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When Will Men Get Birth Control Pills? Your Questions, Answered

The National Institutes of Health is funding a clinical trial to test a contraceptive gel formulation called NES/T, which men would apply to their shoulders and upper arms once per day. The hormonal gel is currently in Phase II clinical trials, said Dr. Wang, who is one of the lead investigators. She estimates that, optimistically, the gel could be available in five years — but even that would be moving very fast, she said.

Contraline, a biotechnology company in Virginia, is awaiting clinical trials for Adam, an injectable hydrogel that lasts for a year. The company bills it as “the IUD, for men.”

Researchers in India are testing a nonsurgical vasectomy procedure known as Reversible Inhibition of Sperm Under Guidance, or R.I.S.U.G., which involves injecting a gel into the tubes in the penis that store sperm. But until these endeavors go through substantial studies — and, critically, trials in humans — a male form of birth control comparable to the pills, patches, shots and rings on the market for women remains a fantasy.

“I’ve been excited about animal studies demonstrating promise for male contraceptives for a while now,” said Dr. Bobby Najari, an assistant professor of urology and population health and director of the Male Infertility Program at N.Y.U Langone Health. “And each time, I get disappointed.”

There are currently only two approved forms of male birth control: vasectomies and condoms.

And while vasectomies are reversible, Dr. Najari said he would never recommend getting a vasectomy with the intention of later reversing it. The American Urological Association vasectomy guidelines note that reversals may not always be successful. The reversal procedure tends to be longer than the original vasectomy, with a longer recovery time, he said, and insurance does not always cover it. Vasectomies have also been linked to complications like infection and both short-term and chronic pain.

Condoms have the additional benefit of protecting people from sexually transmitted infections, but they are “relatively unpopular,” Dr. Najari said. Even when people do use condoms, they can break and tear; the Centers for Disease Control and Prevention estimate that the condom use failure rate is 13 percent.

In the 1990s, the World Health Organization conducted research into testosterone as a potential form of contraception and found it was highly effective at decreasing sperm counts. But high levels of the hormone were needed to effectively suppress the sperm, which led to taxing side effects: weight gain, acne, irritability, mood swings.

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Alpha, Delta and Now Omicron – 6 Critical Questions Answered As COVID-19 Cases Surge Across the Globe

The list of SARS-CoV-2 variants – each with its own unique qualities that give it an edge – just keeps growing.

“The Conversation” Editor’s note: The omicron variant of

Omicron contains a large number of mutations and is much more transmissible than earlier variants of the SARS-CoV-2 virus.

Those properties, and the timing of this variant emerging during the holiday season, resulted in the extraordinary surge in COVID-19 infections in the U.S. Add in wintertime – which brought people indoors – along with pandemic fatigue, and you have the perfect storm for rapid transmission.

The good news is that vaccination and vaccine boosters nevertheless provide good protection against severe disease and hospitalization. But given the current number of cases, that still means a lot of illnesses, hospitalizations and deaths in the weeks to come.

Could omicron move the population closer to herd immunity?

Herd immunity occurs when enough people have immunity to a virus that it no longer spreads well. It is only possible when two conditions are met. First, a large fraction of the population must be vaccinated or recovered from prior infection. Second, vaccination or prior infection must confer enough immunity to block or slow future infections. Will vaccination campaigns, combined with widespread omicron infection, be enough to bring herd immunity?

Three issues complicate the hope of achieving a long-term herd immunity after omicron. The first is that immunity naturally wanes over time, regardless of whether it comes from a vaccine or prior infection. It is not yet clear how long after infection or vaccination immunity to this virus lasts, since SARS-CoV-2 has been infecting humans for only two years. Eventually, controlled studies will be able to determine this.

Second, children younger than age 5 are not yet eligible for COVID-19 vaccines, and new susceptible children are born every day. So, until all age groups are eligible for vaccination, there will likely be ongoing transmission in kids.

And third, we can’t rule out that new variants could escape existing immunity. As omicron has shown, infection with one variant doesn’t guarantee protection against infection by future variants.

Together, these three factors suggest that even if a large enough fraction of the population recovers from omicron, long-term herd immunity is unlikely. These are the same reasons that humans never achieve long-lasting herd immunity to influenza and have to get a new flu vaccine each year.

It’s important to remember that, with all variants to date, most of the people who are hospitalized for COVID-19 are unvaccinated. This shows that vaccines are an effective tool for reducing disease severity and can be beneficial even against new variants.

Where do new variants like omicron come from?

When viruses make more copies of themselves inside of human cells, they make mistakes in that process – mutations – that alter their genetic code. Most of these mutations will not be beneficial to the virus. However, in some instances, a virus hits on a jackpot of one or more beneficial mutations that fuel its spread through a population. The alpha variant possessed some mutations in the spike protein that made it easier for viruses to infect cells. The delta variant had additional mutations that improved viral spread. Omicron, with its staggering number of mutations, is a true oddity. It’s rare for a coronavirus to rapidly accumulate so many mutations in its genome.

The origins of omicron are still poorly understood. One prevailing theory is that an immunocompromised person was infected with a coronavirus for an extended period of time, leading to accelerated viral evolution. Another theory speculates that omicron could have evolved in another animal species and then reinfected humans. Alternatively, omicron could have evolved gradually in a location with poor sequencing surveillance. There is still much more that needs to be understood about the factors that led to the emergence of this highly mutated variant.

Could omicron mutate to become more deadly?

The variants that have risen to prominence have done so because they contain advantageous mutations for the coronavirus. We are essentially witnessing Darwinian evolution – survival of the fittest – in real time. Variants with beneficial mutations, such as those providing escape from antibodies or shorter incubation periods, are rapidly displacing their less fit predecessors.

The most important thing to remember about virus evolution is that natural selection favors variants that spread better than other variants. The great news is that more pathogenic – or dangerous – variants are less likely to spread well. This is because individuals who feel particularly sick tend to naturally self-isolate, reducing the virus’s chance to transmit.

Also good news is that, because infection with one variant provides partial immunity to others, omicron’s rapid spread has brought on delta’s swift decline.

At this point it is expected that all new variants that spread widely – so-called variants of concern – will continue to be highly transmissible.

What about the buzz around ‘deltacron’ and ‘flurona’?

In early January 2022, researchers in Cyprus reported cases of COVID-19 infections containing sequences of both omicron and delta, dubbed “deltacron.” However, other scientists are speculating that this is nothing more than a laboratory contaminant – an omicron sample contaminated with delta. While more details are needed, as of now, there is not cause for alarm over this possible hybrid because it has not been commonly observed.

And in recent weeks the term “flurona” has surfaced, referring to an individual who is infected with both influenza virus and a coronavirus at the same time. While rare, such situations do happen, and it’s important that you reduce your risk by receiving both the influenza and COVID-19 vaccines. But it’s important to note that flurona is not a new combination of the flu and coronavirus genomes, making this term a bit of a misnomer.

Written by:

  • Sara Sawyer – Professor of Molecular, Cellular and Developmental Biology, University of Colorado Boulder
  • Arturo Barbachano-Guerrero – Postdoctoral Fellow in Virology, University of Colorado Boulder
  • Cody Warren – Postdoctoral Fellow in Virology and Immunology, University of Colorado Boulder

This article was first published in The Conversation.



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