The NES/T contraceptive gel — a topical hormonal gel applied daily to the shoulders — continues enrolling participants in its NIH-funded Phase 2 trial across multiple sites, with efficacy holding at approximately 98 percent in suppressing sperm counts to levels associated with contraception [1]. No serious adverse events have been reported beyond the mild side effects — weight gain, acne, and modest libido changes — documented since the trial began.

As this paper noted yesterday, the scientific question was answered years ago. The gel works. The combination of nestorone and testosterone suppresses spermatogenesis effectively and reversibly. Sperm counts recover within months of discontinuation. The mechanism is well understood.

What has not changed is the commercial landscape. No pharmaceutical company has committed to Phase 3 funding, which would require large-scale, multi-year trials costing hundreds of millions of dollars [2]. The NIH cannot fund Phase 3 alone. The market incentive problem persists — female contraceptives generate reliable revenue, and the male market is unproven.

Enrollment continues because the science demands it. Whether Phase 3 ever begins depends on whether anyone decides male contraception is worth funding at scale. The gel sits in the same liminal space it has occupied for years — effective, reversible, available to clinical trial participants, and unavailable to everyone else.

-- NORA WHITFIELD, Chicago