Male contraceptive
Male contraceptives, also known as male birth control, are methods of preventing pregnancy by interrupting the function of sperm. The most commonly used forms of male contraception are condoms, vasectomy, and withdrawal, which together represented 20% of global contraceptive use in 2019. New forms of male contraception are in research and development, but as of 2025, none have achieved regulatory approval for widespread use. They could be available before 2030, assuming smooth development and clinical trials.
These new methods include topical creams, daily pills, injections, long-acting implants, and external devices, with both hormonal and non-hormonal mechanisms of action. Some could even be unisex, or usable by any person, because they could theoretically incapacitate mature sperm in the man's body before ejaculation, or incapacitate sperm in the body of a woman after insemination.
Background
In the 21st century, surveys indicated that around half of men in countries across the world have been interested in using a variety of novel contraceptive methods, and men in clinical trials for male contraceptives have reported high levels of satisfaction with the products. Women worldwide have also shown a high level of interest in new male contraceptives, and though both male and female partners could use their own contraceptives simultaneously, women in long-term relationships have indicated a high degree of trust in their male partner's ability to successfully manage contraceptive use.A modelling study from 2018 suggested that even partial adoption of new male contraceptives would significantly reduce unintended pregnancy rates around the globe, which remain at nearly 50%, even in developed countries where women have access to modern contraceptives. Unintended pregnancies are associated with negative socioeconomic, educational, and health outcomes for women, men, and the resulting children, and 60% of unintended pregnancies end in abortions, many of which are unsafe and can lead to women's harm or death. Therefore, the development of new male contraceptives has the potential to improve racial, economic, and gender equality across the world, advance reproductive justice and reproductive autonomy for all people, and save lives.
Available methods
Vasectomy
Vasectomy is surgical procedure for permanent male sterilization usually performed in a physician's office in an outpatient procedure. During the procedure, the vasa deferentia of a patient are severed, and then tied or sealed to prevent sperm from being released during ejaculation. Vasectomy is an effective procedure, with less than 0.15% of partners becoming pregnant within the first 12 months after the procedure. Vasectomy is also a widely reliable and safe method of contraception, and complications are both rare and minor. Vasectomies can be reversed, though rates of successful reversal decline as the time since vasectomy increases, and the procedure is technically difficult and often costly.Condoms
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. Condoms are less effective at preventing pregnancy than vasectomy or modern methods of female contraception, with a real-world failure rate of 13%. However, condoms have the advantage of providing protection against some sexually transmitted infections such as HIV/AIDS. Condoms may be combined with other forms of contraception for greater protection.Withdrawal
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. Withdrawal is considered a less-effective contraceptive method, with typical-use failure rates around 20%. However, it requires no equipment or medical procedures.| Method | Typical use | Perfect use |
| Vasectomy | 0.15% | 0.10% |
| Condoms | 13% | 2% |
| Withdrawal | 20% | 4% |
Research
Researchers have been working to generate novel male contraceptives with diverse mechanisms of action and possible delivery methods, including long-acting reversible contraceptives, daily transdermal gels, daily and on-demand oral pills, monthly injectables, and implants. Efforts to develop male contraceptives have been ongoing for many decades, but progress has been slowed by a lack of funding and industry involvement. As of 2024, most funding for male contraceptive research is derived from government or philanthropic sources.Novel male contraceptives could work by blocking various steps of the sperm development process, blocking sperm release, or interfering with any of the sperm functions necessary to reach and fertilize an egg in the female reproductive tract. Advantages and disadvantages of each of these approaches will be discussed below, along with relevant examples of products in development.
Sperm production
These methods work by preventing the testes from producing sperm, or interfering with sperm production in a way that leads to the production of nonfunctional sperm. This approach can be accomplished by either hormonal or nonhormonal small-molecule drugs, or potentially by thermal methods. The effectiveness of contraceptives in this group can be easily assessed microscopically, by measuring sperm count or abnormalities in sperm shape, but because spermatogenesis takes approximately 70 days to complete, these methods are likely to require approximately three months of use before they become effective, and approaches that halt sperm production at an early stage of the process may result in reduced testicular size. Methods have been suggested in the 1980s.Hormonal
Hormonal contraceptives for men work similarly to hormonal female methods, using steroids to interrupt the hypothalamic-pituitary-gonadal axis and thereby block sperm production. Administering external androgens and progestogens suppresses secretion of the gonadotropins LH and FSH, which impairs testosterone production and sperm generation in the testes, leading to reduced sperm counts in ejaculates within 4–12 weeks of use. However, since the contraceptives contain testosterone or related androgens, the levels of androgens in the blood remain relatively constant, thereby limiting side effects and maintaining masculine secondary sex characteristics like muscle mass and hair growth.Multiple methods of male hormonal contraception have been tested in clinical trials since the 1990s, and although one trial was halted early, leading to a large amount of press attention, most hormonal male contraceptives have been found to be effective, reversible, and well-tolerated.
Clinical trials
, the following hormonal male contraceptive products are in clinical trials:- NES/T is a transdermal gel that users apply to the upper arms and shoulders once daily. Developed as a collaboration between the NICHD and Population Council, NES/T is in a phase II clinical trial, where it is being evaluated for safety and efficacy, with healthy couples relying on it as their only means of birth control.
- DMAU is a steroid-based contraceptive molecule with both androgenic and progestational activities, which allows it to be used as a single agent. DMAU has been tested in clinical trials in both oral and injectable forms.
- 11β-MNTDC is another dual-function molecule in clinical development as an oral contraceptive for men.
Non-hormonal
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. Because sperm cells are highly specialized, they express many proteins that are rare in the rest of the human body. This suggests the possibility that non-hormonal contraceptives that specifically block these sperm proteins could have fewer side effects than hormonal contraceptives, since sex steroid receptors are found in tissues throughout the body. Non-hormonal contraceptives can work by blocking spermatogenesis, sperm release, or mature sperm function, resulting in products with a wide variety of usage patterns, from slow onset to on-demand usage. Contraceptives targeting mature sperm functions could even be taken by both sperm-producing and egg producing people. Challenges of non-hormonal contraceptive development include bioavailability and delivery past the blood-testis barrier.Clinical trials
, the following non-hormonal male contraceptive product is in clinical trials:- YCT529, a retinoic acid receptor antagonist, began a Phase 1 clinical trial in 2023 organized by the US startup YourChoice Pharmaceuticals. The clinical test on humans is done by the UK company Quotient Sciences. It was originally planned in 2022 instead of 2023, with an expected marketing date 5 years later.
Preclinical development
- BRDT inhibitors such as JQ1 have been shown to produce reversible sterility in male mice by blocking chromatin remodeling, and efforts to develop and evaluate new small-molecule inhibitors with improved pharmacokinetic properties are ongoing.
- Several testis-specific kinases have been linked to male infertility in mice and/or humans, and inhibitors of several of these kinases, such as the testis-specific serine kinases and Cyclin-dependent kinase 2 are in medicinal chemistry development.
- The retinoic acid signalling pathway has been known since the late 1950s to be necessary for spermatogenesis in rodents and humans, and various attempts have been made to develop male contraceptives that work by blocking different enzymes in this pathway. As of 2024, efforts are underway to develop inhibitors of ALDH1A2, Retinoic acid receptor alpha, and SMRT.