Male birth control: is it a thing?

Men can get vasectomies, and women can get their tubes tied. There are condoms for men and women. But when it comes to the pill, it’s ladies only. 

If you’re hoping to see male birth control sometime soon, you’ll have to keep waiting. Researchers are working on developing birth control for men, but it will be some time before it’s available for use.

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Scientists are working on three contraceptive methods for men: hormonal injections, pills, and a gel. 

Until recently, most research efforts focused on using hormones to block testosterone and lower sperm production. Now studies are focused on blocking vitamin A receptors, which may be the most promising option yet.

The pill

The idea of a male birth control pill has been a research topic since the 1950s. Once female hormonal birth control pills became widely available, a male option became less pressing (Jackson, 1975). 

On the back burner, researchers focused on a pill that could block sperm production, a function controlled by testosterone, the dominant male hormone. The big problem was that obstructing testosterone had unwanted side effects, including weight gain and low libido (sex drive). 

Other research has been looking at a hormone called dimethandrolone undecanoate (DMAU). It did seem to block hormones that stimulate sperm production, but the results were underwhelming. Though it wasn’t for lack of effort. 

Sperm live for about three months, and the study only lasted 28 days, meaning existing sperm didn’t have a chance to “die-off” (Thirumalai, 2019). Understanding whether DMAU might be a good option for male birth control will require more research. 

Testosterone shots

Another route to suppress sperm production is testosterone shots. The issue with this method is these injections can have serious, long-term side effects. So researchers came up with the idea to add progesterone, another sex hormone, to combat unwanted side effects. 

The two-hormone shot developed worked, with 96% effectiveness at preventing pregnancy. Despite the effort, the testosterone injections still posed a risk for significant side effects, most notably mood changes (Behre, 2016). 

The most common adverse reaction was acne. However, the mood changes were so significant that some participants became severely depressed and even suicidal. Women who use oral contraceptives might argue that mood changes come with the territory when taking hormonal contraceptives; the phenomenon is common in women, although it’s often dismissed by healthcare providers (Skovlund, 2016). 

Hormonal gel

This option may be the most promising so far. Scientists have developed a hormonal gel combination that blocks vitamin A receptors, which play an important role in sperm development. Research proved the drug to be effective at stopping sperm production in mice (Anawalt, 2019; ACS, 2022).

By targeting vitamin A receptors rather than sex hormones, researchers managed to bypass many of the side effects observed in previous studies. Future studies and clinical trials are needed to examine the safety and effectiveness of vitamin A-blocking pills or gel in humans to determine if these are a good option for male hormonal birth control.

Right now, condoms and vasectomies are the only birth control methods available to men. You may have heard of the withdrawal or “pull out” method, which is where a man withdraws near climax and ejaculates outside of his partner’s vagina. 

But it’s not the safest option as semen can be released before ejaculation, resulting in unintended pregnancy. In fact, the withdrawal method is one of the least effective birth control options out there (Bansode, 2020). 

So far, condoms and vasectomies are the best options for male contraceptives.

Condoms

These are thin, fitted tubes that create a barrier around the penis to catch sperm. Condoms prevent both pregnancy and the spread of sexually transmitted infections (STIs). 

Condoms can be extremely effective contraception—but only if used properly (Sanders, 2012). When used perfectly, condoms only fail 2% of the time; if not put on correctly, the failure rate jumps up to 18% (Trussell, 2011).

Vasectomy

This is a male sterilization procedure that involves cutting the vas deferens, the tubes that carry sperm from the testicles to the urethra. You can still ejaculate after a vasectomy, it just won’t contain sperm.

For women, this method is called tubal ligation or "getting your tubes tied." Unlike the procedure for women, a vasectomy is reversible. While vasectomies don’t prevent all pregnancies, they are a more effective option than birth control pills or condoms (NIH, 2016).

Keep in mind that it takes time for your sperm count to drop down to zero after a vasectomy.  Your healthcare provider will check in with you periodically to let you know when you hit this mark. In the meantime, backup contraception like condoms should be used (NIH, 2020).

Vasectomies are outpatient procedures, meaning you’ll be able to go home right after. You may experience some pain for several days. Generally, icing the area and taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen are enough to manage the discomfort (Stormont, 2020).

When it comes to male birth control, options remain limited. But scientists are working on viable pharmaceutical options that may be available before we know it. 

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Current version

April 26, 2022

Written by

Linnea Zielinski

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.