Until now, men only had two options in terms of contraception: the barrier methods (the condom) or the surgical (vasectomy). Outside of these possibilities, the responsibility has fallen on women, with the costs, side effects and risks that they entail. For years, meanwhile, research into other methods for men has been stagnant.
In more recent times, and thanks to social movements such as the one that fights for the rights of LGTBI people or the women’s movement, initiatives have been resumed to develop things like a ‘pill’ for males.
Differences in research
The study The Future of Male Contraception, prepared jointly by the Youth Development Labs of Harvard University and the manufacturer of sex toys We Vibe on a cohort of 3,549 people from seven countries and with the opinions of seven experts, explains that currently the use of male contraception represents only 27.4% of the total.
This, in part, is understood by taking into account the historical differences in research on contraceptive methods in both genders. Specifically, attempts to develop male ‘pills’ were quickly halted by side effects of the pill. Win 18446 while the feminine ones continued their course and led to the approval of several of the options that are familiar to us today. The criteria, then, was that men’s tolerance for side effects was low or minimal while women would persist in the use of contraceptives despite them (since the balance of risks is different if those associated with pregnancy are taken into account).
Hormonal methods
However, the social circumstances of recent years have favored the resumption of the research on male contraceptive methods, and there are already several that have reached the last stages of development. These can be divided into two broad categories: hormonal and non-hormonal.
The first, as their name indicates, use sex hormones such as testosterone or progesterone to inhibit sperm production. They tend to be associated with an increased risk of adverse effects.
Among them, the most promising consists of a combination of testosterone and nestorone (NES/T), which is applied as a transdermal gel (absorbed into the skin). If all goes according to plan and clinical trials show positive results, it could hit US pharmacies by 2027.
In addition there are several oral options, such as dimethandrolone undecanoate (DMAU) or 11β-methyl19-nortestosterone17β-dodecylcarbonate (11β-MNTDC), which suppress testosterone production, thus theoretically stopping sperm production. However, the long-term efficacy of these methods remains to be clarified, something that also occurs with the 7α-methyl-19-nortestosterone (MENT) implant.
Non-hormonal methods
Non-hormonal methods, for their part, use primarily mechanical methods to interfere with any phase of the sperm production, maturation or transport process.
Perhaps the one that is in the most advanced stages of development is the guided reversible inhibition of sperm, which consists of a gel that is injected into the vas deferens (those that carry sperm out of the testicles), where it forms a partial blockage that prevents the release of sperm and alters it in such a way that it could not fertilize an egg either. It is reversible by a safe injection of sodium bicarbonate, and is expected to be approved for use later this year in some countries.
In a novel way, in recent days the compound has attracted attention TDI-11816, which inhibits an enzyme called adenylyl cyclase necessary for sperm motility, immobilizing them after half an hour and for two to three more hours. Preliminary results seem to indicate that the approach is effective and safe, but its development is in very early stages (it has only been tested in animal models so far).
Other options include a silicone ring called the Andro-Switch, which brings the testicles closer to the body to heat them, and a device called the COSO that uses ultrasound for the same purpose. For now, however, there are no data from clinical trials that prove the effectiveness of none of them.
References
Janagan Alagarajah, Zach Witkin, Therese Bagwaneza, Shola Olabode-Dada, Rebecca Hope. The Future of male Contraception – A seven-country study of users’ perspectives on the next revolution in healthcare. We Vibe / Y labs (2022).
Balbach , M. , Rossetti , T. , Ferreira , J. et al. On-demand male contraception via acute inhibition of soluble adenylyl cyclase. Common Nat (2023). DOI: https://doi.org/10.1038/s41467-023-36119-6