By Ana Espino | Published on september 26, 2025 | 3 min read
#Contraception #MaleContraception
#Gynecology
Contraception remains a major issue
in reproductive health, still largely shouldered by women. On the male side,
the options are few and outdated: condoms, withdrawal, or vasectomy, each with
obvious limitations in terms of effectiveness, reversibility, or acceptability.
Despite growing demand for a fairer distribution of contraceptive
responsibility, concrete progress has been slow, hindered by biological,
social, and regulatory barriers. The development of reversible male
contraception faces the challenge of blocking sperm production without
disrupting overall hormonal functions, while ensuring reversibility and
long-term safety.
In this context, this review offers
an up-to-date overview of therapeutic strategies under development—both
hormonal and non-hormonal—evaluating their clinical maturity and potential as
credible alternatives in the short or medium term.
Pill, gel, heat… what do new
approaches really promise?
Twelve studies, including recent clinical trials and advanced preclinical work,
were selected. The interventions reviewed covered hormonal approaches
(testosterone, progestins, DMAU, 11β-MNTDC) and non-hormonal ones (RISUG, EPPIN, thermal contraception).
Criteria included contraceptive efficacy, tolerance, reversibility, and
acceptability.
Among hormonal approaches,
testosterone/progestin combinations—administered as injections, implants, or
transdermal gels—showed high contraceptive efficacy, with more than 90%
suppression of spermatogenesis. However, side effects such as acne, weight gain,
or mood disturbances still limit their acceptability. New oral molecules like
DMAU or 11β-MNTDC,
combining androgenic and progestogenic properties, are generating strong
interest due to good tolerability and early efficacy.
On the non-hormonal side, several
innovative strategies are emerging. Reversible mechanical barriers, such as
RISUG or Vasalgel, temporarily block the vas deferens, with promising
reversibility potential. Other molecules, such as EP055 or EPPIN, target specific
sperm proteins to reduce motility. Compounds like lonidamide or certain
indenopyridines act directly on Sertoli cells, disrupting spermatogenesis.
Finally, male thermal contraception (MTC)—based on controlled elevation of
testicular temperature via textile devices—shows good adherence and encouraging
results.
The future of male contraception is
being written now
The lack of effective reversible male methods perpetuates an imbalance in
contraceptive responsibility. While social demand is evolving, pharmaceutical
offerings lag behind, struggling to combine efficacy, tolerability,
reversibility, and acceptability.
This review aimed to identify the
most promising innovations, evaluating their stage of development and potential
for application. The findings highlight real advances, especially with
molecules like DMAU or 11β-MNTDC, as well as non-hormonal alternatives such as thermal
contraception, which may represent viable medium-term options.
However, this study also underscores
significant limitations, justifying continued research. Most approaches remain
at the preclinical stage, with limited data on long-term safety, individual
variability, or side effects. Large-scale trials will be essential to validate
these avenues. In the long run, only an integrated, personalized
strategy—together with better contraceptive education for men—will allow for a
durable rebalancing of contraceptive responsibilities.
Read next: Sharing the contraceptive burden: men step into the game
About the author – Ana EspinoPhD in Immunology, specialized in Virology
