Contraception: Is It Finally Men’s Turn?
For decades, contraception has largely been considered a “women’s issue”.
The pill, IUDs, implants, injections, patches, vaginal rings… Women have access to a wide range of contraceptive methods. But many of these methods also involve hormones, medical procedures, side effects and, sometimes, significant risks.
Meanwhile, the range of contraceptive options available to men remains remarkably limited.
So why is that? And could contraception finally become a shared responsibility?
Male contraception: what options actually exist?
The condom: simple, effective — but dependent on consistent use
The condom remains the most widely available reversible male contraceptive method.
It has two major advantages: it prevents pregnancy and protects against sexually transmitted infections (STIs).
Its effectiveness, however, depends entirely on correct and consistent use. Breakage, slippage or simply not using one can lead to contraceptive failure.
And there is an important social reality: a condom only works if the man agrees to use it.
Withdrawal: still widely used, but unreliable
Withdrawal — ejaculating outside the vagina — is sometimes considered a “natural” method.
Its effectiveness is relatively low because it requires perfect timing and self-control. Pre-ejaculatory fluid may also contain sperm, particularly after a previous ejaculation.
It offers no protection against STIs.
Vasectomy: highly effective, but considered permanent
A vasectomy involves cutting or blocking the vas deferens, preventing sperm from reaching the ejaculate.
It is one of the most effective contraceptive methods available.
However, it is intended as a permanent method. Reversal is technically possible in some cases, but success cannot be guaranteed.
It is therefore generally appropriate for men who are certain that they do not want biological children in the future.
And what about a male contraceptive pill?
This is where things become much more complicated.
Researchers have been working for decades on hormonal male contraception. The principle is broadly similar to hormonal contraception in women: suppress sperm production by modifying hormonal signals.
Several approaches have been investigated, including combinations of testosterone with progestogens.
The objective is to reduce sperm production to extremely low levels while maintaining normal testosterone-dependent functions such as libido, muscle mass and bone health.
The problem?
The biology is complicated.
Sperm production is highly sensitive to hormonal changes, and the response varies considerably between individuals.
Clinical trials have demonstrated that hormonal male contraception can work, but development has been slowed by concerns about side effects, tolerability, reversibility and the need for very high contraceptive reliability.
And unlike women, men do not have pregnancy as a potential consequence of contraceptive failure.
That raises an important question:
How much side-effect burden is acceptable for a healthy person who is taking contraception purely to prevent someone else from becoming pregnant?
The non-hormonal “male pill”
Another promising avenue is non-hormonal contraception.
One example is YCT-529, an investigational drug designed to interfere with sperm production without altering testosterone levels.
This type of approach is particularly interesting because it aims to avoid some of the hormonal side effects associated with earlier male contraceptive candidates.
But it remains experimental.
It is not currently an approved contraceptive that men can simply obtain from a pharmacy.
More research is needed to establish long-term safety, effectiveness and reversibility.
Thermal contraception: contraception through heat
Another approach is surprisingly simple in principle:
heat.
Sperm production requires a temperature slightly below core body temperature. Thermal contraception therefore aims to raise the temperature of the testicles sufficiently to temporarily suppress sperm production.
Different devices and techniques have been studied, including specially designed underwear or supports that maintain the testes closer to the body.
The concept has shown contraceptive potential, but it requires very regular and disciplined use, and sperm production does not stop immediately.
It can also take several weeks or months for sperm production to return after stopping the method.
Although interesting, thermal contraception is still not a mainstream, widely approved contraceptive option.
The “male IUD” — or STEOM
Another experimental concept has attracted considerable attention: the STEOM, sometimes described as a “male IUD”.
The idea is fundamentally different from an IUD placed in the uterus.
The device is designed to be placed in the vas deferens, the tubes carrying sperm from the testes.
The aim is to temporarily block or interfere with sperm transport while preserving the possibility of future fertility.
It is an intriguing concept because, theoretically, it could combine:
high contraceptive effectiveness,
reversibility,
long-term protection,
and no daily medication.
But there is an important distinction between an innovative medical concept and an available contraceptive method.
STEOM is still experimental and is not currently an established contraceptive available on the market.
There is therefore no reliable pharmacy price or confirmed date at which it will routinely be available to the general public.
Why don't we already have a whole range of male contraceptives?
The question is not simply scientific.
Developing a contraceptive for healthy men requires an exceptionally high safety standard.
The person taking the medication is not being treated for a disease. He is healthy and is taking the contraceptive to prevent a pregnancy.
That means adverse effects must be sufficiently low to justify exposing a healthy person to the treatment.
But the same principle applies to female contraception.
Women have been taking hormonal contraceptives for decades despite possible side effects and, depending on the method and individual risk factors, rare but serious complications.
So perhaps the real question is not: “Why don't men have contraception?”
but rather: “Why have we historically accepted so much contraceptive burden for women?”
Meanwhile, women have an enormous range of options
Women currently have access to many contraceptive methods, including:
Combined hormonal contraception
Combined oral contraceptive pills
Vaginal rings
Transdermal patches
These contain estrogen and a progestogen.
Possible side effects include breast tenderness, headaches, nausea, mood changes and irregular bleeding.
More importantly, estrogen-containing contraception is associated with an increased risk of venous thromboembolism in certain women, with the absolute risk depending on age, smoking status, thrombophilia and other individual factors.
Progestogen-only contraception
This includes:
progestogen-only pills,
implants,
injections,
hormonal IUDs.
These methods avoid estrogen-related thrombotic risk, but they can still cause irregular bleeding, amenorrhea, acne, mood changes or other hormonal side effects.
The contraceptive injection also has particular considerations regarding bleeding patterns, weight changes and return of fertility.
The copper IUD
The copper IUD contains no hormones.
It can provide highly effective, long-term contraception.
However, it can increase menstrual bleeding and cramping, particularly during the first months after insertion.
And insertion itself is an invasive medical procedure.
Female sterilization
Tubal sterilization is a highly effective permanent contraceptive method.
But, again, it requires a medical procedure — and the woman carries the procedural burden.
So why does contraception so often become a woman's responsibility?
This is perhaps the most uncomfortable part of the discussion.
Pregnancy occurs in a woman's body.
The physical consequences of pregnancy, childbirth and abortion are therefore ultimately borne by the woman.
Yet contraception is frequently treated as if it were primarily her responsibility.
She takes the pill.
She gets the implant.
She has an IUD inserted.
She monitors her menstrual cycle.
She deals with irregular bleeding.
She makes medical appointments.
She worries about contraceptive failure.
And if pregnancy occurs, she is the person who becomes pregnant.
Meanwhile, a man can sometimes simply say: “I didn't want a child.”
But not wanting a child after conception does not erase the biological consequences for the woman.
Contraception should be a shared responsibility
This does not mean that every man must take hormonal contraception.
It means something much simpler:
preventing pregnancy should not automatically become the woman's job.
A man can take responsibility by:
using condoms consistently,
discussing contraception openly,
accepting responsibility for contraceptive decisions,
considering a male contraceptive method when appropriate,
and, if he definitely does not want children, considering permanent contraception such as vasectomy.
A woman can choose the method that is appropriate for her body and circumstances.
But she should not be expected to carry the entire contraceptive burden simply because medical science has historically provided her with more options.
So… is it finally men's turn?
Perhaps not in the sense that contraception should become a competition between men and women.
But it may be time to recognize something that should have been obvious all along:
Contraception is a shared responsibility.
Science is exploring new possibilities for men — hormonal pills, non-hormonal drugs, thermal methods, long-acting devices and other experimental approaches.
Some may eventually become genuine alternatives.
But until then, responsibility does not have to wait for a new pill.
A condom is already available.
Communication is already available.
Taking responsibility is already available.
And perhaps that is where the biggest change needs to happen.
Kindly yours,
Dr. Sandra Yene Amougui
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