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Male birth control: Current options and new breakthroughs

The availability of options for contraception has been a wonderful asset for people when it comes to family planning and preventing unintended pregnancies. That being said, it has largely been the responsibility of females because there have been more readily available methods for them. However, recent advances in male contraception have made it so that there are more birth control options for men both available and on the horizon.

8 birth control options for men

Up until recently, the main contraceptive methods for men included withdrawal, condoms, and vasectomies. However, new progress has been made in the world of male birth control: There are new options both currently available and in development. 

Much like in the case of female contraception, each method comes with its own pros and cons, depending on your unique circumstances. 

Birth control options available for men include:

  1. Condoms
  2. Outercourse
  3. Withdrawal (or “pulling out”)
  4. Male birth control pill
  5. Male birth control shot
  6. Male birth control gel
  7. Vasectomy
  8. Nonsurgical vasectomies 

1. Condoms

Availability: Available for purchase over the counter

Condoms have been a popular form of birth control for men due to their efficacy against both conception and sexually transmitted infections (STIs). Condoms are more effective than withdrawal and can be used in tandem with other forms of birth control (for example, with a female partner who is taking the birth control pill). 

When used correctly, condoms can be very effective at preventing pregnancy; however, there are many opportunities for human error that can render them less effective. For instance, if a condom is put on incorrectly, or has small holes or tears, some semen may get through to the ovum, making fertilization possible. 

If you are using condoms as a birth control method, it’s important to make sure that they are aren’t expired, have been stored correctly, and are put on properly. 

2. Outercourse

Availability: Available for use

According to Planned Parenthood, outercourse is sexual activity that does not involve traditional (penis in vagina) penetration. As a form of birth control, outercourse is effective at preventing the sperm and egg from coming together, which is necessary for fertilization to occur.

Outercourse can mean different things to different people, so in some cases, this may include oral or anal sex. Although these activities will not result in fertilization (unless the sperm ends up entering the vagina), condoms are advisable to prevent STIs.

3. Withdrawal

Availability: Available for use

Withdrawal is more commonly known as “The Pull Out Method.” This is when the man “withdraws” his penis before ejaculation to prevent the sperm from reaching the female egg. As a method of birth control, it is not highly effective, as it can be very difficult to do correctly on a consistent basis. There is a chance that sperm can still reach the egg, causing conception to occur. 

Although this method isn’t very effective, it is more successful at preventing pregnancy than using no contraceptive method at all. 

4. Male birth control pill

Availability: In development 

In March of 2018, there was a breakthrough when it came to a birth control option for men in pill form. Scientists at the National Institutes of Health and Eunice Kennedy Shriver Institute of Child Health and Human Development announced that they had completed preliminary testing of a male pill containing dimethandrolone undecanoate (DMAU). For the course of their study, 100 healthy men took a daily dose of DMAU, and after 28 days effective contraception was observed. Their study determined that the drug was well-tolerated by the male participants and that after 28 days, their fertility was decreased to near castration levels. 

The drug works by reducing the levels of male hormones such as testosterone and inhibiting the formation of sperm cells. Dr. Kendra Segura, a board-certified OBGYN explains that “Dimethandrolone undecanoate (DMAU) is an androgen/anabolic steroid/progesterone once-daily pill that suppresses FSH and LH causing a decrease in production of testosterone and sperm.” She says that it’s currently in clinical trials to assess “long-term effects on kidneys, liver, libido, [and] depression.” 

Other clinical studies are also investigating an injectable version of DMAU. However, due to the lengthy drug approval process by the FDA, we may not see this on the market for a long time. 

5. Male birth control shot

Availability: In development

A 2016 study sponsored by CONRAD and the World Health Organization looked at whether a combination of hormones delivered to men via injection was effective for contraception. However, the study was terminated early due to severe side effects and mood disorders that resulted from the shot. 

The shot contained long-acting versions of a progestin, norethisterone enanthate (NET-EN), and an androgen, testosterone undecanoate (TU). Male participants were given the shot every eight weeks as a form of contraception. The results showed that while the injections were effective in almost completely inhibiting sperm production, the side effects were too severe for the study to continue. Male participants experienced acne, pain at the injection site, increased sex drive, erectile dysfunction, and mood disorders. 

In recent months, researchers in India have completed clinical trials of an injectable male birth control called RISUG (reversible inhibition of sperm under guidance). According to Dr. Segura, this “is an injection that is gel-like, which inactivates the sperm.” RISUG works by injecting a polymer gel into the male’s vas deferens to block sperm cells from leaving the body. This sterilizes the male, preventing pregnancy. A single injection can be effective for up to 13 years and can be reversed if necessary by another injection which acts to dissolve the gel. RISUG shows enormous promise for males who do not want a permanent, surgical vasectomy. The trials included more than 300 male subjects and produced a success rate of greater than 97% pregnancy prevention. It is currently pending regulatory drug approval in India. 

In the United States, Vasalgel, which is a contraceptive method based on RISUG, is in development. It is unclear when Vasalgel will hit U.S. markets if trials succeed.

6. Male birth control gel

Availability: In development

A contraceptive gel called Nestorone-Testosterone (NES/T) has been in the works for more than a decade and has the potential to be a very effective hormonal birth control option for males. The gel shuts down gonadotropin hormones and reduces testosterone production in the testes. This acts to lower sperm count , which in turn prevents pregnancy. The gel, which the FDA recommends applying to the shoulder daily, was shown to be effective in suppressing sperm production in a 2012 study of 99 males. Another clinical trial commenced in 2018. 

Because of the rigorous safety tests  and approval process that is required by the Food and Drug Administration (FDA), this drug may not be available commercially for a while. The gel is anticipated to complete the clinical trial process by 2022, after which time a decision will be made to move the drug into the larger Phase III study. 

7. Vasectomy

Availability: Available as a surgical procedure

One of the more commonly used birth control options for men is a vasectomy. Vasectomy involves surgical sterilization, which is highly effective, but should be considered permanent. They can be reversed in some cases, but not in all, and even with successful reversal, the chances of pregnancy decline depending on length of time since vasectomy first completed.  With a vasectomy, the tubes that carry sperm from the testicles are cut and sealed off. This means that the man is rendered sterile for conception purposes. The sperm stays in the testicles—and out of semen—and is eventually absorbed by the body.

Vasectomies are a common procedure with low risks and are typically performed in an office setting.. Side effects that can arise after having the procedure done may include bleeding, swelling, and bruising. More severe complications are rare. Vasectomies are very effective for preventing pregnancy, however, they do not protect against STIs. 

8. Nonsurgical vasectomies

Availability: Available for use

New innovations have led to nonsurgical methods of vasectomy. Such is the case with a nonsurgical vasectomy. Much like a conventional vasectomy, the vas deferens is cut to prevent sperm from leaving the testicles. However, the approach is different in that instead of using a scalpel to make an incision in the scrotum, a tiny puncture is made in the skin with a special tool. This tool then gently stretches the skin, allowing an opening to reach the vas deferens. This results in less bleeding, fewer complications, no need for stitches, and a quicker recovery.  

Challenges of getting male birth control to market

As with any new medical treatment, getting a new form of birth control to the market represents a significant challenge. “The major challenge to getting drugs approved for market in the U.S. is the time and money investment required to conduct rigorous clinical trials,” says Amber Cann, Pharm.D. and owner of Venus Vitality. “From drug discovery to the final stage of trials can take two decades and hundreds of millions of dollars.” She adds that drugs that don’t have a large market have an even harder time getting researched. 

As with any new drug, the side effects must be addressed if they are to be considered safe and effective enough for use in the general population. When it comes to male birth control, another hurdle is the need for the product to be as effective as existing forms of birth control (such as the many options that already exist for female contraception, including hormonal contraceptives and IUDs).

The bottom line of male contraceptives

Although there are many exciting new developments for male birth control in the works, for the moment the options available on the market are limited. In the future, having more options available for male contraception could have many benefits and help relieve women from being mostly responsible when it comes to pregnancy prevention.

Regardless of which birth control method you choose, it is important  to talk to your healthcare provider about its effectiveness and any potential side effects you may experience. For more information about male birth control options, check out The Future of Male Birth Control.