Male birth control exists, but options are limited compared to what’s available for women. Right now, men can choose condoms or a vasectomy. There’s no pill, gel, injection, or implant approved for men yet. That said, several promising candidates are in clinical trials, and some could reach the market within the next several years.
What’s Available Right Now
External condoms are the only reversible contraceptive method currently available to men. With perfect use, about 2 out of 100 women will become pregnant in a year. In practice, the number is closer to 15 out of 100, because condoms slip, break, or aren’t used every time.
Vasectomy is the other option. It’s a minor surgical procedure that cuts or blocks the tubes carrying sperm, and it’s extremely effective. It’s considered permanent, though reversal surgery can restore sperm flow in 60% to 95% of cases depending on how many years have passed. Actual pregnancy after reversal happens for roughly half of couples who attempt it, and success drops significantly after the 15-year mark.
Hormonal Methods in Clinical Trials
The approach closest to approval is a daily gel called NES/T, a combination of two hormones applied to the shoulders. One component suppresses sperm production while the other keeps testosterone levels in a normal range so men don’t experience the fatigue, bone loss, or sexual side effects of low testosterone. In earlier trials, about 88% to 89% of men using the gel had their sperm counts drop to near-zero levels within five to six months. A large international trial enrolled over 460 couples and was expected to have primary efficacy results in early 2025.
A pill form is also in development. Dimethandrolone undecanoate, or DMAU, is an oral candidate that combines both functions in a single compound. In a 28-day safety trial of 100 men, the pill suppressed testosterone and the hormones driving sperm production within a week, with effects sustained throughout the study. No serious adverse events occurred. The most common side effects were headache (11%), decreased sex drive (11% overall, rising to 25% at the highest dose), and acne (7%). A drop in HDL cholesterol (the protective kind) of about 6 to 15 points was also noted. Longer trials are now underway to see whether sperm suppression at lower doses is sufficient for contraception.
As of mid-2023, both the gel and the pill were in phase II clinical trials. Even optimistic projections suggest it will be several more years before either gathers enough data to apply for FDA approval.
Non-Hormonal Approaches
Several non-hormonal strategies are trying to sidestep the hormone question entirely. One of the most intriguing is an injectable hydrogel called ADAM. A doctor injects the gel into the vas deferens (the same tube cut during a vasectomy) using a no-scalpel technique, where it physically blocks sperm from reaching the ejaculate. The key advantage over vasectomy: it’s designed to be reversible, since the gel can potentially be flushed out. A first-in-human trial has been completed, with results anticipated soon.
Another candidate, YCT-529, takes a completely different approach. It targets a protein receptor that sperm cells need to develop properly. By blocking this receptor, the drug disrupts sperm production without touching testosterone or any other hormone. In lab studies, it showed extremely precise targeting, binding its intended receptor over 300 times more strongly than related receptors, which could mean fewer off-target effects. It has advanced into clinical trials.
An On-Demand Option
Perhaps the most surprising candidate works like a male version of “take it before sex.” Researchers identified a compound called TDI-11861 that temporarily paralyzes sperm by blocking an enzyme they need to start swimming and mature after ejaculation. In mouse studies, sperm lost motility within 15 minutes of dosing, and males were completely infertile for roughly 2.5 hours afterward. Zero pregnancies occurred in 52 mating attempts during that window. By 24 hours, sperm motility had fully recovered.
This is still preclinical, meaning it hasn’t been tested in people. But the concept of a contraceptive you take an hour before sex and that wears off by the next day represents a fundamentally different model from anything available for either sex.
How Side Effects Compare to Female Birth Control
One reason male hormonal contraceptives have been slow to develop is concern over side effects, but the picture is more nuanced than headlines suggest. A detailed comparison of an injectable male contraceptive trial against package-insert data from female methods found that men reported acne far more often (about 46% vs. 1% to 7% for various female methods) and mood changes more frequently (32% vs. 2% to 8%). Men also experienced increased sex drive at a higher rate than women (38% vs. 20% in early pill trials), while decreased sex drive occurred at roughly similar rates for both sexes.
However, with the exceptions of acne, mood changes, and increased libido, every other comparable side effect in the male trial occurred at similar or lower rates than what women experience on existing hormonal contraceptives. And here’s a telling detail: women discontinued hormonal contraceptive trials due to side effects at far higher rates than men did. About 6% of men dropped out due to adverse events compared to 13% to 37% of women across various female methods.
Would Men Actually Use It?
Survey data suggests yes. In a study of over 2,000 men in the United States, 75% said they would be willing to use a novel male contraceptive. Willingness was higher among men with more gender-equitable attitudes and among those whose partners had previously had an abortion. The respondents were a broad mix of ages, education levels, and relationship statuses, not just young college students, which makes the finding more generalizable than earlier, smaller surveys.
The demand clearly exists. The bottleneck is the science and regulatory process catching up. Sperm suppression takes weeks to months with hormonal methods, reversibility has to be proven convincingly, and the FDA holds contraceptives to a high safety bar since they’re used by healthy people. For now, condoms and vasectomy remain the only approved options, but the pipeline is more active than at any point in history.