Birth control has long been thought of as something only available for females. However, more options are becoming available as society evolves, and we continue to make medical advances. One of the latest innovations in reproductive health is contraceptives for males. It’s normal to be hesitant before considering a new medication, which is why it’s important to have all the information before making an informed decision about reproductive health.
How do male contraceptives work?
If having vaginal intercourse with someone who could potentially get pregnant, the idea of contraception may likely be on one’s mind. Historically, birth control has only been available to females, but people should have access to contraception options regardless of gender.
Most female birth control options work by suppressing ovulation so that any incoming sperm cannot fertilize eggs that would have been released during ovulation. However, males don’t ovulate, so how does male birth control work?
Types of male contraceptives
Birth control options fall into two categories — hormonal and non-hormonal. Researchers have been working for decades to find effective forms of male birth control that fall into both categories. So what kind of male contraceptives are being developed, and are any already available?
Non-hormonal male birth control
Non-hormonal methods prevent sperm from reaching an egg in a female’s body, so fertilization can’t occur.
- Intentional preventative measures. This includes behaviors like periodic abstinence — abstaining from sex while their partner is fertile, as well as ex-vaginal ejaculation. Ex-vaginal ejaculation includes the withdrawal method, which is unreliable, as well as masturbation and oral and anal sex. However, these methods are not ideal for people who want to have vaginal intercourse.
- Condoms. Condoms are a barrier method that prevents pregnancy by blocking sperm from reaching an egg during ovulation. Condoms are about 98% effective when used correctly.
- Vasectomy. A vasectomy is a permanent (although sometimes reversible) procedure that prevents sperm from entering the semen, the fluid in ejaculation. While vasectomies are more reliable than condoms, they come with potential risks and are a permanent option.
- YCT529 pill. It is being developed as a once-a-day oral non-hormonal male birth control pill to reduce sperm count. It is supposed to work by attaching to a vitamin A receptor site in the body. However, as of February 2023, YCT529 has only been tested on mice.
- TDI-11861 pill. This non-hormonal medication is still being studied but has shown promise as an effective “on-demand” male birth control, meaning it’s intended to work for 2–3 hours after taking it. It prevents pregnancy by making it difficult for sperm to mature and be able to swim to an egg to fertilize it. So far, TDI-11861 has only been studied in mice.
- ADAM device. It is being developed as a medical device implanted into the vas deferens, the tube that transports sperm out of the testes. This has the potential to be a long-term birth control option, similar to an IUD for females.
Hormonal male birth control
These methods use synthetic hormones to stop the production of sperm safely. Reliable hormonal birth control should ideally not affect someone’s fertility and sperm count after they stop usage.
- Testosterone injections. Taking testosterone via injection can be fairly effective at preventing pregnancy by preventing the testes from producing sperm. However, it is not advisable, thanks to its potential side effects like lowering sperm count in the long term, acne, weight gain, injection site pain, and psychological side effects.
- Dimethandrolone undecanoate (DMAU) pill. It is a once-a-day oral pill that uses hormones to suppress male sex hormones. Hormonal suppression reduces sperm count while someone is taking it. While the “male birth control pill” is still undergoing clinical trials, the first phase of testing has shown promise with few side effects and high efficacy. An injectable version of DMAU is also being developed.
- Nestorone and testosterone (NES/T) gel. Another hormonal medication in clinical trials is NES/T. This combines Nestorone, which reduces sperm count, with testosterone which is used to mitigate any side effects from Nestorone. NES/T is taken as a topical gel applied to the shoulders and upper arms once daily.
Benefits & risks of male contraceptives
Unwanted pregnancy can lead to physical, emotional, mental, and financial strain for people. Male contraceptives give sexual partners more options, especially because many females have adverse effects from different types of birth control.
It’s difficult to say what the risks are of male contraceptives because different types are being developed — none yet approved. However, researchers are examining potential risks and long-term fertility issues, such as lowered libido, weight gain, and psychological changes.
Female vs. male contraceptives
In the push for gender equality, it makes sense for males to share some of the responsibility of contraception. About 40% of pregnancies globally are unwanted, with about half ending in abortion. While abortion must remain an accessible option, it is yet another burden that falls entirely on females. Male contraception can help level the playing field bit by bit.
Is birth control safer for males than for females? Unfortunately, it’s too early for a definitive answer. However, any male contraceptive that becomes available will have been tested rigorously for potential side effects and deemed safe by pharmaceutical regulation boards.
How to choose the best contraceptive
As encouraging as all this research and information is, as of now, there is still no male birth control available on the market in most countries. The only “male contraceptives” that are widely available are condoms and vasectomies.
As more male birth control options become available, some of the most important things to keep in mind are any potential risks and side effects, how easy they are to use, their reliability, their affordability, and how convenient they’ll be for one’s lifestyle.
It’s important to point out that as researchers get closer to launching male contraceptives, sexual partners still need to be proactive about preventing sexually transmitted infections. Condoms are the only male contraceptive that also helps prevent STIs.
If having sex with a partner without using a barrier method, it’s essential to get tested before and after, as well as have an open discussion about testing and STI status.
What percentage of males use contraceptives?
Contraceptives is a broad term, as it includes barrier methods like condoms and behaviors like the withdrawal method. As of now, no males in the general population use male birth control, unless they are in clinical trials, as these medications have not yet been approved. The only contraceptive method that prevents STIs is the condom.
Why are there more female contraceptives than male?
Females are the ones that have to physically deal with the effects of an unintended pregnancy. Societal views that saw pregnancy as a women’s responsibility meant that more emphasis was put on developing female contraceptive methods instead of ones for males. However, male contraceptive methods are being developed as society pushes for further gender equality.
Can contraceptives make males infertile?
Yes, but some methods of male contraception, like taking testosterone or getting a vasectomy, can lead to infertility. However, this can happen as an unintended side effect of testosterone, which is why it’s not recommended for birth control. Vasectomies are a long-term option but are reversible in some cases.