For generations, women have mostly shouldered the birth control burden. The pill was introduced in the 1960s, and new options, like patches and IUDs, have become available over the years. But men’s choices have remained limited to condoms, vasectomies, or using the withdrawal method (which many medical experts don’t actually recommend).
While a male birth control pill and other contraceptives have been in the works for decades, the recent Supreme Court decision overturning Roe v. Wade and the wave of anti-abortion legislation across the country is driving a new interest in the topic, says Heather Vahdat, MPH, executive director of the Male Contraceptive Initiative (MCI), a nonprofit that helps fund non-hormonal male birth control research and development.
“Birth control is everyone’s issue,” she says. “We need to look at reproductive autonomy holistically. We need to think of it as contraception, period, not men’s contraception and women’s contraception.”
The renewed dialogue around male birth control is “huge for guys,” says Dr. Luriel Smith-Harrison, MD, an assistant professor in the Virginia Commonwealth University Department of Surgery’s Division of Urology. “The more we can have an open dialogue about it, and address things openly and safely, the more control people will have over their own lives,” he says. “Having multiple birth control options allows guys to be a part of the conversation for themselves and their partners.”
Here’s a look at what male birth control options are in the pipeline and when they might be available.
Why aren’t there more male birth control options?
Researchers have been working on male contraceptives since at least the 1970s, soon after the birth control pill for women debuted. But, Vahdat says, since the pill was so tied to women’s rights and empowerment, it became the focus of birth control, and men’s options were mostly sidelined.
“You had the kind of social revolution when birth control for women became a thing, and ever since then, the day-to-day onus has been on women,” Dr. Smith-Harrison says, adding that research on male birth control has also lacked funding.
But men are interested in having more contraceptive options. Even as far back as a 2005 survey of about 9,000 men in nine countries, 55 percent expressed an overall acceptance of hormonal birth control options, and 28.5 percent to 71 percent were interested in trying the options.
Dr. Smith-Harrison says he sees more men, especially from younger generations, showing interest in contraceptives. Vahdat says her organization is regularly contacted by men who want to be included in clinical trials for birth control research.
What male birth control types are in the pipeline?
Several non-permanent male birth control options are currently at various stages of the research and clinical trial process. But it could be at least five years, maybe 10, before any new products are available, Vahdat says.
The male contraceptives fall into two categories: hormonal and non-hormonal. The best option for you, when they come out, would be a personal choice, Dr. Smith-Harrison says.
Hormonal birth control disrupts the hormonal process of sperm production and causes the testes to stop producing sperm, he explains. Because they interfere with hormones, these options are more likely to cause side effects like low libido, erectile dysfunction, weight gain, and muscle loss.
Non-hormonal options affect sperm production or function at the sperm level—for example, by blocking the vas deferens (the tubes that carry sperm from the testes through the urethra) and destroying the sperm. Non-hormonal contraceptives tend to bring fewer side effects, Dr. Smith-Harrison says, and Vahdat adds that they’re the best option for transgender individuals or people who are transitioning.
“The holy grail of birth control is something that’s effective, with minimal side effects, and relatively easy to manage,” Dr. Smith-Harrison says. Here are some of the options in development:
Male birth control pills
Currently, hormonal and non-hormonal birth control pills are being studied.
Researchers at the University of Minnesota recently announced the development of a non-hormonal contraceptive pill that reduced sperm counts and was 99 percent effective in preventing pregnancy in mice, without side effects. Gunda Georg, Ph.D., lead researcher on the project and professor in the Department of Medicinal Chemistry at the university, says the next step is to get the Food and Drug Administration’s approval to conduct clinical trials.
“We hope that everything goes well and that the FDA will allow clinical trials to start, which would perhaps be at the end of the year or the beginning of next year,” she says, adding that her team is regularly contacted by men wanting to be part of the trials.
Dimethandrolone undecanoate, or DMAU, is a hormonal oral contraceptive that’s currently in clinical trials, which Dr. Smith-Harrison says shows promise. The medication, which is taken daily, suppresses male sex hormones to reduce sperm counts.
Vas-occlusives are a type of non-hormonal contraception that blocks sperm in the vas deferens. A company called Contraline created a hydrogel, called ADAM, that’s injected into the vas deferens to block sperm from mixing with the semen that’s ejaculated. The company says the product doesn’t affect sensation or ejaculation, and the gel dissolves after about a year, so it’s not permanent
“It’s kind of like a male IUD,” says Dr. Smith-Harrison, who’s done some work for Contraline. MCI has also helped fund ADAM, which began human clinical trials earlier this year.
Another option, Reversible Inhibition of Sperm Under Guidance (RISUG) has been under development in India for years. A similar product, Vasalgel, has been studied in animals in the U.S. This non-hormonal, reversible polymer gel is injected into the vas deferens and damages sperm as it passes through. Research shows RISUG is about 99 percent effective.
Clinical trials are underway for NES/T, a hormonal topical gel that’s applied daily to the shoulders and absorbed by the skin. It contains a combination of Nestorone, a progestin medication that reduces sperm counts, and testosterone to help reduce the side effects of Nestorone, including low sex drive. NES/T’s clinical trials, which are being funded by the National Institutes of Health, are expected to be completed by 2024.
What should men use for birth control now?
Until male birth control pills, gels and injections become available, Dr. Smith-Harrison urges you to stick to condoms. They’re easily accessible and 98 percent effective when used correctly. Vahdat adds that condoms are also an effective way of preventing sexually transmitted infections.
A vasectomy is another option if you don’t want to have children, Dr. Smith-Harrison says, and more men have shown interest in vasectomies since the Roe v. Wade ruling. The surgical procedure blocks sperm from reaching the semen that’s ejaculated. While a vasectomy reversal is sometimes possible, the procedure is considered permanent, according to the Mayo Clinic.
There’s the pull-out method, too. “Withdrawal is technically an option, but the failure rate isn’t really acceptable,” Dr. Smith-Harrison emphasises. Pregnancy occurs in about 20 percent of couples who use this method each year.
This article was first published in Men’s Health US.