There are few options available to men for controlling fertility. Those choices are far from ideal. There are drawbacks to each method. Condoms can be cumbersome; vasectomies require surgery for reversal, and pulling out is not that reliable.

Efficient methods like a pill, a gel and a nonsurgical vasectomy are making their way through clinical trials.

Options that can be considered!

Sexually active men can have these options to control their fertility. Following are the options that one can use like:

  • Condoms.
  • Control pills.
  • Vasectomy.

There are proposed methods, which are under clinical trials through which male birth can be controlled.

A gel that can stop sperm production

A gel called “Nestorone-testosterone” is a male control birth gel. It is the furthest along in the clinical trials.

This gel contains testosterone and progestin, which is a synthetic form of the female sex hormone progesterone. Males have progesterone, too but only at the low levels.

The progestin in the gel is meant to be applied to the arms and shoulders every day. It works to shut down the gonadotropin hormones responsible for stimulating testosterone production in the testes.

Sperm production is dependent on very high testosterone levels in the testes. Gonadotrophins lowers sperm production. When you lower the testosterone levels in the testes, the testosterone in the blood also drops. It can lead to problems like low libido and the problem with ejaculation.

A study shows that the gel suppresses the sperm level in 90 percent of men to 1 million per milliliter or less. This is the amount needed to prevent pregnancy but with a few side effects.

A promising male birth control pill is about to enter phase two clinical studies:

Previously, the male birth control pills that were introduced had faster clearance from the blood. This is why it requires more than one daily dosage. The latest advancements have led to the formulation of long-lasting pills and can provide effective contraception if taken daily for a month.

These pills are about to enter the phase II clinical trials. In these trials, the efficacy and potency, i.e., the pill’s effectiveness, will be determined. This new drug is DMAU, which stands for dimethindene undecanoate. Its effects last for 18 hours.

Nonsurgical vasectomy

Vasectomy is a surgery that involves cutting or tying the tube that carries sperms from the testis to the male urethra. Researches in India have proposed a reversible technique called RISUG, which stands for Reversible Inhibition of Sperm Under Guidance. It is a non-surgical vasectomy. In this procedure, the polymer gel is injected into the vas deferens to block sperms. It has only been performed in animals so far.

“Scientists have been working on a male contraceptive for decades,” says Monica Laronda, a reproductive endocrinologist at the Ann & Robert H. Lurie Children’s Hospital of Chicago, who was not involved in the research. “DMAU shows great promise.” Surveys show that many men are interested in forms of contraception besides condoms and vasectomies, she says, and men “would prefer a pill.” Other methods, including topical gels, are also being developed.

Hormonal contraception works for men as much as it does for women by manipulating levels of certain hormones so that the body backs off on making its own. In men, extra testosterone suppresses the brain’s release of luteinizing hormone and follicle-stimulating hormone, which stops testicles from making testosterone as well as sperm. Once the treatment ends, the body goes back to producing reproductive hormones, and fertility returns.

The testosterone can’t stay in the blood for a long period of time. It makes a single dose less likely to work for contraception. An excess amount can affect the liver badly. DMAU, which becomes an active compound called dimethandrolone in the body, is designed to avoid these problems. The men on the highest dose experienced a precipitous fall in luteinizing hormone, follicle-stimulating hormone, and testosterone from taking just one daily pill for 28 days. Those low levels are known to prevent sperm development.

“That’s critical for people being able to use it effectively,’ explained Stephanie Page, a professor of Medicine at the University of Washington. It is a steroid drug having both testosterone and progestin effects. It suppresses sperm production. It has very few side effects. New studies are underway to prove their efficacy.

When female pills were introduced, the concentration of hormones was high and hence more side effects. The pills, which are now available, contain less concentration and hence fewer side effects. The goal is to develop male pills that are essentially side-effect-free.


Men should have choices. Male contraceptive options should be wider. The male contraceptive landscape should look like that of a woman. Moreover, men should share the burden of contraception, which is more inclined towards women.

Researchers believe that if only 10 % of males use these new contraceptive options, unintended pregnancies can fall by up to 5% in the United States and South Africa and by as much as 38% in Nigeria. If more choices available, it would lead to fewer chances of unwanted pregnancies.

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I have a MBBS from King Edward Medical University and did my clinical training at Pakistan’s Mayo Hospital, one of the most prestigious medical institutions in South Asia. My passion for medicine led...

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