Is male birth control finally here?

Summary

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Unexplainable (Vox)

Episode: "Is male birth control finally here?"

Date: April 1, 2026

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Episode Overview

In this episode, host Amy Padula explores the current state and future prospects of male birth control, a long-promised innovation that may finally become a reality. With input from health reporter Annalisa Morelli, the conversation dissects why male contraceptive options have historically lagged behind, details the latest breakthroughs in research and clinical trials, and debates whether social and cultural tides are finally turning in favor of male contraceptive responsibility.

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Key Discussion Points & Insights

The Status Quo of Male Birth Control (01:13–06:59)

• Limited Options: Currently, the only reliable male contraception methods are condoms—often fallible with a 13–18% failure rate—and vasectomies, which are highly effective but expensive, involve minor surgery, and aren't always easily reversible.
  • “There’s not anything remotely comparable to all the range of options that women have ... I want to say none of the options that women have is ideal, but most of them do the job and work and are reliable.” — Annalisa Morelli (05:01)
• Responsibility Gap: The burden of contraception—and often its side effects—has historically fallen on those with uteruses.

Male Contraceptives in Development (07:07–14:24)

Classes of New Contraceptives

• Two Categories: Medications (slower FDA path) and Devices (potentially faster approval).

Notable Methods Discussed:

• Hormonal Gel (“NEST”: Estrogen + Testosterone)
  • Applied daily on the arm/shoulder; raises testosterone, leading to infertility during use.
  • Downsides: Requires daily compliance; risk of transferring hormones through skin contact.
  • “Because of the fact that he couldn’t really have skin contact with someone else after he put on the gel, this made him essentially plan his day out ... but he was sold on it.” — Annalisa Morelli (08:31)
  • Minimal side effects reported; mental health was a key concern for male trial participants.
• Non-Hormonal Pill (“YCT529”)
  • Blocks vitamin A receptors in testes, temporarily halting sperm production.
  • Early trials show promise and high participant satisfaction, but larger studies are needed.
• On-Demand Pill (“NLS133”)
  • Taken 90 minutes–3 hours before intercourse; stops ejaculation but not orgasms.
  • Seen as a more reliable alternative to condoms, with use tailored per encounter.
  • “The way that I think about it is it’s a more reliable alternative to a condom ... you have to do every time. Upon occasion, it's on demand.” — Annalisa Morelli (12:37)
• Implantable Gel Device (“Adam” and “Plan A”)
  • Hydrogel injected to create a barrier, physically blocking sperm; considered “set it and forget it.”
  • Seen as a less painful male equivalent to an IUD.
  • Plan A is hormonal and lasts up to five years.

Why Has It Taken So Long? (17:42–24:35)

• Cultural Barriers: Assumption that pregnancy prevention is a woman’s responsibility led to lack of demand, skepticism that men would use contraception reliably, and consequently little incentive for innovation.
  • “We belong to a society that believes pregnancy is a woman’s responsibility ... Birth control was a woman’s game.” — Annalisa Morelli (17:42)
• Business Disinterest: Pharmaceutical companies see limited profits due to expired patents and existing products. Most male birth control research is funded by grants and nonprofits.
• Public Health History: AIDS epidemic reinforced condoms as the default and further sidelined the development of other male contraceptive methods.

What’s Changing Now? (20:23–26:42)

• Shifting Attitudes: Increasing numbers of men want agency over their fertility, particularly since the U.S. Supreme Court’s Dobbs decision overturned Roe v. Wade in 2022.
  • “...every organization that I spoke with, a company who’s developing birth control, told me that the interest they got in clinical trials since Dobbs just skyrocketed.” — Annalisa Morelli (23:00)
• Couple-Based Responsibility: Some men now participate because their partners are “tired” of birth control side effects or because both partners want to double up for certainty.
• Survey Data:
  • U.S. male openness to birth control went from 39% to 49% after Dobbs, compared to much higher rates in countries like Nigeria.

What’s Needed to Bring Male Birth Control to Market? (24:35–25:15)

• The Funding Gap: The main barrier is money—to pay for expensive phase three trials and commercialization.
  • “Money…Assuming those are successful, then the products can go into the market and we’re relatively close.” — Annalisa Morelli (24:43)
• Hope for a New Era: Annalisa expresses cautious optimism that we may be on the cusp of a new era in reproductive health—one driven more by culture than by pharma, if interest and funding align.

Notable Quotes & Memorable Moments

• “If I had to choose between no birth control and putting this gel on my arm every day, I'll put my gel on my arm every day.” — Trial participant via Annalisa Morelli (09:10)
• “I’ve spoken with men who told me, you know, my partner, my girlfriend, my wife has been taking hormonal birth control for a decade. She’s tired of it. I think it’s my turn.” — Annalisa Morelli (22:15)
• “Birth control for people with sperm is just about almost, but not quite here.” — Amy Padula (26:20)
• “Since Roe v. Wade was overturned ... vasectomies increased by 1/5 in the country, according to a study done in 2023.” — Amy Padula (26:20)

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Timestamps for Major Segments

• 01:13 — Introduction to the gender gap in birth control responsibility
• 02:32 — Current state of male birth control research; why earlier efforts stalled
• 03:55 — Explanation of clinical trial phases and progress of current options
• 05:01 — Breakdown of existing male methods: condoms and vasectomy
• 07:07 — Overview of drugs vs. devices in the pipeline
• 07:48 — Details on the “NEST” hormonal gel
• 11:03 — Introduction of non-hormonal pill YCT529
• 11:58 — “On-demand” pill NLS133 explained
• 13:10 — Injectable/implantable gel device “Adam”
• 17:42 — Deep dive on cultural and business reasons for the delay
• 20:23 — Social/legal catalysts for increased interest (e.g., Dobbs decision)
• 24:43 — What it will take to get these products to market
• 25:15 — Will this truly be a new era? Annalisa’s reflections
• 26:20 — Impact of Roe v. Wade overturn and spike in vasectomies
• 26:42 — Concluding remarks on cultural change and closing optimism

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Conclusion

The episode paints a cautiously hopeful picture: major hurdles remain, especially funding and overcoming ingrained cultural narratives, but for the first time male birth control options are on the brink of becoming widely available. Key catalysts—like legal changes and shifting societal perspectives—are fueling new research, greater urgency, and deeper willingness among men to share the contraceptive load. As Annalisa Morelli emphasizes, this moment is “a small but important sort of cultural change,” one that could soon reshape reproductive responsibility for everyone.

Transcript

[Podcast Host (Ad Read)]

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[Annalisa Morelli]

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[Amy Padula]

for as long as I can remember, I've heard this vague promise that someday there will be a birth control pill for men. And meanwhile, I've heard endless stories about the struggles that people with uteruses have to navigate the pill, the shot, the ring, hormonal iud, copper iud. Trust me, it was the most pain I've ever experienced in my entire life and the inevitable side effects. Even with all of these options, almost every person who takes birth control I know has faced some kind of pitfall at some point while figuring out what's best for them. And that responsibility is normally up to whoever has the uterus. But I learned recently it seems like things might finally be changing. Birth control options for people with sperm are here.

[Annalisa Morelli]

I've found out that there's actually quite a few options that are being studied, tested in various stages of testing. But we might be getting commercial availability if all goes well, which is a very, very big and heavy if we may get that commercial availability, you know, in a matter of a few years, like it's not really in the remote future.

[Amy Padula]

I called up a health reporter, Analisa Morelli, who wrote about the drugs and devices in development right now for Stat. For a while, the drugs in development always halted. Some were met with side effects, others never made it to human trials. But for the first time in history, some of the options are looking really, really viable, and there's a lot of confidence that they'll go to market. And I wondered, like, is this for real today? Will male birth control work? And do people really want to take it? I'm Amy Padula. This is unexplainable. Do you think this is something that will happen in our lifetime?

[Annalisa Morelli]

Oh, for. I mean, for sure is never. You should never say that with science, but I think it's very likely. I was just talking to one of the developers of two of the methods. They're thinking three years, two. Three years. There is a couple others that are going to enter phase three trials. So again, we're talking a handful of years and potentially several options might be available.

[Amy Padula]

Before we keep going, I want to break down what these trials mean. It's kind of like drafts of a story. Phase one trials, draft one, let's say, look at safety and dosage within a small group of participants. Phase two looks at how the drugs work in a larger group. And then phase three confirms how effective the drugs are, watches for side effects, and then compares the new treatment to other proven forms in larger studies. And by that point, we really have a solid sense of what the drug does and how it performs. Final draft. Essentially, the male birth control methods in development right now are in phase two, which is much further than they've been in a long time. The last time one of the options made it to phase two was back in 2011. But the options being tested right now so far are working and they're showing a lot of promise, which is good because the options on the table for male birth control today are really limited.

[Annalisa Morelli]

They can use condoms or they can get a vasectomy. Condoms I think many of us are familiar with. There's an issue of reliability, right? Even in the best case scenario, they're fallible. They can break. But, you know, add to that human error and you're talking about depending on the study, but like 13% to 18% rate of failure, very high. And then when it comes to vasectomies, vasectomies can be very effective. They do fail upon occasion, but very, very rarely. They are also, which not many men or people know are reversible, especially if you do that within the first five years. However, there are a number of downsides. Number one, you may not want to undergo a procedure of that type. Two, it is not guaranteed that it can be reversible. So if you're a younger man, you may not just want to run the risk. Number three, it can be expensive. And unlike contraception for women, contraception for men in America is not free and not covered by the Affordable Care Act. So you, you know, some of the men that I spoke with when I wrote about male birth control would have been happy to get a vasectomy and then found out it was going to be depending on their insurance status, could be run into thousands of dollars. And the reversal is expensive, can be expensive, even more so than the vasectomy, and it might be hard to find someone to do it. This all makes vasectomy, like a bigger decision. For someone who is, let's say, done or never wants to have children or is sure never want to have children. There's not anything remotely comparable to all the range of options that women have. And I am aware, as anyone, that I want to say none of the options that women have is ideal, but most of them do the job and work and are reliable, which is something.

[Amy Padula]

So Annalisa says there's a couple interesting options in these clinical trials, and we're going to break them down into two groups.

[Annalisa Morelli]

There are medications and there are devices. And the reason why I'm breaking them down this way is that because of the. The way the FDA approval process works, devices are faster to get approval and to get cleared than medications. And so some of the products that have been seem to be a little bit behind in the testing phase because they aim to be cleared, as devices will have a likelihood to come in on the market sooner than medications.

[Amy Padula]

The first one is a hormonal gel.

[Annalisa Morelli]

It's called nest, which stands for estrogen and testosterone. And these are the two components of this gel. It's a gel that men have to apply. I believe it's either on the arm or on their shoulder daily, raising testosterone. This sort of leads to infertility. They have completed their phase two studies a while ago. I've spoken to one of the people who took part in the studies. They liked it very much. It was very effective. It has some downsides. One is that you need to apply it every day. So it requires very high compliance.

[Amy Padula]

There's a couple sort of lifestyle issues with this gel, though.

[Annalisa Morelli]

The other downside is that testosterone gel, testosterone transfer to other people when you have a gel put on yourself. And so say, like, you can't touch a child if you've just applied testosterone. You have to wait a few hours. You can't cuddle with a partner if you've just put on your testosterone gel because she will have effects from the exposure to those levels of testosterone. This essentially means when I was talking to the person who underwent the trial, who, by the way, was 100% on board, this man was saying, if I had to choose between no birth control and putting this gel on my arm every day, I'll put my gel on my. On my arm every day. Like, he was sold on it. So the person that I spoke with was saying that because of the fact that he couldn't really have skin contact with someone else after he put on the gel, this made him essentially plan his day out, right? So he would put it on in the morning. If he knew that he was seeing his girlfriend later in the day, or if he was staying at home that morning, then he would put it on at a time where he knew he could be away from scratch in contact with people for a little while, which is a bit of a downside, I suppose. He said it was manageable. In fact, he said that when he was in the phase two study, when the study ended, he wished it could continue, and he immediately looked for another trial that you could participate in.

[Amy Padula]

Were there any side effects with that trial?

[Annalisa Morelli]

You know, not really. Not really. One of the men's book said that initially he was a little bit fatigued, but he couldn't really put it down to the gel itself. He said it might be something else going on in his life. One of the reasons why the hormonal birth control trial was halted is that the mental health side effects were really felt by men. And when I was talking to men and asking them, well, would you take a birth control appeal and what would make you not want to take it? Depression, anxiety, like the increasing. The mental health side effects were really the one thing that men were aware of. And we know this exists in women's. For women who take birth control pills as well. But I thought it was remarkable how really that specifically seemed to be the one where they drew the line. I didn't hear men talking, for instance, with like weight gain or other things that you may think about. Mental health really was a top concern.

[Amy Padula]

Another option is something called YCT529, a non hormonal birth control pill for men. Basically, it stops the receptors of vitamin A in the testes, which are essential for making sperm. So while you're on it, you don't make any. You're sort of temporarily infertile.

[Annalisa Morelli]

These has had a lot of success in the trial, so far as we can tell. The science behind it was just published in several papers. It's sort of like an innovative way of thinking about suppressing Fertility. From what I hear, men who are participating in the trials, I'm pretty happy with it. They wish to continue when the trial ends. It's still. It still needs to go to, like, a larger size trial. But the expectation of the company that's developing this are pretty good and high.

[Amy Padula]

And there's a different pill in development. It's sort of like the on demand option. It's called NLS133, and you take it 90 minutes to three hours before intercourse.

[Annalisa Morelli]

The way that it works essentially stops men from ejaculating. You have intercourse as you were going to, but you don't ejaculate. Essentially, you don't produce. This doesn't mean that you don't have orgasms. It just means that you don't ejaculate. And that way nobody gets pregnant. The medication is a combination of two existing drugs that do different things.

[Amy Padula]

The drug works by stopping a receptor that plays a role in sperm production.

[Annalisa Morelli]

The idea is that it would be similar to Viagra. You'd go to the doctor, you'd have a prescription, you have a few pills on you, and then you take them when you need them. Essentially, the way that I think about it is it's a more reliable alternative to a condom. This is not going to alter your fertility permanently. It's something that you have to do every time. Upon occasion, it's on demand.

[Amy Padula]

And then there's a fourth option, an injectable implanted gel. It's called Adam a set it and forget it option.

[Annalisa Morelli]

These are the other group that I was mentioning, which are devices. So one is Adam, which is a hydrogel. So hydrogels are like gels that are injected in the body. They can be done for a lot of things. They are not rejected by the body as an external tissue or. So there's no issue of having reactions to them or anything like that. And what a hydrogel does, in this case, it sort of creates a seal that is small enough that the head of the sperm literally will not go through. The other thing that I think about is like, oh, it's like a male iud, but I'm told far less painful than an IUD insertion. For many reasons, including the male anatomy, they would have it easier. But essentially it creates this barrier. There is another product which is called Plan A, that another company is doing, which doesn't need to be dissolved. So it's longer active. It will last for a few years. It's basically like a hormonal birth control that releases a steady amount of hormone in your bloodstream and it lasts up to five years.

[Amy Padula]

So an abundance of methods it seems. One thing I learned that surprised me was that there was a male birth control pill in the works at the same time the female birth control pill was in development like back in the 1950s and that made me think why has it taken this long to develop these new drugs? We'll dig into it all after a short break.

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[Amy Padula]

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[Annalisa Morelli]

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[Amy Padula]

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[Annalisa Morelli]

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[Amy Padula]

So these drugs are in various stages right now. It seems like we're further ahead, though, in these trials than we have been in the past.

[Annalisa Morelli]

Why is that? So I believe that the number one reason why we don't have middle birth control is today, you know, in 2026, is cultural. We belong to a society that believes pregnancy is a woman's responsibility. Maybe because men are not used to being compliant with medications. They're not used to having to account for pregnancies. But there's just been a skepticism that men would be reliable. And so that if a man were taking birth control, the question was always, would a woman trust it? Would a woman trust that they're taking it for real when they're supposed to, if it has any side effects? Would women really not want to take birth control themselves, or would they want to take birth control? Birth control was a woman's game. You know, there are products that exist. Are they great? No. Do women still use them? Yes. You know, so even then, there's not even a great incentive to make a better product because, you know, what we have is fine. You know, nobody is going to invest large sums of money to go through the complicated process of making sure that something works for birth control, which is a pretty, you know, pretty high bar when it comes to, you know, even when it comes to, like, headcount trials. Recruiting people is not necessarily so easy to recruit someone. Be like, do you want to try and see if maybe you get pregnant, maybe you don't. There's a second reason, which is business. All of the innovations in birth control and reproductive health that has been made in recent years are all typically funded by nonprofits, grants. Even the ones that I've mentioned are receiving grants because big pharmaceutical companies stepped away. They had some of the products, they had the pill. Talk about a money maker. And then, you know, those were developed, and then the patents expired, and it just doesn't make that much money. And so it's sort of like not really being an area of great business appeal now. What has changed are a number of things. So, number one, men, some of the sort of research and development and even thinking about male birth control was getting momentum right as the AIDS epidemic. And so there was such a push, understandably, towards using condoms that that kind of became the default.

[Amy Padula]

I just wonder what has kept a lot of these methods in testing and not made it to market.

[Annalisa Morelli]

Well, I think right now the push is stronger, the attention is greater, there's dedicated research. There's been a change. There's been a shift in how we think about contraception and male responsibility in contraception. And this is social and it's personal. Many more men than ever before want to be responsible and want to be in charge and have agency over their fertility. I believe this is a result of a changing legal landscape in many ways, while also noting that we're still. Still. It's still, you know, some of the products that I spoke with will still tell me that, you know, we'll get into, you know, phase three trial when we got the funding. They're still not being, like, flashed with tons of funding and investment and still not getting to that desirable level. But I think the things that changed are. Are several. As I said, they're the cultural, but they're also, in America, legislative. So one is the reversal of Roe v. Wade. The Dobbs decision was a massive catalyst and in the interest that men have in birth control. And I know this because every organization that I spoke with, a company who's developing birth control, told me that the interest they got in clinical trials since STOP just skyrocketed. If you no longer have choices to terminate pregnancies, you now live in a society in which two people are responsible for it, and it's easier to hold men accountable in a way that wasn't until too long ago. And so you suddenly have men who have shifted. I don't want to necessarily frame it only this way because obviously there's always been men who have been aware and allies and willing to participate in being responsible in their sexual life. But that said, you know, you suddenly have men who see not having birth control not so much as, like, this is not my job and I'm free of a burden. But as I don't have agency, I don't have agency over my own body and my own fertility because pregnancy is so much more invasive and, you know, so much more of a burden on the woman than it is on the man. There's a cultural movement which is of much bigger awareness of the challenges that women face through their entire life dealing with fertility and, you know, the side effects that birth, hormonal birth control can have. Her skin is breaking, she's gaining weight, she feels depressed. And so I've spoken with men who told me, you know, my partner, my girlfriend, my wife has been taking hormonal birth control for a decade. She's tired of it. I Think it's my turn. Like there's. There is that really encouraging willingness to share the burden and to understand that, you know, avoiding a pregnancy and unwanted pregnancy is not just a woman's responsibility. It's a responsibility of both partners. And I think that's an important cultural shift. Another thing that I've heard mentioned more than once is that sometimes couples, typically American couples, in connection with the Dobbs decision, both partners want to take birth control at the same time. Both partners, they want to be that sure that there are no accidental pregnancies. And, you know, to add a data point that can support the impact of the DoP's decision, there was a survey that was done asking men if they'd be up for taking male birth control. And in some countries, I believe Nigeria, I might be wrong, but I believe it's Nigeria. It was up to like more than 70%. Men were like, sure, sign me up. In the United States, it was relatively low. It was 39%. And then they redid the same survey after the D.O. decision. And in a matter of a year, I believe it was 49%. I think the men who are open for it are also likely in a position to be trusted to do it.

[Amy Padula]

So what would it really take for these drugs to go from the lab and to the market? Like, are we close?

[Annalisa Morelli]

Money. And obviously there's a number of other things, but money, you know, sufficient funding would make sure that there are the next step of trials that are done and are paid for and then all the research can be done. Assuming those are successful, then the products can go into the market and we're relatively close. I believe the on demand pill and Adam, it might be a matter of a couple of years, like really close.

[Amy Padula]

Do you think we're really at a moment in reproductive healthcare history that's the beginning of a new era?

[Annalisa Morelli]

I hope so. My most hopeful self thinks of this as a cultural counterweight to the political sort of rolling back of reproductive health funding and money and options. It seems to me like this is like a small but important sort of cultural change. You know, large pharmaceutical companies aren't so interested in investing in reproductive care. And that remains true. It's also true that if the interest and if the market matches what has been studies and surveys, like this is a huge, huge market. We're talking like billions of people. So there is a hope that that too will perhaps then move financial interests, which unfortunately are always at the base of, you know, spreading, having more option, having more research, more availability,

[Amy Padula]

birth control for people with sperm is just about almost, but not quite here. I was struck by some pretty wild data. Since Roe v. Wade was overTurned back in 2022, vasectomies increased by 1/5 in the country, according to a study done in 2023.

[Annalisa Morelli]

I want to stress how heartening the conversations that I've had with men who participated in the trials have been. Nature is designed the way that it is. There's some things we cannot avoid. People who have a uterus get pregnant. The burden will always be on the body that carries the pregnancy. But the level of awareness and willingness to do as much as possible to share the responsibility really struck me, and I found it again, very hopeful.

[Amy Padula]

This promise, 80 years in the making, finally seems within reach. This episode was produced by me, Amy Padula. It was edited by Joanna Solotaroff, mixing and sound design from Christian Aella, and music from Noam Hassenfeld. Melissa Hirsch checked the facts. Jorge Just is our editorial director. The team includes Sally Helm, Meredith Hodnot, Christian Ayala, Noam Hassenfeld, and Bird Pinkerton got out of the train at 190th Street Station and started walking down the long pedestrian tunnel looking for any kind of cue. Sun never shines. Shadows run from themselves. And then she heard a beep. As always, thank you to Brian Resnik for co creating the show with Noam and Bird. If you'd like to support this show and the journalism that Vox does, we would love it if you would become a member. It's really easy to do. Just go to Vox.com members. You'll get access to all of Vox's journalism. And for those of you who have emailed us to let us know that you signed up because of Unexplainable, thank you. If you can't join our membership, that's okay. If you wanted to leave us a nice review on your podcast platform five stars or a written review, we would appreciate it a lot. Or you can tell someone in your life that they should listen to the show. Those things make a real difference. Unexplainable is part of the Vox Media Podcast network, and we'll be back soon with another episode about everything we don't yet know.

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