What Are the Options for Male Birth Control?
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Medically reviewed by Soma Mandal, MD
The most common and effective methods of male birth control are condoms and vasectomies. Other methods include the withdrawal method, outercourse, and abstinence, although these are often less effective and more difficult to sustain. Hormonal male birth control options are being studied, but are not yet available.
About 45% of pregnancies in the United States are unintentional. Major strides have been made in the past century for female birth control, providing several effective methods to choose from, but the options available for male birth control methods are much more limited.
For example, the most common method of male birth control—condoms—isn’t nearly as effective as female hormonal birth control choices. Vasectomy, the most effective male birth control method, requires surgery and is intended to be irreversible. As such, there is significant interest in hormonal birth control for men and the majority of both men and women.
Related: Birth Control Methods Ranked by Effectiveness
Condoms
Condoms are the most commonly used type of male birth control, with over 50 million couples using them to prevent pregnancy. Condoms can prevent, though not fully eliminate, the chances of acquiring a sexually transmitted infection (STI) from intercourse.
The advantages of condoms are that they are relatively easy to acquire, inexpensive, and don’t have many side effects. However, many users complain that sexual intercourse is less enjoyable and can feel disrupted when condoms are used.
Importantly, condoms are less effective than other forms of birth control. When used correctly and consistently, condoms are 98% effective, meaning that for every couple that uses them about 2% will become pregnant.
However, when you look at typical use for condoms—meaning how they are used in real-life situations—they are only about 82% effective. This means that 18% of couples using condoms as their main birth control method will become pregnant within about a year.
You can increase condom effectiveness in the following ways:
Use condoms every time you have intercourse
Put the condom on directly before intercourse, not during foreplay
Don’t use expired condoms
Read condom instructions carefully and put the condom on correctly
Check that there are no tears in the condom
Store condoms in a cool, dry place (don't keep them in your wallet)
Don’t use condoms with nonoxynol-9 spermicide
Use latex or polyurethane condoms only
Use water-based or silicone-based lubricants, and avoid oil-based lubricants or products
Related: Can a Condom Get Stuck Inside You?
Withdrawal Method
The withdrawal method is when you end intercourse right before ejaculation, and ejaculate somewhere other than the vagina. This method has been used for centuries, is free, and has no side effects. However, it has several disadvantages, including the fact that many couples don’t use it correctly or consistently. Its typical use rate also translates to a low effectiveness rate.
The withdrawal method is not an effective or reliable method of preventing pregnancy. When used perfectly, meaning that you use it every time you have intercourse and don’t begin to ejaculate before pulling out, the method is 96% effective. However, the typical use rate for this method is low, with a 73% effectiveness rate. This means that 27% of couples using this method will get pregnant.
Related: What Is the Likelihood of Getting Pregnant From Precum?
Abstinence
Abstinence is when you refrain from having intercourse altogether. It’s the most effective method of birth control, with a success rate of 100%. However, most people can’t follow this on a long-term basis. The failure rate among couples during the first year of using this method is about 25%.
Related: What Does It Mean to Be Asexual?
Outercourse
Outercourse is defined as sexual practices that don’t involve ejaculation in the vagina. This can include oral and anal sex, masturbation, ejaculation on other parts of the body, dry humping, and other non-vaginal intercourse options. Many couples use this method and it’s 100% effective when used consistently. Similar to abstinence, this method can be challenging to adhere to and when not followed correctly, pregnancy can result.
Related: Is Oral Sex Really a Leading Risk Factor for Throat Cancer?
Vasectomy
Vasectomy is a surgical procedure used to cause male sterility. Over 40 million couples choose vasectomy as a form of birth control, usually when they are done having children or when they are sure they don’t want to have children at all. During the procedure, your genital area is numbed, a small incision is made in the scrotum, and the vas deferens (the tube that helps carry sperm out of the body) is cut.
The advantage of a vasectomy is that it’s a relatively simple surgery, especially compared to surgeries for female sterilization like tubal ligation. Recovery times are usually low and there are few side effects.
The success rate for vasectomies is high, with 99.7% of couples not becoming pregnant after the vasectomy is complete, and sperm samples indicating there are no longer sperm in the ejaculate.
The main disadvantage of vasectomy is that it’s meant to be an irreversible procedure, so if you change your mind and want to have biological children, you will face challenges. It’s possible to reverse a vasectomy with a procedure called a vasectomy reversal, but this method is not always effective and some men will not regain their fertility.
Related: Can You Get a Vasectomy Reversed?
Male Birth Control Options Being Developed
There are currently no hormonal birth control methods available for men, and it’s unclear when and if they will become available. However, there is significant interest in male hormonal birth control among the public, and ongoing research to develop these products.
Numerous studies have shown a high demand for hormonal male birth control methods. For example, a non-profit organization called Male Contraceptive Initiative surveyed American men in the U.S. between 18 and 49. They found that 50% of the men showed high levels of interest in male contraceptives. Other surveys have found similar high interest among both men and women.
Hormonal birth control for men would work similarly to how it works in women, by using synthetic hormones to disrupt the reproductive system so that pregnancy is no longer possible. Most methods have relied on testosterone in the form of injections, implants, or gels. Sometimes progestin is added; some studies have found this addition to make the method more effective. Surveys have found that many men could prefer a pill to an injection or implant, but so far, there are few male birth control pill candidates.
As of 2022, there have been eight studies done on hormonal birth control for men. Five have focused on methods with testosterone only, and three included both testosterone and progestin. Overall, these studies found hormonal birth control for males to be highly effective. But they are not without side effects. These side effects are similar to side effects for women’s hormonal birth control, and may include acne, weight gain, mood swings, and changes in libido.
So why are there still no available hormonal birth control methods for men? There are several theories about why this is, including the fact that some men find the idea of side effects to be intolerable. There have also been barriers to getting pharmaceutical companies on board to test and develop hormonal male birth control. Clear guidelines for how to prescribe these medications and whether they will be covered by health insurance also need to be developed.
Another primary challenge to creating a hormonal contraceptive for men is that males produce an exceedingly high level of sperm—in the ballpark of about 1,000 sperm per second. Halting this production completely can be difficult.
Additionally, if a male were to start using a birth control pill or injection, it would take about two months for sperm production to be stopped. The male would then have to undergo testing to ensure there were low enough sperm levels in their semen to prevent pregnancy. These methods would have less immediate success rates, and follow-up medical appointments would be required for maximum effectiveness.
A Quick Review
The most common and effective methods of male birth control are condoms and vasectomies. Other methods include the withdrawal method, outercourse, and abstinence. Condoms are popular, but their typical use success rate is only 82%. Vasectomies are highly successful, but they are not meant to be reversible and require minor surgery. Although hormonal birth control for men is being studied and shows promise, it’s unclear when and if this option will become available.
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