Unexplainable · Vox

Is male birth control finally here?

April 1, 2026·28 min·2 clips
An on-demand Viagra-style pill called NLS-133 lets men have intercourse without ejaculating.
Host Amy Padula opens with the long-running promise of a male birth control pill and the overwhelmingly female burden of contraception. STAT health reporter Annalisa Morelli says she has identified several male contraceptives in active trials, with some developers telling her two to three years to market. She explains the phase one, two, and three trial structure and notes that male birth control has not been this deep into phase two since 2011. She frames the current options as limited to condoms, with a 13 to 18 percent failure rate depending on the study, and vasectomies, which are effective but expensive, sometimes reversible, and not covered by the Affordable Care Act. She then breaks the new pipeline into medications and devices, noting the FDA clears devices faster than drugs. The first product is the NEST hormonal gel containing Nestron and testosterone, applied daily to the arm or shoulder. Trial participants liked it, but it transfers testosterone through skin contact, so users must avoid touching children or partners for hours after applying it. She notes that past hormonal male birth control trials were halted over mental health side effects like depression and anxiety, which surveyed men flagged as their top concern. The second option, YCT-529, is a non-hormonal pill that blocks vitamin A receptors in the testes to temporarily stop sperm production. The third, NLS-133, is an on-demand pill taken 90 minutes to three hours before intercourse that blocks a receptor in sperm production so men can orgasm without ejaculating. The fourth, ADAM, is an injectable hydrogel that blocks the passage of sperm, which Morelli compares to a male IUD but reportedly less painful. A competing device called Plan A is a longer-acting hormonal implant lasting up to five years. Morelli then explains why progress stalled for decades, citing cultural expectations that pregnancy is a woman's responsibility, pharma companies walking away from reproductive health research once patents expired on existing products, and the AIDS epidemic defaulting contraception to condoms. She argues the Dobbs decision was a major catalyst: developers report skyrocketing trial interest, surveys of US men's willingness to use male birth control rose from 39 percent to about 49 percent in a year, and vasectomies increased by roughly one fifth after Roe v. Wade was overturned in a 2023 study. She ends by saying funding is the main barrier to market entry, with the on-demand pill and ADAM closest to launch.

As heard by us

A clear look at male birth control, with real trial signal but no false finish line.

The piece treats male birth control as a real question, not a punch line, and that keeps the focus where it belongs. It spells out the main approaches in plain language: NLS-133, an on-demand pill taken 90 minutes to three hours before intercourse, and ADAM, an injected…

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Male birth control moves from theory into early trial data.

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