Justin Houman: Should Men Wait for Male Contraception Instead of a Vasectomy?
Justin Houman, Men’s Health Urologist at Tower Urology at Cedars-Sinai Medical Center, shared a post on LinkedIn about a paper by Michelle Leach et al. published in the International Journal of Impotence Research։
“For colleagues who counsel men asking whether to wait for male contraception instead of a vasectomy.
Leach et al. (International Journal of Impotence Research, 2026) reviewed the pipeline. A daily testosterone plus nestorone gel has completed phase IIb, with sperm concentration at or below 1 million/mL in 82% of participants by 12 weeks.
YCT-529, an oral non-hormonal agent that targets a retinoic acid receptor, was 99% effective and reversible in animal models; the only published human data is a single-dose phase Ia study in 16 men, well tolerated, with no change in testosterone, LH, FSH, mood or sexual desire. RISUG, an injected vas-occlusive gel, has been through phase III, with azoospermia in about 77 to 97% at three weeks. None is approved, and earlier hormonal regimens were discontinued over mood, libido, lipid and acne side effects.
For a man who is certain he is done having children, vasectomy remains the option available today: over 99% effective, a brief outpatient procedure, with no effect on testosterone, libido or erections. It should be considered permanent. Reversal is possible through microsurgery, but success is never guaranteed, so the counseling conversation is about certainty.
Happy to see these patients in Los Angeles.”
Title: Male contraception: a historical analysis of the condom, vasectomy, and future innovations.
Authors: Michelle Leach, Vi Nguyen, Darshan Patel, Tung-Chin Hsieh.
You can read the Full Article in the International Journal of Impotence Research.
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