An injectable gel ushers in a new era of male birth control

Last month, we were excited when our Pulse Check interviewee—Evvy’s Laine Bruzek—gave a shout-out to an underrecognized health tool: Male birth control.

This week’s we’re diving into where our industry stands on this exciting, yet controversial, innovation.

Just this month, medical device startup Contraline released clinical data on its injectable male birth control gel. The results are early, but positive.

The approach, which Contraline refers to as being “like the IUD for men,” is a fascinating medical advancement in the reproductive health space. It also appears to have come at the right time in history.

Illustration by Mary Delaney
Illustration by Mary Delaney

How does this male birth control work?

No, this product is not a male version of the infamous “pill”—but more on that in the next section.

The procedure here is simple: Urologists remove a small piece of the vas deferens—aka the sperm duct—and inject the gel into it. They then put the vas deferens back in. Once the removable gel is in, it physically blocks sperm from coming out.

Within the 30-day study period, researchers found results comparable to vasectomy and no serious adverse events.

Plus, Contraline isn’t the only player in this game. Other male birth control products in development include:

So when can male partners expect to benefit from these innovations? 

Contraline is hoping for FDA approval for their product by 2027. Yet, history suggests we may be in for a frustrating wait.

A long time coming: The mixed history of male birth control

Though male birth control may not be popular, it isn’t new.

Hormonal male birth control pills were studied and even found to be quite effective in trials as early as the middle of the 20th century. 

So why didn’t male birth control find more of a share of the birth control market? The reasons are largely cultural and political.

Let’s look at a quick timeline of birth control development in the U.S.:

  • 1855: Rubber male condoms are invented
  • 1897: The first vasectomy is performed
  • 1950s: New York State biochemists test male contraceptive pill on incarcerated men and Gregory Pincus’ team runs oral contraceptive trials on “poor, uneducated” women in Puerto Rico
  • 1960: The female hormonal birth control pill is approved by the FDA
  • 1968: The first intrauterine device (IUD) is approved by the FDA
  • 1970s: Male hormonal contraceptives undergo clinical trials
  • 1993: The female condom is approved by the FDA
  • 1999: The Plan B emergency contraceptive pill is approved by the FDA

As you can see, for the past several decades, female contraceptives have become the default birth control interventions. But why—especially since male contraceptive pills were found to be largely safe, affordable, effective, and reversible?

For the pill tested in the 1950s in New York, the issue was not the coercive context under which the experiment took place—it was one of the side effects: Men could not safely drink while taking the pill.

In the 1970s, hormonal injection interfering with testosterone production were also found to be safe, effective, and reversible. Yet, many participants dropped out of these trials because the injections took time to work, and they disliked the injection schedule.

Even in the 2010s, a Stage II trial of a male hormonal contraceptive was stopped—not because the injection was ineffective. The issue this time around? Side effects like acne and mood swings.

Reactions around the internet in 2016 were pointed: Women have endured side effects like weight gain, mood swings, and pain for the sake of birth control for decades. Why shouldn’t male partners take on some of that burden?

The answer seemingly came down to responsibility and risk-benefit analysis. 

For women, the risk-benefit analysis comes down to balancing the side effects with the possibility of pregnancy. For men, the specter of pregnancy hasn’t been as compelling.

For innovators in this field, the Big Pharma companies currently running the birth control market also play a role.

“The fact that the big companies are run by white, middle-aged males who have the same feeling—that they would never do it—plays a major role,” said Herjan Coelingh Bennink, a gynecology professor who helped develop the contraceptives Implanon and Cerazette as head of research and development in women’s health for Organon International from 1987 to 2000. “If those companies were run by women, it would be totally different.”

Is 2024 male birth control’s year?

While setbacks in the last decade were a damper on scientists’ optimism, they haven’t killed the hope for an effective and marketable male birth control.

And now may be the time when the risk-benefit analysis has more male partners willing to participate.

Men are more interested than ever in taking a more active role in birth control, especially in the U.S., where women’s reproductive rights have been growing ever more limited over the past few years. Ever since the U.S. Supreme Court struck down federal abortion rights in 2022, vasectomies have been on the rise.

The tide may finally be turning in male birth control’s favor, and startups like Contraline are perfectly poised to take advantage. In the next few years, we hope they’ll change the world’s collective minds over who takes responsibility and how we bear the burden of contraception and reproductive health. 

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