Male Birth Control Options

Right now, with the exception of abstinence and withdrawal, there are only two available male birth control options: condoms and vasectomy.

Condoms are a single-use barrier method that is 98% effective at preventing pregnancy when used perfectly. A vasectomy is a permanent procedure that is nearly 100% effective, although it takes about two months for the results to set in. While condoms can also protect you against STIs, a vasectomy will not.

This article discusses male birth control options, including those that are available and those in development.

Types of Male Birth Control

Men produce about seven million sperm per day. The main goal of male birth control is to prevent sperm from reaching and fertilizing a female partner's egg.

Condoms

The purpose of a condom is to keep sperm inside the condom after you ejaculate. In order to accomplish this, the condom must be the right size for you. A condom that is too tight may break, and a condom that is too big can fall off. To ensure you get the right size, you will need to measure your penis.

There are many types of condoms to choose from. When shopping for condoms, consider the following factors:

• Size: Once you measure the length and girth of your penis, use a condom size chart to find your size. Generally, condoms are available in "snug" sizes, as well as regular, large, and extra-large sizes.
• Shape: The classic condom fit isn't for everyone. If you find them uncomfortable, consider trying anatomical condoms, which have an indent below the head of the penis for a better form fit. Baggy condoms are bigger at the top, giving the penis head a bit more space.
• Material: Most condoms on the market are latex. If you have a latex allergy, you can also find condoms made of polyurethane, polyisoprene, and lambskin. Keep in mind that your partner could have a latex allergy too, so it's best to check with them before having sex.
• Extras: Condoms come in different textures that are meant to increase pleasure both for yourself and your partner. Textured condoms are available with dots, studs, ribbing, and beyond. You can also find lubricated condoms, flavored condoms, and even condoms that glow in the dark.

Different materials of condoms have their pros and cons. For example, polyurethane condoms tend to be thinner, but they are also more likely to tear than latex condoms. Lambskin condoms are not vegan, but they are biodegradable. And polyisoprene condoms are usually stretchier than latex, but at a higher cost.

Vasectomy

For males who want to eliminate the possibility of impregnating their partner(s) permanently, a vasectomy is the only option. This surgical procedure is also known as male sterilization.

A vasectomy works by permanently cutting off the supply of sperm to the semen. Semen is the white fluid that comes out of the penis when you ejaculate. Sperm is one component of semen that contains the male reproductive cell. Without sperm, an egg cannot be fertilized.

A vasectomy is done by blocking off the vas deferens tubes in the testicles. Also known as sperm ducts, the vas deferens carry sperm to the head of the penis for ejaculation.

Vasectomies are invasive procedures done under general anesthesia. You can choose between a traditional vasectomy or a no-scalpel (keyhole) vasectomy. Both of these are simple, effective, and relatively low-cost procedures.

With a fail rate of approximately .3% to .9%, vasectomies are almost 100% effective at preventing pregnancy. However, it takes at least two months after the vasectomy for your semen to be completely sperm-free. In the meantime, you will need to use backup birth control.

Methods In Development

There are several male birth control methods that are currently in varying stages of development.

Male Hormonal Contraception

Hormonal methods have progressed further than any other form of male birth control. Although more research needs to be done, a formulation of the androgen testosterone with progestin (the synthetic form of progesterone) seems to hold the most promise.

The use of testosterone in male contraceptives reduces luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland of the brain. This significantly reduces sperm production in the testis.

Research shows that androgen-based hormonal methods may lower sperm count with only minor side effects, like acne, increased libido, muscle aches, and mood changes. The main disadvantage of this method is that it can take anywhere from three to four months to become effective.

Gendarussa

Justicia gendarussa, or gendarussa for short, is a medicinal plant local to tropical areas in Southeast Asia and the Pacific Islands. For many decades, locals have brewed gendarussa leaves and drank them before sex as a form of birth control.

Gendarussa contains an active flavonoid called gendarusin A, which has been shown to temporarily weaken enzymes that sperm need to reach a female's egg.

For the purpose of male contraception, researchers are exploring the possibility of extracting gendarusin A from the gendarussa plant and delivering it in capsule form.

However, due to a lack of clinical trials examining their safety and efficacy, gendarussin contraceptives are a long way from being approved.

Epididymal Protease Inhibitor (Eppin)

On the surface of male sperm are proteins called EPPIN that play a significant role in protecting the sperm.

The EPPIN protein was discovered in 2001 by a team of researchers at the University of North Carolina. One of these researchers went on to lead the discovery of a compound called EP055 that paralyzes sperm by targeting EPPIN.

That same researcher founded Eppin Pharma Inc. with the goal of developing a male contraceptive pill that harnesses EP055 to stop sperm from swimming. The pill is non-hormonal and its effects are both short-term and reversible.

Although the EP055 male contraceptive pill shows great potential in animal studies, the pill has not been tested in humans. Significant research is needed before the pill is proven safe and effective, and made available for use.

Male Birth Control Shot

RISUG, which stands for reversible inhibition of sperm under guidance, is a long-term, non-hormonal male contraceptive being studied as an alternative to vasectomy. It is delivered via injection and is effective for up to 10 years.

After receiving a local anesthetic, RISUG uses a polymer gel that's injected into the vas deferens (two tubes that carry sperm from the testes to the penis). This positively charged gel attaches to the inner walls of the vas deferens.

When negatively charged sperm flow through the vas deferens, the gel damages their heads and tails, rendering them infertile.

RISUG is closest to being approved for market in India, where it completed phase III clinical trials in human volunteers in October 2023. The Indian Council of Medical Research deemed RISUG safe and effective. If approved, it will be the world's first injectable male contraceptive.

In one study, the most commonly reported side effect of RISUG was swelling of the scrotum. About 83% of males were infertile within one month, and about 17% within three to six months.

In the United States, Vasalgel, which is a contraceptive method based on RISUG, is the male birth control option furthest along in clinical trials. Vasalgel is currently undergoing animal and safety trials, but human clinical trials have not yet started.

Support for Male Birth Control

Nearly 65% of U.S. women ages 15 to 49 use some form of birth control. Many women also feel like the responsibility to use birth control rests mainly on them. Male birth control research is expensive, and many developers are stopping their attempts to create additional male birth control options because of the costs.

A 2019 study led by the Male Contraceptive Initiative concluded that there are approximately 17 million sexually active men ages 18-44 years looking for new forms of contraception that fit their lifestyle and relationships. Of these 17 million men, 8.1 million are "very likely" to use new male methods, and 5.6 million are "somewhat likely" to do so.

Critics of male birth control point to how often men refuse and complain about wearing condoms. They say that if men are put off by the simple act of having to roll on a condom, then these same men would most likely also object to having an injection in their scrotum.

In the end, though, more options are always better. And most women will probably not object to finally being able to unload some of the burden of contraception use on men.

Summary

There are only two forms of male birth control: condoms and a vasectomy. Condoms are 98% effective at preventing pregnancy when used perfectly every time. While most are latex, they can be found in a variety of materials, textures, and sizes. Finding a condom that fits properly is critical for ensuring it doesn't break or fall off.

A vasectomy is a permanent male birth control option that involves surgery. Vasectomies may be reversed with a separate procedure, although the reversal does not always work. Several other forms of birth control, like the birth control shot and a male hormonal pill are under development. However, significant research is needed before they can be approved for use in the United States.