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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.
Types of male birth control
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 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.
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).
Female condoms: how to use, benefits, and effectiveness
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.
Male birth control options available today
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.
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).
Condom anxiety: how to conquer it
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.
- American Chemical Society (ACS). (2022). A non-hormonal pill could soon expand men’s birth control options. Retrieved from https://www.acs.org/content/acs/en/pressroom/newsreleases/2022/march/non-hormonal-pill-could-soon-expand-mens-birth-control-options.html
- Anawalt, B. D., Roth, M. Y., Ceponis, J., et al. (2019). Combined nestorone-testosterone gel suppresses serum gonadotropins to concentrations associated with effective hormonal contraception in men. Andrology, 7(6), 878–887. doi:10.1111/andr.12603. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30969032/
- Bansode, O. M., Sarao, M. S., & Cooper, D. B. (2021). Contraception. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK536949/
- Behre, H. M., Zitzmann, M., Anderson, R. A., et al. (2016). Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men. The Journal of Clinical Endocrinology & Metabolism, 101(12), 4779–4788. doi:10.1210/jc.2016-2141. Retrieved from https://academic.oup.com/jcem/article/101/12/4779/2765061
- Endocrine Society. (2016). Male Birth Control Shots Prevent Pregnancy. Retrieved from https://www.endocrine.org/news-and-advocacy/news-room/2016/male-birth-control-shots-prevent-pregnancy
- Endocrine Society. (2019). Second potential male birth control pill passes human safety tests. Retrieved from https://www.eurekalert.org/pub_releases/2019-03/tes-spm032019.php
- Jackson, H. (1975). Progress towards a male oral contraceptive. Clinics in Endocrinology and Metabolism, 4(3). Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0300595X7580051X
- National Institutes of Health (NIH). (2020). Vasectomy: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/002995.htm
- National Public Radio (NPR). (2016) Male Birth Control Study Killed After Men Report Side Effects. Retrieved from https://www.npr.org/sections/health-shots/2016/11/03/500549503/male-birth-control-study-killed-after-men-complain-about-side-effects
- PhRMA. (2015). Biopharmaceutical Research and Development: The Process Behind New Medicines. Retrieved from http://phrma-docs.phrma.org/sites/default/files/pdf/rd_brochure_022307.pdf
- Sanders, S. A., Yarber, W. L., Kaufman, E. L., et al. (2012). Condom use errors and problems: a global view. Sexual Health, 9(1), 81. doi:10.1071/sh11095. Retrieved from https://www.publish.csiro.au/SH/fulltext/SH11095
- Skovlund, C. W., Mørch, L. S., Kessing, L. V., & Lidegaard, Ø. (2016). Association of Hormonal Contraception With Depression. JAMA Psychiatry, 73(11), 1154–1162. doi:10.1001/jamapsychiatry.2016.2387. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2552796
- Stormont, G., & Deibert, C. (2020). Vasectomy. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549904/
- Thirumalai, A., Ceponis, J., Amory, J. K., et al. (2019). Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill. The Journal of Clinical Endocrinology and Metabolism, 104(2), 423–432. doi:10.1210/jc.2018-01452. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30252061/
- Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5), 397–404. doi:10.1016/j.contraception.2011.01.021. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638209/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.