Non-surgical contraception options for men: New methods coming?

Dear Reader,

Unfortunately, research on new forms of male contraception has yet to produce any non-surgical, non-drug methods (besides condoms) that are approved and on the market. However, there is hope on the horizon with some methods that are currently being researched. The methods you mention in your question — medical-grade silicone rubber (MSR), medical-grade polyurethane (MPU), and the Shug (a silicone plug) — are all still experimental methods that focus on blocking sperm from leaving the penis (similar to a vasectomy), and it’s unclear as to whether these methods are continuing to be researched. Some methods that are currently being researched with the intention of bringing them to a larger population are the reversible inhibition of sperm under guidance (RISUG) and Vasalgel (more on these in a bit). Additionally, although you noted interest in non-drug methods, some hormonal methods are currently being explored as well, such as the transdermal gel and dimethandrolone undecanoate (DMAU).

The MPU, MSR, and Shug are all various forms of plugs that are inserted into the vas deferens (which is the tube in the body that carries sperm cells from the epididymis to the urethra). While not a surgical procedure, the plugs were inserted through the skin using a needle. The MPU used medical-grade polyurethane, but after concerns about the safety of the material, researchers looked for other materials and started to try silicone. The MSR and Shug are both made of medical-grade silicone rubber. Similar to the MPU, the MSR would require an injection in which the silicone would form a plug in the vas deferens that would prevent sperm from ending up in the ejaculate. The Shug, while made of silicone, differs in that it injected pre-formed silicone plugs into the vas deferens. For any of these plugs to be reversible, the removal process may require surgery. Additionally, these methods were only available in clinical trials, and some of the most recent research on these methods is decades old, suggesting that research hasn’t continued.

Other non-hormonal products currently in clinical trials are RISUG and Vasalgel. For RISUG, a polymer is injected into the vas deferens and solidifies on the tube wall within 72 hours. Instead of blocking sperm, the RISUG actually ruptures the cell membranes of sperm passing by, leaving them unable to fertilize an egg. It appears that a single injection can provide up to ten years of contraceptive use. Vasalgel is based on the same idea as RISUG, except that this polymer gel blocks the flow of sperm altogether as opposed to rupturing the sperm itself. Both the RISUG and Vasalgel compounds are removed by flushing the vas deferens with a solvent, restoring fertility. There seem to be few complications and side effects yet observed.

Though you mention an interest in non-drug options, some of the more widely researched methods include hormones, which could be taken in pill form, absorbed through a skin patch, or injected through a needle. The current goal is to identify a hormonal male contraceptive that’s efficient, reversible, safe, with few or tolerable side effects, inexpensive, and accessible. Two promising options are transdermal gel and DMAU. Transdermal gel contains two synthetic hormones that are rubbed into the skin and has already been shown effective in a six month study. DMAU is a hormone combination pill that is taken once a day; however, users have complained of slight weight gain and a decrease in HDL ("good") cholesterol. Research is continuing to monitor side effects and look at these in the longer term.

For those not interested in hormonal contraceptives and non-surgical procedures, condoms and the withdrawal method (also known as pulling out) are the other two options available, although the withdrawal method has a 28 percent failure rate. Your girlfriend could also look into non-hormonal methods, such as the copper IUD, the diaphragm, internal (female) condoms, or the symptothermal method. You may consider speaking with your health care provider about your options or checking out the Go Ask Alice! Sexual and Reproductive Health for an array of Q&As on contraceptive options, including barrier methods. Remember, of all the existing and new methods for men, only condoms will provide protection against sexually transmitted infections (STIs).

More people are expressing interest in male-directed contraceptives; hopefully there will be new methods on the market in the next few years. Until then, safer sex through barrier methods may be your best bet!