Safe, secretive, and nonsurgical: Designing the future of male contraception

By Lucy Wilson and Rebecca Callahan

If you could design a future male contraceptive method, what would it be? How would it work? And what would it look like? What characteristics would it need to have for men to use it?

We asked men in Kenya to tell us what they desire in a future contraceptive method. Their answers were wide-ranging, including some responses that were expected, but a number of surprises, too. Aesthetic characteristics were important: if a pill, it should be sweet and small, so that it is desirable to take and easy to swallow. The ability to use it in secret was strongly voiced, a feature that we know is desired by some women who use contraception, but that we had not expected to hear from men.

Instantaneous, so that if you take it at 4:30, it should be working by 4:31.
It should be convenient for both people, without adversely affecting either partner.
It should be cancer-free; those who have gone for it will not be prone to testicular cancer.

After brainstorming characteristics that they wanted to see in a product, teams came together to develop two “prototypes” for future methods. The prototypes designed were unique, thoughtful, and responsive to the desires expressed in the brainstorming.

The first prototype was very similar to an actual product that is currently under development, known as Vasalgel. This synthetic polymer would be injected into the man’s vas deferens to block the passage of sperm, as in a vasectomy. Unlike vasectomy, however, it could be reversed with a second injection that would dissolve the polymer plug. A price was proposed at 18,000 Kenya Shillings (about US $175) for the first injection. The team in Kenya named their product “Reversible.”

The second prototype, “Vesmy,” is a pill that a man would take once per week. The pill would be sweet and small, making it easy to swallow and therefore appealing to men. It would be thoroughly tested for safety and have no side effects. Ideally, Vesmy would also be a multi-purpose preventative technology, not only preventing pregnancy, but also the transmission of HIV and other sexually-transmitted infections to one’s sexual partner. A packet of five pills would cost only 100 Kenya Shillings (about US $1).

FHI 360 sponsored this ideation as part of the World Vasectomy Day event on November 18. World Vasectomy Day is a celebration of men who are stepping up for their partners, their families, and their future. The full-day event, held in Nairobi, Kenya, included 53 live-streamed vasectomies; panel discussions with leaders in the field; and conversations with men, providers, and advocates from all over the world.

FHI 360’s Marsden Solomon, project director for sexual and reproductive health in Kenya, moderated the panel on the future of male contraception, and ThinkPlace Foundation, a strategic design firm, facilitated the design portion. The session also included presentations by experts in the field, including Aaron Hamlin from the Male Contraception Initiative, a nonprofit that works to advance new male contraceptives. Aaron described the results of hypothetical acceptability studies that have explored men’s preferences for the characteristics of new male contraceptive methods, including mode of delivery, mechanism of action, side effects, and effectiveness.

We were disappointed to miss hearing from John Amory, a professor at the University of Washington. Professor Amory had been scheduled to join by Skype to review the pipeline of male contraceptives currently in development, but technology, unfortunately, did not cooperate.

Although existing methods of male contraception, such as vasectomy, remain under-utilized in sub-Saharan Africa, the excitement expressed during this event in Kenya tells us that men are interested in having a range of methods to help them decide when and if to have children.

FHI 360 is currently pursuing a diverse pipeline of contraceptive methods for the future. Learn more about this work here.

Lucy Wilson is a technical advisor at FHI 360, where she works on contraceptive technology innovation and other family planning efforts. Rebecca Callahan is a scientist with FHI 360’s Contraceptive Technology Innovation Department where she designs and implements studies focused on the acceptability of new products. She is especially interested in new contraceptives for men.