Oh yes! Let’s talk about male contraception.
Condoms have been the main male birth control for many decades. Not only are they great contraceptives but, of all female and male contraceptives, they are the only ones that prevent the spread of sexually transmitted diseases.
Male birth control options, however, aren’t as varied as those for women.
Let’s look at where we are at with regard to male contraception.
What is male birth control?
Male birth control is a type of contraception where the man is in charge of avoiding pregnancy.
There are various male birth control options: barrier methods, hormonal methods, methods that target the sperm’s capacity to move towards the egg and even surgical methods.
Male birth control
Men and women have a long history of trying to prevent pregnancy. Most of the burden of birth control, however, has been on women’s shoulders. At the end of the day, it’s women who experience pregnancy and, as a result, their lives can become more complicated if, for example, their partner decides to walk out on them.
For many years we’ve been hearing about male hormonal contraception but, in terms of the male contraceptive initiative, where are we at this stage? Is there a male pill? What about an on-demand male contraceptive? What are the new contraceptives for men?
Is there an alternative to condoms?
With regard to non-hormonal contraception, condoms are the number one choice for both men and women.
If we compare the sexes, there’s a substantial minority of men who are in charge of contraception. In those cases, condoms are the number one choice when choosing a male contraceptive.
Research shows that, in most couples in the USA, women are responsible for contraception. In those cases, the pill is more widely used, followed by condoms as a distant second.
With regard to male birth control, there are several alternatives to ‘rubbers’. There is a male pill that prevents sperm production, as well as other non-hormonal birth control pills that prevent pregnancies by interfering with the sperm’s capacity to move on its own after ejaculation.
The withdrawal method is the most natural male contraceptive, although it requires a very precise and active role on the part of the man.
Vasectomy is a surgical method – the most effective form of male birth control that has hardly any side effects.
Let’s look at each of these types of contraception for males:
#1. Male birth control: the male pill
For men, two main types of hormonal contraception have been developed.
The first is a male contraceptive pill that gives men a small dose of androgens and progesterone. These hormones suppress the production of gonadotropin, another hormone responsible for producing testicular testosterone and, therefore, interfere with sperm production.
Another hormonal male contraceptive targets the nuclear receptors of the sperm cells, dramatically reducing the sperm count.
The biggest challenge associated with male hormonal birth control is the amount of sperm a human male produces daily. Approaches involving male hormones require continuous treatment and at least two months of taking a daily pill for this male birth control pill to be effective. It also takes about two months for everything to go back to normal.
More research is needed into finding the fastest reversible inhibition of sperm production hormones.
There is continued development of human clinical trials on ways to affect human sperm production or its ability to reach the egg.
#2. Male birth control: targeting sperm mobility
Research on contraception for men is very active nowadays. This is understandable, as men and women should be equally responsible for contraception – as a couple but also as individuals. More options mean more choices and greater suitability. What doesn’t work for some, does wonders for others. The Weill Cornell Medicine Center and other national institutes are actively researching new forms of male contraception.
Targeting sperm mobility is the latest endeavor in male contraception, as sperm production has proved to be complicated, due to the large number of sperm a healthy man produces every day.
Scroll down further to find out about these new contraceptives in ‘Newest male birth control’
#3. Male birth control gel
The only information we have on this gel is that it’s still being trialed. The gel is called NES/T and combines two hormones: segesterone acetate and testosterone. It has been developed by The Population Council, a non-profit organization that conducts research in biomedicine and public health.
As with all hormonal products designed for male contraception, this hormonal combination targets sperm production. The segesterone acetate stops natural sperm production in the testicles, reducing it to almost non-existent levels.
The producers claim that it does not reduce sex drive or libido.
The gel is meant to be applied on the man’s back, between his shoulders, which is not the easiest place to apply a gel. Obviously, the woman shouldn’t help with the gel application, as it is absorbed through the skin; it is not a good idea for a woman to touch a gel full of male hormones.
#4. Male birth control: the withdrawal method
Male contraceptives must clear a higher bar for side effects and safety.
The withdrawal method is the only male natural birth control. It requires a lot of self-knowledge and self-control. It also requires a lot of trust from the woman, especially when unintended pregnancies are not welcome at that particular time in her life.
There are advantages to this method, compared with other male contraceptives. Intercourse isn’t interrupted, as with other methods, and it doesn’t break the spontaneity of unexpected sex. There are no uncomfortable side effects, such as mood swings, weight gain or even blood clots or high blood pressure. This makes it the contraceptive of choice in many stable couples.
Apparently, Iran is a country where withdrawal is more widely used, so extensive research has been done on the Iranian population.
Of course, this natural method doesn’t prevent sexually transmitted diseases and therefore should just be used only with trusted sexual partners.
#5. Male birth control: vasectomy
Of all types of male birth control, vasectomy is the safest option, because it provides a mechanical barrier in the path of the sperm. There are no hormones, no gels, no continuous treatment and no barrier methods that interfere with the natural course of a sexual encounter. In a vasectomy (a surgical procedure), the natural channels (vas deferens), which that conduct the sperm towards the penis, are blocked during a very quick surgery.
A vasectomy doesn’t require an overnight stay in a medical facility. It doesn’t even require admission to the hospital. It can be done in a day clinic and the procedure usually lasts less than an hour.
It is usually performed under local anesthesia, which means the man is ready to walk out of the room once the vasectomy procedure is finished.
If you’re thinking about having a vasectomy, congratulations! That says a lot about your willingness to carry part of your family’s reproductive responsibility on your shoulders.
Not only has the woman done her fair share – especially if you’ve had children – but, for women, a tubal ligation is a far more complicated surgery than a vasectomy.
The success rate of vasectomy reversal keeps improving, as technology keeps advancing and surgeons become more skilled in performing, and reversing, the procedure.
Newest male birth control
Reproductive health research is continually looking for new ways to develop an effective male pill.
Non-hormonal male contraception looks most promising as it doesn’t affect sperm production but targets sperm motility.
Following ejaculation, once inside the female reproductive tract, the sperm move their tails vigorously to reach the egg. The enzyme soluble adenylyl cyclase (sAC) is responsible for this sperm motility.
Men who naturally lack sAC are infertile, highlighting the importance of sAC in sperm function.
Clinical trials with mice at Weill Cornell Medicine Center are producing quite promising results, as the sperm of male mice treated with sac inhibitors aren’t able to fertilize the egg of the female mice, although they show normal mating behavior. This makes sac inhibition a promising possible treatment for healthy men who might worry birth control methods come hand in hand with low libido.
A single dose of sAC inhibitor showed the effects on the male mice’s sperm motility for up to two and a half hours after treatment. Male mice treated with the alternative vehicle control blend impregnated females 30% of the time.
Some more good news: 24 hours after treatment with sAC inhibitor, the sperm motility was completely recovered.
The latest 2023 non-hormonal research focuses on making sac inhibitors that prevent sperm from moving in the female reproductive tract. Once the appropriate procedures allow, the Weill cornell medicine institute will start human trials.
This type of non-hormonal option looks quite promising as the ability to produce sperm remains intact and the effects wear off quite rapidly.
How effective is pulling out?
Pulling out, or ‘withdrawal’ is one of the oldest techniques used in birth control, trying to prevent pregnancies.
However, the success rates of this method can be a bit of a gamble, as contraception relies solely on the man’s ability to pull out in time.
Even if the man has mastered this natural way of family planning and pulls out in time, some sperm might have made their way toward the egg, prior to ejaculation.
Is it safe to have a vasectomy?
This surgery is performed as an outpatient, takes less than an hour in total and it’s done under local anesthesia. Therefore the side effects are just those from the local anesthesia and the simple surgical procedure.
At the same time, a vasectomy can be reversed later on in life if your circumstances change and you wish to become a parent.
Vasectomy is much safer than female tubal ligation.
Tubal ligation requires accessing the woman’s abdominal cavity which means abdominal surgery, in-hospital admission, stay and recovery.
Vasectomy, on the other hand, doesn’t require any of this, as the tubes that carry the sperm out of the testicles (the vas deferens) can be accessed easily through the scrotum.
A female tubal ligation is permanent, it can’t be undone. However, the success rate for reversed vasectomy is quite high.
Read more in Vasectomy | Interesting Facts About Having A Vasectomy and