In the past few decades, a number of new, innovative birth control methods have hit the market. Most of them, however, rely on hormones in one way or another; people who can’t or prefer not to use hormonal methods still have limited options. But a new form of contraception called Ovaprene could become the first new barrier method in nearly 15 years.

Still in its early stages of testing, Ovaprene is a small device that is inserted inside the vagina. It releases a chemical that works locally to immobilize sperm. The device is made out of a tightly knit polymer that also physically blocks sperm from getting into the cervix when used correctly. If approved by the FDA, Ovaprene would also be the first barrier method capable of working for an entire month. (Most barrier methods are single-use only and need to be put in place directly before intercourse.)

Initial test results released at the end of 2019 found that the device successfully blocked sperm. Daré Bioscience, the company behind Ovaprene, tested the device in 23 women by comparing the number of sperm found in their cervical mucus two to three hours after intercourse with and without the device (with the same partner each time). The company concluded that Ovaprene blocked “essentially all sperm.”

The last barrier method to come on the market was the redesigned “female” condom, now called the internal condom, in 2006. (The original version debuted in 1993.) Other barrier methods include “male” condoms, diaphragms, cervical caps, and the sponge. While traditional male condoms remain popular for both pregnancy and STI prevention, other barrier methods are rarely used these days. In 2014, Guttmacher Institute found that only 0.6 percent of contraceptive users relied on “other methods” of contraception, which includes the diaphragm, internal condom, foam, cervical cap, sponge, suppository, jelly or cream, and other unnamed methods.

Hormonal methods have dominated the contraceptive landscape since the pill was invented in the 1960s. Since then, updated formulations of the pill have been released, as well as new methods to ingest the hormones—including the shot, the patch, the ring, and the implant. All of these methods rely on synthetic hormones, which control the menstrual cycle to prevent ovulation and thicken cervical mucus (to make it harder for sperm to get to the fallopian tubes where fertilization would take place).

The pill remains the most popular method of contraception. In 2014, 25 percent of contraceptive users depended on the pill, followed by 22 percent who relied on female sterilization, 14 percent who used the male condom, and 6 percent who relied on male sterilization. Newer hormonal methods were chosen by a small percentage of users: the shot (3.9 percent), the implant (2.6 percent), the ring (2.4 percent), and the patch (0.2 percent).

Intrauterine devices (IUDs) were used by 12 percent of contraceptive users. Around since the early 1900s, IUDs were once among the most popular methods of contraception. In the 1970s, there were 17 models of IUDs under development by 15 different pharmaceutical companies. One model, the Dalkon Shield, had serious design flaws that resulted in a higher failure rate, infections, and at least 18 deaths. After that, usage rates plummeted and IUDs nearly disappeared from the U.S. market.

A modern era of IUDs began with the approval of Paragard in 1988 and Mirena in 2000. There are now five designs on the market. With the exception of Paragard (also called the Copper-T), all of them contain hormones and prevent pregnancy by inhibiting the movement of sperm toward the egg. Those that contain hormones thicken cervical mucus, thin the uterine lining, and may prevent ovulation.

Much of this innovation in contraceptives ignores people who either shouldn’t or choose not to use hormonal methods. People with high blood pressure and cigarette smokers are warned against using birth control pills that contain both estrogen and progestin, for example, because of the increased risk of blood clots. Patients with a history of breast or uterine cancer may be told to avoid some IUDs. Some health-care providers recommend that women with diabetes, heart conditions, or a history of migraines avoid certain hormonal methods.

Some do not want to affect their menstrual cycle or have had a history of unpleasant side effects with hormonal birth control.

People who don’t use hormonal methods are left to choose between the current barrier methods, copper IUDs, sterilization, natural family planning, or abstinence. Ovaprene could be a welcome addition to the market for many.

Ovaprene still has to go through more clinical trials before it gets FDA approval. In January, Daré Bioscience signed a licensing agreement with Bayer that will give the pharmaceutical giant exclusive rights to commercialize Ovaprene. If the clinical trials are positive and the device is approved, Ovaprene is expected on the market in 2023.