In a world where many consider contraception as solely a woman’s responsibility, it’s time to shift the paradigm. Currently, there’s a wide array of contraceptive options for women — intrauterine devices, implants like Nexplanon and birth control pills — but the landscape of long-acting, reversible contraceptive options for men remains mostly uncharted territory.
With recent advances in clinical trials for male birth control, however, more options are emerging and may be hitting the U.S. market in a few short years. Let’s take a look at what’s available now and what’s coming down the line.
Male Birth Control Currently Available
Some forms of birth control, such as spermicide, affect male anatomy, and others involve a shared responsibility, like the withdrawal method or cycle tracking. However, there are just two options for male-only birth control on the market: condoms and vasectomies.
Condoms
Condoms prevent pregnancy by creating a barrier where sperm is not able to enter the vagina and fertilize the egg. Some condoms have spermicide on them to add an additional layer of pregnancy prevention.
How effective are condoms? The failure rate is about 13%, according to the Centers for Disease Control and Prevention. With perfect use, though, they’re up to 97% effective at preventing pregnancy. Condoms have the added benefit of preventing HIV and other sexual transmitted infections, or STIs, to varying degrees (over 90% for some STIs, according to a 2015 study). Plus, condoms are affordable, accessible and customizable.
The downside: Human error, such as using them incorrectly, can make condoms less effective, and condoms run the risk of breaking, wearing out or expiring. In addition, public perception of condom use can veer negative because of beliefs that they interrupt intercourse or can be cumbersome to apply.
[READ: Natural Birth Control Methods: Do They Work?]
Vasectomies
Vasectomies are a permanent — though often reversible — option.
During a vasectomy, a medical provider cuts a small section of the male reproductive system called the vas deferens, a tube that allows sperm to travel to the testes. Doing so blocks sperm from mixing with semen during ejaculation.
After the procedure, which usually takes place in a clinic setting, patients can take ibuprofen, an over-the-counter anti-inflammatory medication, for a few days to help with post-procedure pain. Providers also sometimes prescribe Valium, a medicine to ease anxiety. The pain typically goes away after one or two weeks.
Vasectomies are 99% effective at preventing pregnancy, but patients need to use a backup form of birth control for up to three months after the procedure; it takes some time to clear up any remaining sperm the body produced before the vasectomy.
A vasovasostomy is the reversal procedure for a vasectomy: A medical provider reconnects the vas deferens at the previous procedure site. A vasovasostomy has a success rate of around 90%, according to a 2022 study.
What are the drawbacks to a vasectomy? It can be painful, permanent and not suitable for everyone. Providers might take caution, for instance, with those who have genital infections, chronic testicular pain or testicular cancer. Vasectomies also require establishing a relationship with a primary care provider and verifying insurance coverage.
[READ: What Is a Vasectomy? Everything You Need to Know.]
New Research on Male Birth Control
There’s a dearth of long-acting, reversible male contraceptives at the moment, but demand is necessitating an uptick in research, says Rahima Benhabbour, an assistant professor in the University of North Caroline/North Carolina State University Joint Department of Biomedical Engineering in Chapel Hill, North Carolina.
Options in the research and clinical trials stages include:
— Vasalgel.
— Eppin.
— sAC inhibitor.
Vasalgel
Vasalgel is the American counterpart of the Indian drug RISUG, or “Reversible Inhibition of Sperm Under Guidance.” Vasalgel is a polymer gel — a molecule with many connected parts — called SMA acid that a medical provider injects into the vas deferens. In contrast to a vasectomy, the nonhormonal injection is not a near-permanent “snip,” and the drug eventually wears off after around 10 years.
Vasalgel is also reversible, by flushing the gel out. Vasalgel still has a few more rounds of trials, according to a 2020 study, so it won’t hit the market until at least 2024.
Eppin
EP055 is an organic compound known for targeting a molecule called EPPIN, which plays a crucial role in sperm regulation — the basis of the drug currently being developed by Eppin Pharma Inc.
There is promising data for the EP055 liquid injection after successful preclinical trials, notes Benhabbour, who also serves as an adjunct professor at the UNC Eshelman School of Pharmacy. The goal is to improve how long the injection lasts to create a first-in-line injectable and reversible nonhormonal male contraceptive.
“This long-acting option will mitigate a daily pill burden, lack of adherence and pill fatigue,” Benhabbour says, adding that the injection would likely be a monthly or quarterly regimen.
sAC Inhibitor
Soluble adenylyl cyclase, or sAC, is an enzyme — a protein that causes chemical reactions — essential for sperm mobility. A medication that inhibits sAC is currently in clinical trials, and it has shown encouraging results, though more research is needed, says Dr. James Elist, a urologist based in Beverly Hills, California.
This medication could have multiple formulations. One option would be a medication that blocks sperm from ejaculate. Patients would only need to take the medication prior to sexual activity and not daily. According to a 2022 study, there could potentially be a formulation for women as well. This version would be a “couples pill” that both parties could take. Clinical trials may also steer sAC inhibitors to be formulated for vaginal insertion, so it would work more like a spermicide.
[READ: What Is Non-Hormonal Birth Control and How to Use It?]
The Impact of Male Birth Control on Family Planning
Urology is becoming a fertile — no pun intended — field for research on innovative contraceptives.
“The field of urology is constantly evolving, and advances in technology will continue to shape the field and provide more options for men seeking effective and safe contraception,” Elist says.
Where does all the potential research for male birth control take us?
“Options for male contraception will overall enhance men’s ability to control their reproductive health and, as such, improve their wellness,” Benhabbour says.
Plus, with men taking a more active role in pregnancy prevention, Elist believes it could improve communication between partners and shared responsibility for family planning.
Increasing male birth control options may also play a critical role in achieving greater gender equity.
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What Is Male Birth Control? originally appeared on usnews.com
