One couple's contraceptive journey

Mattie stopped taking birth control in 2021 because of depression and mood changes. When her husband Ryan saw a trial for male contraceptive gel, they both saw a solution.

“I was like, I can't do this anymore. I was just not feeling like myself, and I was pretty depressed.”

The NES/T gel trial results

Ryan applied hormonal gel to his shoulders daily for over a year. His sperm count dropped, he had no side effects, and Mattie didn't get pregnant. After stopping, his fertility returned quickly.

“For Ryan and Mattie, the gel was ideal: He didn't experience side effects, and she didn't get pregnant.”

Men have almost no contraceptive choices

For decades, men could only choose condoms, which fail 16 percent of the time with typical use, or vasectomy, which feels too permanent for younger men.

Women have borne the burden alone

Women have pills, shots, patches, rings, implants, and IUDs. Contraception has been framed as women's responsibility and women's empowerment, leaving men out of the conversation.

“Contraception has been completely associated with not just women, but women's empowerment as well as women's burden. Men haven't been asked to come to the table.”

Three new male contraceptives in development

NES/T, a hormonal gel, enters late-stage trials next year. Contraline is also developing ADAM, a nonhormonal implant effective for 24 months. YourChoice Therapeutics is testing a nonhormonal daily pill.

The 1950s male pill that failed

Scientists developed a male contraceptive pill in the late nineteen fifties, tested on Oregon prison inmates. It worked until one man drank alcohol and became violently ill, revealing the pill blocked alcohol metabolism.

Fifty years of false starts

From 2008 to 2012, a hormonal injection showed promise with 80 percent of men willing to use it. But side effects like acne, muscle pain, and mood changes emerged. One participant attempted suicide, ending the trial.

“There's a joke in the world of male contraceptives: They've been five years away for the past 50 years.”

A glaring double standard

More than 6 percent of Mirena IUD users experience depression, double the rate in the failed male injection trial. Yet women's side effects are expected while men's are deemed intolerable.

Men actually want male contraceptives

A 2021-2022 international survey found 61 percent of men interested in new contraceptives. In the US, interest jumped from 39 percent to 49 percent after the Dobbs abortion decision in 2023.

Men are desperate to help their partners

Over 23,000 men have signed up for Contraline's trial registry. Most emails say partners cannot use contraception. Men want to offer something and be good partners.

“Ninety-five percent of them are things like, 'I have a partner that can't use contraception.' It's mostly men desperately trying to be a good partner, trying to offer something.”

Big pharma won't touch it

Major pharmaceutical companies have stayed out of male contraceptive development because contraceptives don't treat illness and carry unique liability. They see no problem to solve since female contraceptive use is already high.

“There's this sense of, 'We have good enough products.' That's where the misogyny starts to eke in a little bit.”

Regulatory uncertainty ahead

The FDA will face a lengthy review since male contraceptives are a new category. Guidelines and side effect tolerance are unclear. Products may also face cultural backlash over testosterone and virility concerns.

NES/T could launch by 2030

Contraline plans to introduce NES/T as a monthly subscription gel by 2030, then follow with ADAM, a 10-minute implant procedure. The strategy mirrors how the pill preceded IUDs for women.

“We have to get people excited about male birth control, and then they can be like, 'Well, I'm already doing this thing every day, maybe I'll go get this 10-minute procedure."”

A future of shared responsibility

Ryan and Mattie hope their daughters grow up in a world where male contraceptives are so common they're unremarkable. They believe reproductive responsibility should be shared equally.

“I don't think it should be any one person's job to do it. I just think there should be like equal options for men and women.”