The National Institutes of Health is funding a clinical trial to test a contraceptive gel formulation called NES/T, which men would apply to their shoulders and upper arms once per day. The hormonal gel is currently in Phase II clinical trials, said Dr. Wang, who is one of the lead investigators. She estimates that, optimistically, the gel could be available in five years — but even that it would be moving very fast, she said.
Contraline, a biotechnology company in Virginia, is awaiting clinical trials for Adam, an injectable hydrogel that lasts for a year. The company bills it as “the IUD, for men.”
Researchers in India are testing a nonsurgical vasectomy procedure known as Reversible Inhibition of Sperm Under Guidance, or RISUG, which involves injecting a gel into the tubes in the penis that store sperm. But until these endeavors go through substantial studies — and, critically, trials in humans — a male form of birth control comparable to the pills, patches, shots and rings on the market for women remains a fantasy.
“I’ve been excited about animal studies demonstrating promise for male contraceptives for a while now,” said Dr. Bobby Najari, an assistant professor of urology and population health and director of the Male Infertility Program at NYU Langone Health. “And each time, I get disappointed.”
What birth control options are available for men now?
There are currently only two approved forms of male birth control: vasectomies and condoms.
And while vasectomies are reversible, Dr. Najari said he would never recommend getting a vasectomy with the intention of later reversing it. The American Urological Association vasectomy guidelines note that reversals may not always be successful. The reversal procedure tends to be longer than the original vasectomy, with a longer recovery time, he said, and insurance does not always cover it. Vasectomies have also been linked to complications like infection and both short-term and chronic pain.
Condoms have the additional benefit of protecting people from sexually transmitted infections, but they are “relatively unpopular,” Dr. Najari said. Even when people do use condoms, they can break and tear; the Centers for Disease Control and Prevention estimate that the condom use failure rate is 13 percent.
Why hasn’t there been a birth control pill for men before?
In the 1990s, the World Health Organization conducted research into testosterone as a potential form of contraception and found it was highly effective at decreasing sperm counts. But high levels of the hormone were needed to effectively suppress the sperm, which led to taxing side effects: weight gain, acne, irritability, mood swings.