The modern male contraception is no longer a utopia

Abstract

Despite significant advances in reproductive health, male contraceptive options remain limited to condoms, withdrawal, and vasectomy. While these methods are effective, each of them has important limitations, highlighting the need for additional safe, effective, and reversible male contraceptive approaches. This review provides an overview of the current landscape of male contraception and summarizes recent developments in both hormonal and non-hormonal strategies. Promising hormonal candidates include transdermal testosterone/segesterone (Nestorone®) gel, dimethandrolone undecanoate (DMAU), and 11β-methyl-19-nortestosterone derivatives, several of which have progressed to clinical trials. Emerging non-hormonal approaches target specific mechanisms involved in sperm production, maturation and function, including retinoic acid signaling, epididymal peptidase inhibitor (EPPIN), and soluble adenylyl cyclase (sAC). Additional innovative strategies include reversible vas deferens occlusion techniques, such as RISUG-derived technologies and hydrogel implants, as well as thermal contraception. Although most of these methods remain in phase of clinical or preclinical evaluation, recent progress suggests that effective and reversible male contraceptive options may become available within the upcoming decade. Continued research, investment, and stakeholder engagement will be essential to translate these advances into clinical practice.