This story is published jointly by non-profit organizations Fortify Utah and The Salt Lake Tribune, in association with Salt Lake Community Collegeto highlight different perspectives in local media through student journalism.
Kaylee Gates suffered for months waiting for her body to adjust to her hormonal contraceptive implant.
Weight gain, mood swings, and acne began to damage her body and mind. The longer she waited, the more her hope faded.
“The challenges I faced were really terrible,” she said. “[It got] to a point where it wasn’t even worth it anymore.”
Two years later, Gates decided she’d had enough when extreme nausea, irritability, and period pains knocked her out for a full week. She discussed the risks with her doctor, hoping that after the implant was removed, the worst would now be over.
“I’m two years away from that and I still have these issues,” said Gates, 22. “It still gives me issues with my mood, like I’m irritable, and it’s caused me to gain a lot of weight and making my periods heavier.”
Gates and her new husband, 22-year-old Azhurel Mendes, wed in March and are contemplating their future as parents. They’re not ready yet, they said, but because birth control has made Gates so unhappy, other options — like a new prescription male contraceptive — could have helped them better manage their own family planning.
The University of Utah’s ASCENT Center for Reproductive Health and seven other sites across the country, commissioned by the National Institutes of Health, are currently investigating a potential hope for couples like Gates and Mendes.
A new possibility
Nestoron-Testosterone, also known as NES/T, is a gel that is applied to a sperm-producing man’s shoulder. NES/T consists of two main ingredients: Nestoron and a testosterone substitute.
“This is a combination gel,” said Dr. David Turok, director of the US ASCENT Center and principal investigator at the Utah site. “Nestoron is basically a synthetic version of progesterone, [which] used in an FDA-approved vaginal ring.”
Progesterone blocks the hormones that enable ovulation in many female-born patients. According to Turok, NES/T can achieve a similar hormone-blocking effect in men. Contraceptive methods that use progesterone are currently only available to female patients.
“[The gel] basically does the same thing, but the end result, the goal, is in the testicles,” Turok said. “It does two things there: it stops sperm production and [negatively] affects testosterone production. That’s why you need the second drug in it, [the synthetic] Testosterone.”
A man using the gel daily may have to wait one to six months for his sperm count to drop to a level considered reliable to prevent pregnancy, according to Turok.
shift of responsibility
The US study of NES/T included 20 heterosexual couples. For Turok, this new method has shown the potential for shifting the responsibility for hormonal birth control that normally rests with women.
“The most common theme is the female member of the couple saying, ‘I’ve tried all these things and they didn’t work, and now it’s his turn,'” Turok said.
Turok said he believes there are feelings among many couples that they don’t want children or are not ready for pregnancy.
“The way our society tries to shame and blame women [unplanned or undesired] To experience pregnancy and then amazingly not pursue or acknowledge the man’s role in it is truly phenomenal,” Turok said. “From what we have seen from the participants in this process, men [are] I acknowledge: ‘I play a role in this and I want to develop further.’”
After years of watching his wife suffer from the side effects of her contraception, Mendes said he was interested in learning more about the male version of such contraceptives.
“If it’s not worse for women than birth control, I think it’s only fair that men could, for once, take the brunt,” he said.
The second phase of the study is still ongoing. According to Turok, if the gel is to receive U.S. Food and Drug Administration approval, it still needs to go through a third phase of a study that would likely involve more than 1,000 couples and follow them for a year — then have the data analyzed and submitted to the FDA be submitted.
As the researchers continued their work, both Mendes and Gates expressed concern about the gel’s side effects and wondered if they might be similar or worse than birth control methods currently available to women.
“If we would do a lot [personal] “If you do your research … and there’s been a lot of other people who’ve tried it, I think I’d be up for it if you try it,” Gates said, gesturing toward her husband. Mendes first heard about the study when it was announced in January 2022 and wanted to know more about it at the time.
Four years earlier, the Male Contraceptive Initiative found that many other men shared Mendes’ interest. Of 1,500 men aged 18 to 44 in the United States, 80% believed that they bore sole or joint responsibility for preventing pregnancy. 70% of these men said they would be willing to try new birth control methods.
While there is evidence that men want to share the burden of birth control with their partners, Turok says NEST/T could lead to trust issues as women may find it difficult to trust their partners to use birth control consistently and correctly .
“One of the main questions researchers have asked there is, ‘Is this acceptable for female partners?’ We’re collecting some data on that,” he said. “If a man says, ‘I’ll use this,’ his partner will accept that [and trust] them?”
While modern methods of contraception for women, such as the IUD, were being introduced around the turn of the century, the development of male contraception encountered several obstacles. Turok said he’s excited for the results of the gel to be released, but “I have no idea when that will be,” he added.
Whenever the gel finally hits the market, Turok said, “It is like this.” [likely not] will be the most popular choice right off the bat, but I think it’s an important step forward.”
Ethan Udy wrote this story as a journalism student at Salt Lake Community College. It is published as part of a collaboration that also includes non-profit organizations Fortify Utah and The Salt Lake Tribune.