Why male contraception still stalls: translational, social, and ethical gaps

Despite advances in reproductive medicine, a widely acceptable male contraceptive method is still lacking, leaving the burden of birth control largely on women. As a result, female-centric methods continue to dominate global contraceptive trends, as male options are limited to condoms and vasectomy, both of which are constrained by issues related to reliability, reversibility, or social acceptability. Adoption of novel methods in this regard remains low as well due to social perceptions, myths surrounding masculinity, and concerns regarding side effects. This study was conducted as a narrative literature review to synthesize current scientific, translational, social, and ethical perspectives related to the development of male contraceptive methods. In this narrative review, we have provided a historical record of developments in the field of male contraception, from traditional methods such as condoms and vasectomy to novel hormonal and non-hormonal methods, highlighting major clinical trials along with various scientific, social, economic, ethical, and cultural barriers that impede both the development and acceptance of these novel approaches. In addition, the review explores the role of unequal gender expectations and cultural norms that discourage male participation, and the broad impact of this on reproductive health. Lastly, we discuss how pairing scientific advancements with societal norms and preferences could be pivotal in promoting shared responsibility, equity, and sustainability in reproductive health.