Male contraceptive
[2][3][4][5] New forms of male contraception are in clinical and preclinical stages of research and development, but as of 2024, none have reached regulatory approval for widespread use.
[6][7][8][9] These new methods include topical creams, daily pills, injections, long-acting implants, and external devices, and these products have both hormonal and non-hormonal mechanisms of action.
[42][46][41] A condom is a barrier device made of latex or thin plastic film that is rolled onto an erect penis before intercourse and retains ejaculated semen, thereby preventing pregnancy.
[47] Condoms are less effective at preventing pregnancy than vasectomy or modern methods of female contraception, with a real-world failure rate of 13%.
[50] The withdrawal method, also known as coitus interruptus or pulling out, is a behavior that involves halting penile-vaginal intercourse to remove the penis out and away from the vagina prior to ejaculation.
[53][54][55] Efforts to develop male contraceptives have been ongoing for many decades, but progress has been slowed by a lack of funding and industry involvement.
[84] Non-hormonal contraceptives for men are a diverse group of molecules that act by inhibiting any of the many proteins involved in sperm production, release, or function.
Vas-occlusive methods generally aim to create long-acting reversible options, through a second procedure that removes the blockage.
Drugs or devices that target mature sperm are likely to be effective on-demand (taken just before intercourse), and could even be delivered either in sperm-producing or egg-producing bodies, leading to unisex contraceptives.
[18][20][190][193][194][195] Interestingly, some of the highest rates were reported in low-income countries like Nigeria and Bangladesh where 76% of men surveyed indicated that they would be willing to use a new method within the first 12 months that it is available.
[18] This is particularly compelling, since it has been estimated that a mere 10% uptake of new male contraceptive methods could avert nearly 40% of unintended pregnancies in Nigeria.
[25] Across the world, many young and middle-aged men especially want the ability to control their own fertility, and are not well-served by existing family planning programs.
[196] Although a phase II trial for an injectable male contraceptive was halted in 2011 by an independent data safety monitoring board due likely to rare adverse effects experienced by some participants,[197][67] leading many popular articles to suggest men could not tolerate side effects similar to those that many women endure on hormonal birth control,[70][198] in reality more than 80% of the study's male participants stated at the end of the trial that they were satisfied with the contraceptive injection, and would be willing to use the method if it were available.
[199] Subsequent hormonal male contraceptive clinical trials have progressed successfully, showing high levels of efficacy and acceptability among the participants.
[210] In the United States, which has a higher unintended pregnancy rate than many other developed nations,[211] one important reason that women cite for nonuse of contraceptives is concerns about the side effects of existing products.
[18] Independent modelling predicts that even if real-world usage is only 10% as high as the market research suggests, the introduction of a male contraceptive would avert roughly 200,000 unintended pregnancies per year in the USA and Nigeria each.
[218][219][220] Positive outcomes of effective birth control include improvements in women's health, self-agency, education, labor force participation, financial stability, as well as decreases in pregnancy-related deaths,[221][222][223] and these positive social and health impacts may be further realized by the addition of novel male and unisex methods.
It is reasonable to assume from these data that increasing male involvement as contraceptive users will further improve gender equity.
[228] This dynamic may contribute to the higher rates of unintended pregnancies seen in the LGBTQ+ community as compared to heterosexual peers,[230][231][232] which could in theory be ameliorated by the introduction of unisex contraceptives.
[25] In addition to the personal financial savings of avoiding unintended pregnancy mentioned above, on a societal level, contraceptives are a public health intervention with a high return on investment: for every dollar the United States government spends on family planning programs, it saves $7.09, for a total of over $13 billion per year.
[242][243][244] This suggests that the introduction of new forms of male contraception could prevent a significant number of abortions, save lives, and avoid unnecessary suffering.
A variety of plant extracts have been used throughout history in attempts to prevent pregnancy, though most were used by women, and the efficacy and safety of these methods is questionable.
Instead, it was first used as an attempted treatment (later proved to be ineffective) for enlarged prostates, and within a few years, one-sided vasectomy became popular as a supposed method of sexual rejuvenation in older men.
[255] In the early 1900s, the use of vasectomy took a darker turn, and it became widely promoted and practiced as a means of eugenic involuntary sterilization.
