Matthew Wosnitzer, MD, is a board-certified urologic surgeon and physician scientist. He specializes in male infertility.

Right now, with the exception of abstinence and withdrawal, there are only two available male birth control options—condoms and vasectomy. Both of these birth control methods, though, offer men different choices:

One male birth control shot has been showing very promising results for decades: RISUG. RISUG, which stands for reversible inhibition of sperm under guidance, is non-hormonal, minimally invasive, reversible, and is effective for up to 10 years. It's like having a vasectomy—without the permanent snip.

Current clinical studies show that the male birth control shot has been shown to be 99% effective—this is about the same rate as female hormonal birth control methods.

As of 2019, RISUG was in the late stages of clinical testing in India and had been patented in India, China, and the United States.

In the United States, Vasalgel, which is a contraceptive method based on RISUG, is the male birth control option furthest along in clinical trials and is closest to be the first new U.S. option marketed for men. Vasalgel is currently undergoing animal and safety trials, but human clinical trials have not yet started.

After receiving a local anesthetic, RISUG uses a polymer gel that's injected into the vas deferens (two tubes that carry sperm from the testes to the penis). This positively charged gel attaches to the inner walls of the vas deferens.

When negatively charged sperm flow through the vas deferens, the gel damages their heads and tails, rendering them infertile.

The good news is that these male birth control injections are also completely reversible. All it takes is a simple injection of water and baking soda to dissolve and flush the gel out of the vas deferens. Also, the shot appears to have no side effects.

There are several male birth control methods that are currently in varying stages of development.

The United Nations World Health Organization, the University of California, Los Angeles, and the University of Sydney have all conducted trials to study the effects of weekly testosterone injections on sperm production.

The use of steroid hormones (called androgens) has been shown to lower sperm count without any change in libido, ability to get an erection, and achievement of orgasm. The main disadvantage of this method is that it can take anywhere from three to four months to become effective.

Hormonal male birth control is about 95% effective, has few side effects, and is reversible. Male hormonal contraceptives involve testosterone which works by reducing luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary. This significantly reduces sperm production in the testis.

Another study investigated combining the use of the birth control implant (Nexplanon) with injectable testosterone decanoate. Men received testosterone injections every 4-6 weeks. The results showed that this combined hormonal method signif icantly lowered sperm count. Plus, the lowered sperm count lasted for up to one year.

This is a non-hormonal male birth control pill that has been offered through clinical trials in Indonesia since the 1990s. This potential herbal male contraceptive comes from the Justicia gendarussa plant. Similar to the pill, this male birth control alternative appears to be 99% effective when used correctly.

It works by interfering with an enzyme in the sperm's head—this weakens the sperm's ability to penetrate the egg. Unfortunately, it is difficult to find published data on gendarussa's use as a male contraceptive, so it is hard to predict the future of this method.

Eppin Pharma Inc. is trying to develop a non-hormonal male birth control pill. They claim that it is an effective, reversible, and short term male birth control option.

This male contraceptive works by binding to the protein on the sperm's surface—preventing sperm from swimming towards the egg. Preclinical animal studies have been conducted by the O’Rand Laboratory at the University of North Carolina and show promising results.

This is a fast-acting male birth control method currently in the early stages of development in London. This contraceptive allows a man to orgasm without ejaculating.

The Clean Sheets Pill has the added potential to significantly lower male-to-partner transmission of HIV/AIDS. It is called the Clean Sheets Pill because it stops semen from being released.

This contraceptive pill is taken two to three hours prior to sex and lasts for 16-24 hours. The development of this male birth control option may be stalled due to funding issues. More research is needed before this potential male birth control pill could begin the long FDA research, testing, and approval process.

Nearly 65% of U.S. women ages 15 to 49 use some form of birth control. Many women also feel like the responsibility to use birth control rests mainly on them. But male birth control research is expensive, and many developers are stopping their attempts to create additional male birth control options because of the costs.

The willingness of men to use a new type of male birth control varies widely between population groups.

A 2019 study led by the Male Contraceptive Initiative concluded that there are approximately 17 million sexually active men ages 18-44 years looking for new forms of contraception that fit their lifestyle and relationship. Of these 17 million men, 8.1 million are "very likely" to use new male methods, and 5.6 million are "somewhat likely" to do so.

Critics of male birth control point to how often men refuse and complain about wearing condoms. They say that if men are put off by the simple act of having to roll on a condom, then these same men would most likely also object to having an injection in their scrotum.

In the end, though, more options are always good. And most women will probably not object to finally be able to unload some of the burden of contraception use on men.

Yes, but it is not yet available in the United States. Reversible inhibition of sperm under guidance (RISUG) is a non-hormonal, minimally invasive procedure that is reversible. The drug is currently being studied in clinical trials. In the U.S., RISUG was patented under the brand name Vasalgel.

The male birth control shot Vasalgel blocks the flow of sperm from the body, thus preventing pregnancy. The shot is a gel injected into the vas deferens, the tubes that carry sperm from the testes to the penis. The gel binds itself to the walls of the vas deferens and damages the sperm, rendering them infertile. 

Vasalgel is not yet approved by the Food and Drug Administration, so it's not available in the United States.

The male birth control shot, also known as RISUG and Vasalgel, lasts up to 10 years. It can also be reversed at any time with another injection.

Vasalgel works by injecting a polymer into the vas deferens, which causes sperm to be infertile. A polymer-dissolving agent can be injected into the vas deferens to reverse the procedure and restore fertility.

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