By Lila Rouland | Published September 25, 2025 | 2 min read
#Contraception
#MaleContraception #Gynecology #Testosterone
For more
than half a century, contraception has rested primarily on women’s shoulders.
But a turning point seems to be approaching: research on hormonal male
contraception is progressing rapidly, opening the way to a new era of shared
responsibility.
The
strategy relies on a simple but effective principle: administering testosterone
(alone or combined with a progestin) to block the hormonal axis that stimulates
sperm production. The result: a drastic reduction in sperm output, reversible
once treatment stops. Men retain sexual function thanks to circulating
testosterone, but their testes stop producing the sperm needed for
fertilization.
The first
studies, conducted as early as the 1970s, already demonstrated the
effectiveness of testosterone enanthate in inducing temporary azoospermia.
Since then, large-scale trials—particularly in China—have confirmed its
potential. With monthly testosterone undecanoate (TU) injections, more than 95%
of men reach sufficient suppression of sperm production, with a failure rate
comparable to the female pill. Fertility typically returns within six months
after discontinuation.
Winning
combinations… and their limits
Adding progestins such as norethisterone enanthate further improves
contraceptive efficacy, but some trials had to be stopped due to reported mood
changes and cases of depression—even though most participants declared
themselves satisfied. Other approaches, such as GnRH analogues, still face
issues of cost and practicality.
Towards
a “male pill”
New generations of molecules are raising considerable hope. Synthetic androgens
with dual action (androgenic and progestogenic), such as dimethandrolone
undecanoate (DMAU) or 11β-MNTDC,
are being tested as daily pills or long-acting injectables. Early results are
encouraging: good tolerability, effective hormonal suppression, and maintenance
of the androgenic effects required.
A
response to a global challenge
Nearly 50% of pregnancies worldwide are unplanned, with major health and
economic consequences. Hormonal male contraception appears as an essential
public health lever, enabling men to share the contraceptive burden. Surveys
and polls show growing public interest, especially among younger generations.
The
scientific evidence is mounting: hormonal male contraception is effective,
reversible, and safe. Injections, gels, or pills—several formats are on the
horizon. What remains is to clear the final regulatory steps and ensure
equitable access. If funding follows, the “male pill” could well join the
global contraceptive arsenal within the next decade.
Read next: The pill, myths & realities: what you’re not (often) told
About the author – Lila Rouland
Doctor of Oncology, specialized in Biotechnology and Management
