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Why Is There No Male Birth Control Pill?

Medically Reviewed by Arefa Cassoobhoy, MD, MPH on August 13, 2020

People have used contraceptives to prevent pregnancies as far back as 1850 B.C. They've used everything from honey and crocodile dung to do it.

Throughout history, much of the responsibility for contraception and birth control has fallen on women. These days, they're front-and-center for three of the most common forms of birth control:

  • Sterilization (surgery)
  • "The pill" (which contains hormones that prevent pregnancies)
  • LARCs, or long-acting reversible contraceptives, like an intrauterine device (IUD).

Certainly, men play some part in preventing pregnancies. Some wear condoms (another popular method of birth control) or have sterilization surgery (called a vasectomy).

Still, the search for the long-promised male version of "the pill" continues.

Why?

The Challenge of a Male Birth Control Pill

Research shows that many men would welcome the choice of a hormone-based male birth control pill. Depending on who you ask, up to 83% say they'd use it. But coming up with a safe, reliable, effective male birth control pill is slow work.

Why? Researchers are after a lot in an ideal male pill. Of course, it should be effective, and also:

  • Cheap
  • Easy to use
  • Free of serious side effects
  • Easily available
  • Reversible

The science of male birth control is tricky, too. In order for a pill to be effective, researchers look for it to do at least one of a few things:

  • Slow or stop the creation and formation of sperm
  • Stop the sperm from leaving the body
  • Slow down the sperm to keep them from reaching their destination
  • Keep sperm from fertilizing the egg (possibly through a nonhormonal drug)

So far, most tries at this have been injectables, not pills. That's not ideal. Some pills made have the potential to create problems for your liver. You'd have to take others more than once a day -- again, not ideal. And other side effects -- things like acne, weight gain, altered sexual drive, and mood changes -- can happen, too.

Work continues, though. Many researchers are using testosterone, either alone or with other hormones, in their potential contraceptives. These may be closer to the market than other options. But other, nonhormonal methods are in the mix, too.

Where We Stand

In 2012, a hormone-based gel that you rub over your upper arms once a day significantly lowered sperm counts with only minimal side effects. Studies on this option are still going on.

A large study of an injectable hormone combination showed promise in 2016. Even with some side effects, 75% of those interviewed after the study said they'd use it again.

A procedure called RISUG -- reversible inhibition of sperm under guidance -- has been under development for decades in India. With this treatment, you'd get a one-time shot of a long-acting substance. It goes into the tube that carries sperm out of your testes (called the vas deferens). After that injection, sperm can't leave the body. If circumstances change, another shot can clear the blockage and reverse the procedure.

But a safe, effective male birth control pill is still in the making.

A study of 82 men in early 2019 determined that a hormone-based pill called dimethandrolone undecanoate (DMAU) was safe when used every day for a month. It also had no serious side effects.

Another promising pill, 11β-MNTDC, was announced in March of 2019.

Trials are ongoing for both.

WebMD Medical Reference

Sources

SOURCES:

Planned Parenthood Federation of America: "A History of Birth Control Methods."

CDC: "Current Contraceptive Status Among Women Aged 15-49: United States, 2015-2017."

U.S. Department of Health and Human Services: "Birth Control Pill."

Indian Journal of Endocrinology and Metabolism: "Male contraception."

Therapeutic Advances in Endocrinology and Metabolism: "Update on male hormonal contraception."

Human Reproduction: "Potential impact of hormonal male contraception: cross-cultural implications for development of novel preparations."

The Journal of Clinical Endocrinology & Metabolism: "Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men," "A New Combination of Testosterone and Nestorone Transdermal Gels for Male Hormonal Contraception," "Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill."

U.S. National Library of Medicine, ClinicalTrials.gov: "Study of Daily Application of Nestorone (NES) and Testosterone (T) Combination Gel for Male Contraception."

Male Contraceptive Initiative: "Vas-occlusion -- One new type of male birth control."

Indian Journal of Medical Research: "RISUG: An intravasal injectable male contraceptive."

Journal of the Endocrine Society: "SUN-LB042 The Novel Androgen 11β-Methyl-19-Nortestosterone Dodecylcarbonate (11β-MNTDC) Effectively Suppresses Gonadotropins and Testosterone in Healthy Men: A Potential Oral Male Hormonal Contraceptive."

Endocrine Society: "Second potential male birth control pill passes human safety tests."

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