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Despite scientific advances, birth control options for men remain limited to condoms or vasectomy. There are also wing-and-a-prayer options such as pulling out (withdrawal) and outercourse.

Since half of all U.S. pregnancies are unintended, there seems to be a real need for additional family planning methods that don’t rely solely on women. Many men express a desire to share this responsibility equally with their female partners. Even so, the gap in options is large.

Science has tried to fill the void, but multiple research studies have started and stopped over the course of many years. Some potential male birth control options are in the pipeline, but we don’t know when they’ll hit the market.

For now, the birth control methods men have used for decades will have to suffice.

In this article we’ll go over options men can use to prevent unintended pregnancy, and we’ll let you know what may be coming in the future.

Condoms

Condoms are a type of barrier birth control. To prevent pregnancy, a condom is placed onto an erect penis and worn during vaginal intercourse. Condoms work by stopping semen from entering the vaginal canal, so an egg can’t be fertilized.

Condoms are usually made from latex or polyurethane. They may also be made from lamb membrane called lambskin.

Condoms come in various sizes and textures. Some are lubricated to make penetration easier and reduce friction, which can cause a condom to tear. Others are coated with spermicide for added protection against pregnancy.

Benefits

  • When used correctly, condoms are highly effective at preventing pregnancy.
  • They also protect against sexually transmitted infections (STIs), such as HIV, chlamydia, gonorrhea, and syphilis.
  • Condoms are widely available and inexpensive, and they don’t require a prescription.

Risks

  • Condoms can rip or slip off if they don’t fit or aren’t put on correctly.
  • Condoms can expire or become damaged by light and heat. An old or dried-out condom may be more likely to tear during use.
  • If you or your partner has a latex allergy, you may have an allergic reaction to latex condoms. Symptoms include itching and swelling after sex.
  • Condoms lubricated with spermicide may increase the risk of urinary tract infections in people who have vaginas.

Cost

Condoms vary in price, based on the brand you’re buying and the retailer you’re shopping from. In general, a 24-count box of condoms will cost around $15.

Conventional vasectomy

Vasectomy, also known as male sterilization, is a surgical procedure designed to be permanent birth control.

During a vasectomy, your surgeon will divide and close off the ends of the tubes that transport sperm (the vas deferens). Since this stops sperm from entering seminal fluid, your ejaculate will not be able to inseminate your partner.

Conventional vasectomies are outpatient procedures. Since general anesthesia is not used, you’ll be awake during a vasectomy. Here’s how the procedure goes:

  • Your surgeon will numb your scrotum with a local anesthetic.
  • Your surgeon will make two small incisions on either side of your scrotum, which will allow them to reach the tubes that carry sperm out of each testicle (the vas deferens).
  • The surgeon will cut and remove a small section of each tube.
  • The surgeon will close the ends of the tubes, either by using heat or by tying them.

Recovery from a vasectomy usually takes about a week. During that time, you should avoid sexual activity and physical activities such as heavy lifting.

Benefits

  • Conventional vasectomy is more than 99 percent effective at preventing pregnancy.
  • This procedure eliminates your dependency on other forms of birth control, both male and female.
  • Vasectomy doesn’t change your testosterone production. It won’t reduce your sex drive or your ability to get an erection or to orgasm.

Risks

  • It takes between 8 and 12 weeks before a vasectomy starts to provide contraceptive protection.
  • Vasectomy is meant to be permanent. This procedure can often, but not always, be reversed. You shouldn’t get a vasectomy if you think you may want children at a later date.
  • You may experience bruising, swelling, and pain after the procedure.
  • In some cases, ongoing testicle pain may occur.
  • Like any other surgical procedure, vasectomy carries a risk of infection.
  • A hard, pea-size lump caused by sperm leakage may form. This lump is called a sperm granuloma. Sperm granulomas can be painful but usually dissolve on their own.
  • Sperm buildup in your testes may cause a feeling of pressure that lasts for weeks to months.
  • If you’re concerned about getting an STI, you’ll need to wear a condom during sex after having a vasectomy.

Cost

Many insurance plans, including Medicaid, cover the cost of vasectomy. Without insurance, you can expect to pay anywhere from $300 to $3,000 for this procedure.

No-scalpel vasectomy

Like conventional vasectomy, no-scalpel vasectomy is a permanent form of male birth control. It has the same success rate for preventing pregnancy. It’s also done as an outpatient procedure without general anesthesia.

  • If you have a no-scalpel vasectomy, your surgeon will numb your scrotum with a local anesthetic.
  • Instead of making incisions with a scalpel, they will use a sharp pointed forceps to make a small hole on each side of your scrotum.
  • The surgeon will use the forceps to pull the vas deferens out through each hole and cut it.
  • They will then seal the ends by tying or using heat.

Benefits

  • No-scalpel vasectomy provides the same benefits as a conventional vasectomy, including the ability to forgo birth control without worrying about pregnancy.
  • This procedure doesn’t change testosterone production. It won’t affect your sex drive or your ability to get an erection or to orgasm.
  • The procedure has more than a 99 percent success rate for achieving sterility.
  • No-scalpel vasectomy takes less time and has fewer side effects, such as infection and blood clots, than conventional vasectomy.
  • You’ll likely have minimal pain after this procedure.
  • Some studies suggest that recovery time for a no-scalpel vasectomy may be shorter than it is for conventional vasectomy. You may be able to comfortably resume sexual activity sooner, although your doctor may recommend waiting at least a week.

Risks

  • It takes between 8 and 12 weeks for a no-scalpel vasectomy to provide contraceptive protection. Make sure to use a condom or another form of birth control to prevent pregnancy during this time.
  • No-scalpel vasectomies can sometimes, but not always, be reversed. It’s best not to have this procedure unless you’re sure you don’t want children.
  • You can expect bruising, swelling, and minor bleeding or oozing after the procedure.
  • Sperm granulomas may form and cause pain, but they typically resolve on their own.
  • You may experience pressure in your scrotum. This can last several weeks.
  • No-scalpel vasectomy won’t protect against STIs.

Cost

Many insurance plans, including Medicaid, cover the cost of vasectomy. Without insurance, you can expect to pay anywhere from $300 to $3,000 for this procedure.

Research exists on hormonal forms of birth control for men, including a daily pill, but currently there’s no male birth control pill available for men to take. There are several reasons for this.

“Studies on a male pill started decades ago, but there were lots of hurdles. Researchers had to solve questions like how to make modes of delivery that last a long time. Another hurdle was how to define the level of sperm production that constitutes sterility, if it doesn’t go down to zero,” says Logan Nickels, PhD, research director for the Male Contraceptive Initiative.

In addition to scientific concerns, practical issues have hampered innovation and production.

“A lot of the stalling of these early studies was caused by an inability to find a pharmaceutical partner to help finance the research. Lots of pharmaceutical companies in the early 2000s didn’t want to get involved with new birth control methods because they were concerned about litigation.

“Large pharmaceutical companies moved to a business model where smaller startups do the risky stuff and they will provide financing later on. This small space isn’t at that point yet. So no products have crossed that chasm and don’t have the financing. Even so, I’m optimistic that a male pill will be produced within the next 10 years,” Nickels adds.

Nickels suggests keeping an eye on the following clinical trials on male birth control pills:

  • 11-beta-methyl-19-nortestosterone dodecylcarbonate (11-beta-MNTDC). This pill has successfully passed a phase 1 trial led by researchers at the University of Washington School of Medicine and UCLA. Researchers say the pill reduces the levels of the male hormones required for conception, with few side effects.
  • Dimethandrolone undecanoate (DMAU). Another University of Washington School of Medicine study analyzed DMAU for its potential as a once-daily male birth control pill. DMAU works similarly to 11-beta-MNTDC. It suppresses testosterone and two hormones required for conception.

Just as women have, men will gravitate toward different forms of birth control once enough options are available.

“Many men say they want a daily pill, but that may be because it’s what they’re familiar with, based on the current birth control type used by many women,” says Nickels.

Other male birth control options currently being studied include:

  • Vas-occlusive injected gel. ADAM is a nonhormonal gel that’s injected into the vas deferens. It blocks sperm from traveling into seminal fluid. Like an IUD, ADAM is long-lasting and should prevent pregnancy for a year or longer. Recruitment for clinical trials is currently underway.
  • Topical gel. UC Davis Health is running a clinical trial on a hormonal gel product that is rubbed into the shoulders. The gel contains synthetic progestin, which blocks natural testosterone production in the testes. The gel also contains replacement testosterone to reduce side effects such as decreased libido.

Currently, the only male birth control options are condoms and vasectomy. Men can also use behaviors, such as outercourse, to reduce the risk of pregnancy.

No male birth control pill is currently available. Research is being done on male birth control options such as a daily pill, an injected nonhormonal gel, and a topical hormonal gel.