Male birth control
Reviewed by our clinical team
In the UK, the most popular form of contraception used to be “the pill” – a catch-all term for female contraceptive (birth control) pills containing synthetic hormones.
In recent years, other forms of female contraception have risen in popularity. Long-acting reversible contraceptives like the IUD (coil), IUS, injection and the implant have become more common – in part, perhaps, because they’re seen as more convenient.
Increasingly, there have also been calls for effective male contraceptive. While male birth control is still limited to male condoms and sterilisation, research into other methods has proved promising.
What is male birth control?
In the past two decades, a few different methods of male contraception have been developed and trialled.
Hormonal male birth control options
Male contraceptive gel
In 2019, an international study was launched in several countries across Europe, South America, Africa and the US to study the effects of new contraceptive gel aimed at men called Nes/T. The UK trial centres are Edinburgh and Manchester.
NES/T is a gel that contains synthetic forms of progesterone (nestorone) and testosterone. The progesterone “switches off” sperm production in the testicles, and lowers levels of natural testosterone – the synthetic testosterone in the gel counters the effects of this.
The gel is designed to be rubbed into the shoulders and chest every day, and absorbs quickly into the bloodstream through the skin. It's anticipated that with correct usage, it will be just as effective as female hormonal contraception.
In some study centres, 100 couples have now completed at least one year of the study and results have been been encouraging so far.
Male contraceptive pill
There have been a few different types of the “male pill”. An early version contained only synthetic progesterone, and required the use of an implant that releases testosterone to counter any unwanted effects.
More recently, a couple of oral contraceptive pills for men have been through early, successful trials in the United States.
One pill is called 11-beta-MNDTC and works in a similar way to NES/T gel, by blocking sperm production. In a small trial it caused the hormones required for sperm production to drop, and some men experienced side-effects such as acne, fatigue and headaches. Some men reported low sex drive and erection difficulties, but none of the participants stopped the trial due to side effects.
This was a very small, preliminary study. These so-called Phase I trials are simply establishing whether a new substance is safe for use in humans. After this, larger studies re needed. The whole process from establishing that a new substance appears safe and well tolerated to a medicine that's available in the pharmacy or on prescription can take many years and a lot of investment. So far no further studies shave been undertaken.
Male contraceptive injections
In the past, a male contraceptive injection has been trialled by the same team currently working on NES/T gel. The injection worked in a very similar way, using synthetic progesterone to halt sperm production, and synthetic testosterone to counter unwanted effects.
The injections proved highly effective, with only four pregnancies occurring among 274 couples taking part. This is similar to the efficacy of the female pill.
Unfortunately, the trial was stopped early because it was felt that the hormonal side-effects would be unacceptable for men. The side-effects included acne, headaches, fatigue and change in sex drive. How serious or severe these side-effects are viewed differently by different researchers- and the men themselves. 75% of study participants were happy to continue despite side-effects; this probably compares with women stopping hormonal contraception due to side-effects.
Non-hormonal male birth control options
Not all male contraceptives currently in development involve hormones. Some involve a physical procedure that blocks the vas deferens, the tube that transports sperm to the urethra (the pee tube).
RISUG
One method is RISUG, which stands for “reversible inhibition of sperm under guidance”. It involves injecting a non-toxic chemical into the vas deferens, which creates a block and kills sperm as they pass through. Another injection can be used to dissolve the chemical when contraception is no longer wanted or needed.
IVD
Another method involves the intra-vas device (IVD), a physical plug injected into the vas deferens to filter sperm. As with RISUG, this method can be easily reversed, in this case simply by removing the plug.
Trials are still ongoing, but this type of method is thought to be potentially very effective.
Vasectomy
A vasectomy is a surgical procedure performed to cut or seal the tubes that carry sperm from the testicles out of the penis. It’s thought to be around 99% effective at preventing pregnancy but it’s generally considered to be permanent. A vasectomy can be reversed, but the success rate depends on how long ago the vasectomy was done. A vasectomy reversal usually has to be privately funded. So, if you have the surgery, you have to be sure on your decision.
Condoms
Male condoms are one of the most popular types of contraception across the world. They’re popular because not only do they help prevent pregnancy (with perfect use they’re 98% effective), they also protect against most STIs.
Male birth control side effects
As we’ve talked about, most of these new types of male birth control are very much in the testing phase, so it’s hard to say what the potential side effects will be. However, in some of the trials some men experienced symptoms like a change in sex drive, acne, headaches and tiredness.
In terms of the male contraceptive options that are already available, condoms and vasectomy, there are a couple of side effects you might want to be aware of.
The main side effect of condoms is a possible allergy or sensitivity to latex, which is the material most condoms are made from. If you think you or your partner might be allergic you should try non-latex condoms instead.
Because a vasectomy is an operation, it has the same general risks as any operation: pain, swelling, excessive bleeding, bruising or infection. A vasectomy can cause numbness in parts of the genitals, groin or upper thigh, very rarely, the vasectomy doesn't work.
Is male birth control effective?
Vasectomies tend to be around 99% effective and condoms, with perfect use are 98% effective. With typical use condoms are 82% effective.
Other contraceptive options
Currently there are are only two contraceptive options for men, but many more for women. They include hormonal as well as non-hormonal options. Hormonal contraception comes in the form of pills, patches, rings, injections, hormone coil and implants. Non-hormonal options are the copper coil, diaphragm and female condom.
It can be difficult or inconvenient for women to get hold of birth control, but attending your GP or contraception clinic isn't your only option.
Here at Online Doctor we can help take away some of the hassle by prescribing over the internet, and making your pill, patch, or ring available for home delivery or collection from your nearest LloydsPharmacy.
References
https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2021-22
https://pubmed.ncbi.nlm.nih.gov/30969032/
https://www.bbc.co.uk/news/health-48756761
https://www.theguardian.com/society/2019/jan/31/male-contraceptive-gel-couples-trial-manchester-edinburgh
https://pubmed.ncbi.nlm.nih.gov/27715345/
https://www.eurekalert.org/news-releases/832968
https://www.nhs.uk/conditions/contraception/male-pill/
https://clinicaltrials.gov/ct2/show/NCT03452111
https://www.nichd.nih.gov/newsroom/news/080222-NEST
https://mft.nhs.uk/2021/09/07/couples-wanted-to-be-part-of-pioneering-male-contraceptive-research-study-nes-t/
https://www.nhs.uk/conditions/contraception/vasectomy-male-sterilisation/
