Almost half of all pregnancies worldwide are unintended.
Men contribute to all pregnancies. A male oral contraceptive is long overdue.
KEY INSIGHTS
- Women have had access to oral contraceptives (OCP or “The Pill”) since the early 1960s, and since then, more than 300 million women worldwide have used OCPs to achieve reproductive freedom, as well as for other medical reasons.
- While they certainly have immense benefits, female oral contraceptives are not without side effects and risks, and they are not suitable for use by all women.
- To date, the only male contraceptive options are condoms and vasectomy; vasectomy should be considered as a permanent contraceptive solution. This gender gap must be closed, as the responsibility for contraception should not be a woman’s to shoulder alone. Clinical trials are looking at a new male oral contraceptive pill, with promising results.
- Gynaecology Centres Australia is an NSW-based private women’s health provider of IUD insertions under sedation, legal abortion services, and vasectomies for men.
More than 20 categories of contraceptives have been approved by the FDA in the USA and the TGA in Australia (OCPs, implants, IUDs, diaphragms, vaginal rings, sterilisation, injections, and others). Remarkably, only two of these are available for use by men to prevent pregnancy in their partners: condoms and vasectomy.
Female Oral Contraceptives: An Historical Perspective
25% of women who use contraception today take The Pill. It is a drug that was first developed in the 1950s to regulate women’s menstrual cycles – and its contraceptive properties were discovered as an unintended side effect.
The first oral contraceptive was approved for use by women in the USA in 1960, and within 2 years, 1.2 million American women were using it. In 1961, Australia became the second nation to introduce it. Initially, it was only available to married women, reflecting the social mores of the time (though some doctors did indeed quietly prescribe it to unmarried women).
The impact of this for women’s health and wellbeing was unprecedented – radically enabling control over not only their reproductive health and giving them agency to plan their parenthood, but also allowing women wider participation in the workforce and supporting major social change. In 1972, Australia’s incoming Prime Minister, Gough Whitlam, abolished the 27.5% luxury tax on the OCP, widening its economic availability.
Early versions of the OCP had very high levels of synthetic hormones, resulting in significant side effects for women such as nausea, weight gain, mood issues, breast pain, migraine, and associations over time with serious conditions such as blood clots and a higher risk of developing breast cancer.
Today’s generation of the OCP has much lower doses of hormones, better quality synthetic hormones themselves, and is medically considered to be a very effective, low-risk contraceptive alternative for most women.
The Pill works by influencing female hormones to trick the brain into thinking the body is already pregnant. Used properly, it effectively prevents ovulation, alters the lining of the uterus, and thickens cervical mucous – all making pregnancy extremely unlikely. OCPs are also used to treat or manage heavy periods, irregular menstrual cycles, acne, polycystic ovarian syndrome (PCOS), premenstrual syndrome (PMS), and endometriosis.
The Overdue Need to Close The Gender Gap
There is a distinct gender gap between approaches to women’s and men’s health. Contraception has historically been considered the exclusive responsibility of women – after all, “women are the ones who become pregnant”. The gender bias extends to the drug companies, who are responsible for developing new and effective options, but have failed to direct their focus to researching new male contraceptives, as the female ones work. It’s arguably an attitude of, “if it’s not broken, why fix it?”
This burden is unreasonable, especially as there are potential health consequences for women who use hormonal contraceptives – and not all women can.
Pregnancy is as much the man’s responsibility as the woman’s. Development of an effective male oral contraceptive is long overdue.
Current Male Contraceptive Options
There are currently only two male contraceptive options available.
- Condoms are essential for the prevention of sexually transmissible infections. If used properly every single time you have sex, they are contraceptively effective up to 98% of the time. Accidental pregnancy occurs, however, at rates of almost 20% due to misuse.
- Vasectomy is male sterilisation. It involves an operation whereby the surgeon cuts and ties off the vas deferens, which are the tubes through which sperm must pass from the testes to the penis. After a vasectomy, it takes around 3 months for the semen to be 100% sperm-free (and testing to confirm this must be completed at this time). The success rate thereafter is over 99.9%. While vasectomies may sometimes be reversed through microsurgery, it should be considered a permanent contraceptive solution.
Development of an Effective Male Contraceptive Pill
There has recently been a positive shift in the attitudes of men towards their contraceptive options and obligations. A large global survey in 2024 found that more than 60% would consider trying new methods, including taking a pill.
Previous attempts have been made to create a more effective male contraceptive, but to date have not passed clinical trials due to unacceptable side effects, including not being fully reversible in all men, altering electrolytes in the bloodstream, and feeling unwell when alcohol is consumed.
A positive step towards the future of male contraception lies in the development and testing of a better drug.
The Male Contraceptive Pill
Phase 2 clinical trials have been undertaken into a new male non-hormonal contraceptive drug called YCT-529 that works by blocking Vitamin A receptors, which are critical for sperm production. This drug is being developed by Columbia University in NY, in collaboration with YourChoice Therapeutics.
In animal studies (mice and non-human primates), YCT-529 demonstrated temporary, fully reversible male infertility at a 99% success rate of preventing pregnancy. Sperm counts dropped dramatically within 4 weeks of use in male mice and within 2 weeks in male non-human primates, without any side effects of clinical significance. Upon stopping the drug, male mice and primates fully regained their fertility within 6-15 weeks and went on to produce healthy, normal offspring.
The first tests of this drug in a small group of human volunteers took place in 2024. Initial results have been promising:
- Uses no synthetic hormones
- Well-tolerated with no unwanted side effects
- No impact on testosterone production in the testes
- No adverse effect on cardiac safety
- No adverse impact on mood or sex drive
Safety and efficacy testing is being undertaken at this time in a second clinical trial.
Exploring Other Male Contraceptive Possibilities
- Nonhormonal Options – US scientists have identified a compound that inhibits and inactivates an enzyme that is essential for sperm motility (the ability to swim, reach, and fertilise an egg). Taken 30 minutes before sexual intercourse, it demonstrates 99% efficacy in lab settings – comparable with the women’s OCP.
- Male Hormonal Gel – a recent US trial looked at a male contraceptive hormonal gel that contains hormones that suppress the production of sperm. Similar in use to hormone replacement gels used by some perimenopausal and menopausal women, it is applied once daily to the shoulders and upper arms and absorbed into the body via the skin. Study data shows promising effectiveness with few, if any, side effects – likely in part due to being taken via the skin, which is a gentler way to administer medicines. This option, however, is not as practically appealing, as gels can be messy.
- Male Hormone Injections – several Australian clinical trials have studied a male contraceptive injection that uses the hormones testosterone and progesterone to prevent sperm production (implants have also been considered). There are no plans at this time for this to be made publicly available, but it could be further explored in the future.
These are promising developments that warrant closer scientific attention.
As of the end of 2025, there are no commercially available male oral contraceptives. We fervently hope that this will change in the foreseeable future.
Vasectomies for Men at Gynaecology Centres Australia
Gynaecology Centres Australia performs vasectomies for men. This is a 30-minute operation with minimal side effects and is among the best forms of contraception for men who do not wish to have children in the future. Having a vasectomy has no impact on a man’s sexual drive or performance.
Find more information about vasectomy at GCA here.
For vasectomy enquiries please contact us by phone on (02) 42274100 or contact us online.