner is using them,” said Shane Sullivan, a senior at Colgate University in New York. But, “I’m adverse to solutions that may induce side effects.”

But as with contraception for women, methods free of side effects are hard to come by.

Nestorone-Testosterone is a hormonal birth control gel for men that’s been in the making for more than a decade. The gel is applied to the arms and shoulders every day and works to shut down hormones responsible for sperm production. But because it drops testosterone levels, reported side effects include a low libido or problems with ejaculation.

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Contraceptive pills. Wikipedia

 

Meanwhile, scientists at the National Institutes of Health in Bethesda, Maryland have developed a daily birth control pill called DMAU. It lowers testosterone and sperm production, which decreases the likelihood of pregnancy, according to a study by the University of Washington Medical Center and at Harbor-UCLA Medical Center in Torrance, California.

All participants who tried DMAU noted some weight gain and a decrease of high-density lipoproteins (HDL, “good” cholesterol responsible for healthy cardiovascular functioning).

“Despite having low levels of circulating testosterone, very few subjects reported symptoms consistent with testosterone deficiency or excess,” said the study’s senior investigator, professor of medicine Stephanie Page at the University of Washington in Seattle.

“DMAU is a major step forward in the development of a once-daily ‘male pill,’” Page said. “Many men say they would prefer a daily pill as a reversible contraceptive, rather than long-acting injections or topical gels, which are also in development.”

Contraceptives such as Vasalgel block the vas deferens, or the tubes through which sperm travel, with the injection of a gel into the scrotum. The Indian developer of Vasalgel licensed it to non-profit company Parsemus Foundation in the U.S., which focuses its development on innovative but neglected pharmaceutical advances.

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DMAU is a major step forward in the development of a once-daily ‘male pill

 

Vasalgel can last a few months to a few years. It has shown minimal adverse impacts and the developer calls it the “IUD for men” because it is non-hormonal.

Robert McLachlan, professor of men’s health at Monash University in Melbourne, found another injectable option for men. McLachlan designed an intramuscular shot delivered in the buttocks, increasing testosterone, which greatly reduces sperm production.

The most common side effects for the injectable hormonal contraceptive included acne, injection site pain, mood disorders, and an increased libido.

In a survey conducted with 134 young adults aged 18-27, of which 61 were male, their average likelihood of supporting male contraceptives was 8.6 on a scale from 1 to 10, (1 being the least likely and 10 being the most like to support.) Of all the respondents, 29 percent were quick to note that hormonal contraceptives for women already include the side effects that some of the newer drugs would present for men.

Brennan Sullivan, a 24-year-old research assistant from Johns Hopkins Medical Institutions (JHMI) noted the impact a male-dominated medical field has on women. He emphasized that “male contraceptives should not be seen as equivalent to female birth control,” and explained how many scientists have not considered these biological differences between men and women when developing medications.

Ahead of Food and Drug Administration approval for oral contraceptives for women in 1960, couples relied on withdrawal and condoms to prevent pregnancy. Soon, women on the early forms of the Pill began to complain of side effects that included hormone imbalance, weight gain, acne, and mood changes because of high estrogen levels. According to the Centers for Disease Control and Prevention, (CDC), nearly 30 percent of users stopped oral contraceptives, and dosage was modified to balance contraception with user tolerance.

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For men, contraception had remained fairly stagnant for the past century, Wikimedia commons

 

Despite successful findings and trials, the pharmaceutical industry thinks there is a relatively small market for male contraceptives, so it may be a while before these drugs actually hit the shelves. McLachlan noted the industry was “involved in this research until about five years ago and both the big companies that were involved — one pulled out [of research] about a decade ago.”

“Seeing as they’re the same side effects as most female birth control options, it’s not too bad,” said Pavan Devraj, a sophomore at the University of Georgia.

Jameson Carter, a research assistant at the Library of Congress, also expressed support.

“I think this stuff has to start somewhere. I understand it won’t be as convenient as just using a condom, given the side effects. I’d try it.”

Some men see birth control as an opportunity to be equally accountable for contraception.

“Men should absolutely engage in the same difficult choices that women do if they choose to engage in sexual activity,” said Mishka Naiker, 22 and a recent graduate from the University of Alabama. “Women are biologically more responsible for the existence and welfare of a child, even though the creation of a fetus takes both a man and a woman. That is the only time the responsibility is honestly 50/50.”

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Male contraceptives proved safe and effective.

Wazir Hossain, a 24-year-old recent graduate from the University of Georgia, agrees and says it’s great for men to “have some form of control over the outcome of a situation and hold themselves accountable.”

Computer programmer Kaden Weaver, 23, expressed concerned about potential side effects.

Also Read: Ovarian Caner Risks Cut in Half With A New Birth Control Pill: Study

“I am fully supportive of male contraceptive options similar to birth control, but… I feel as though things with these side effects don’t belong in the human body. ”

That attitude is not embraced in all parts of the world. The responsibility for family planning routinely falls to women, and contraception is not accessible to an estimated 214 million women in developing countries, according to a report by the Guttmacher Institute. (VOA)

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A New Virus Typhus Rises In Los Angeles

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases.

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Retired coal miner James Marcum, who has black lung disease, takes a pulmonary function test at the Stone Mountain Health Center in St. Charles, Virginia, U.S., May 18, 2018. (VOA)

Typhus, a bacterial infection that is sometimes life threatening, is on the rise in Los Angeles and several other U.S. cities. Public health officials say homelessness is making the problem worse and that the disease, which is associated with poverty and poor sanitation, is making a comeback in the United States.

Los Angeles County has seen 64 cases of typhus this year, compared with 53 at the same point last year and double the typical number, with a six-case cluster among the homeless in L.A. this year. Two cities in the county that have separate counts are also seeing higher numbers: Long Beach with 13 cases, up from five last year, and Pasadena with 20, a more than three-fold increase from 2017.

At a clinic in the L.A. neighborhood called Skid Row, Dr. Lisa Abdishoo of Los Angeles Christian Health Centers is on the lookout for symptoms.

“It’s a nonspecific fever,” she said, “body aches, sometimes a headache, sometimes a rash.”

This kind of typhus is spread by fleas on rats, opossums, or even pets and is known as murine typhus, from the Latin word for “mouse.”

The risk is higher when people live on the streets in proximity to garbage, but the disease seems to be spreading through the Southern United States.

Not the typhus of WWI

“It’s never been considered a very common disease,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, “but we seem to see it more frequently. And it seems to be extending across from Southern California all along the Mexican border into southeastern Texas and then into the Gulf Coast in Florida.”

 

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A homeless man sits at his street-side tent along Interstate 110 along downtown Los Angeles’ skyline, May 10, 2018. Thousands of homeless people sleep on the streets of Los Angeles County.. VOA

 

Texas had 519 cases last year, said spokeswoman Lara Anton of the Texas Department of State Health Services. That’s more than three times the number in 2010, with clusters in Houston and Galveston. No figures for this year have been released.

This is a separate disease from typhoid fever and is not the epidemic form of typhus that caused hundreds of thousands of deaths in war time. That type, called epidemic typhus, is carried by body lice and often spreads in conflict zones. It led to millions of deaths in World War I alone.

Flea-borne typhus, the kind seen in California and Texas, is serious but often clears up on its own and responds to an antibiotic, Abdishoo said.

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Dr. Peter Hotez, dean of the Baylor College of Tropical Medicine, shows Associated Press journalists areas of Houston’s 5th Ward that may be at high risk for mosquitoes capable of transmitting the Zika virus in Houston.. VOA

“It seems to get better a little faster if you have the treatment,” she said. “But there are cases where people have had more severe complications — it’s rare, but getting meningitis, and even death,” she cautioned.

Migration, urbanization, climate change

The reason for increased typhus numbers is uncertain, but it may be linked to migration, urbanization and climate change, said Hotez, the disease specialist. In some parts of the world, typhus is still linked to war and instability, “in the conflict zones in the Middle East, in North Africa, Central Asia, East Africa, Venezuela, for instance with the political instability there,” he said.

Murine typhus is one of several diseases on the rise in the southern United States, Hotez said.

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People line up on Skid Row in Los Angeles to receive food, water, clothing and other basic necessities from Humanitarian Day Muslim volunteers.. VOA

“Others include dengue, now emerging in southern Texas and Florida, the Zika virus infection, Chikungunya. We have a huge problem with West Nile virus,” he added, and Chagas disease, a condition usually seen in Latin America.

A report in May from the U.S. Centers for Disease Control and Prevention found that such “vector-borne” diseases, transmitted by ticks, fleas or mosquitoes, more than doubled in the United States between 2004 and 2016.

Hotez says they are on the rise in many industrial nations with crowded cities and pockets of poverty.

Also Read: A Full Guide To Public Health Disease Hepatitis

Skid Row physician Abdishoo says flea-borne typhus is still uncommon on the streets of Los Angeles, but “it has us all on high alert for this illness that we don’t necessarily think too much about. We want to be vigilant,” she added, “when you see a communicable disease on the rise.”

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases. Voters approved funding in 2016 and 2017 to finance the efforts. (VOA)