Male Contraception
Birth Control Methods For Men

Contraception

vasectomy diagram
The vas deferens tubes are cut during a vasectomy.

Male Contraceptives

Contents

What Male Contraceptives Are Available?
Is There A Male Contraceptive Pill?
What Is A Vasectomy?
Reversible Vasectomy Anyone?
Contraceptive Implants



Related Articles:

Birth Control Methods
Male Infertility
What Male Contraceptives Are Available?

Despite the multitude of different types of birth control options for women, there are still very few practical options for men. Currently male contraceptives include:

Condoms: in practice condoms are still the only real (non-surgical) option for men.
Withdrawal method: withdrawing just before ejaculation - not the most reliable method. See, natural birth control methods for more details.
Vasectomy: The tubes, in which sperm travel through when the man ejaculates (called vas deferens), are cut. The man will still be able to ejaculate but his semen contains no sperm. Although technically reversible, it is considered a permanent method of birth control.

In reality, the only two effective forms of contraception for men are condoms and vasectomy. Condoms are 98 percent effective in preventing pregnancy if used correctly (but more like 88 percent in practice) and they offer protection from sexually transmitted diseases (STDs). Vasectomy on the other hand is a fool-proof defense against pregnancy but it is considered irreversible. In effect it is a form of surgical sterilization. The very fact that the only option for men outside of condom involves surgery and sterilization demonstrates the technical challenges scientist have in developing new methods. In practice producing a method of birth control that can keep millions of sperm at bay without interfering with the man's sexual drive, health or future fertility has been challenging. And ultimately if it is produced, the question still remains will men use it and secondly, are women willing to place their trust in men. At the end of the day, it is the woman who is at risk of pregnancy and not the man.

That said, it is worth noting that nearly half of all pregnancies in the United States are unplanned, and half of those women have an abortion procedure. Some people feel that an effective male contraceptive might result in fewer unwanted children and far fewer abortions.

Is There A Male Contraceptive Pill?

No. Although referred to as the 'male pill', any significant hormone contraception in development for men are in the form of injections, rub on gels or slow release implants. These methods, still in clinical trial stage, deliver doses of synthetic testosterone which it turns out is not particularly effective if taken orally as a pill. When combined with progesterone (a female sex hormone), the testosterone–progesterone combination improves the effectiveness of injections/gels and implants. However it is only about 90 percent effective (for unknown reasons it does not work in some men) compared to 98 percent for the female contraceptive pill. In 2011 clinical trials for the testosterone–progesterone shot were ended when higher than expected rates of side effects were reported (acne and irritability). In reality, no new medication can come to the market without funding from industry. Nearly all current research in the U.S. into male contraception is funded by the National Institutes of Health (NIH) but researchers agree that support from the pharmaceutical industry is essential if there is to be any hope for the future. In 2006 a major blow came when two major companies (Schering AG and Organon) shut down their joint male hormone contraception program after Schering was sold to Bayer.

What Is A Vasectomy?

It is a permanent form of birth control which should only be undertaken if the man is sure he does not want to father children in the future. It involves cutting the two tubes called the vas deferens so that sperm can no longer get into the semen. He will still be able to have sexual intercourse as normal and ejaculate. It is just that the ejaculation fluid (semen) will not contain sperm. A vasectomy is performed in an outpatient surgery center and takes about half an hour. It is performed under local anesthetic, where the scrotum is numbed. The doctor will make a small puncture in the skin on one side of the scrotum and pull out the vas deferens. He will remove a small section of the tube and seal the ends. He will repeat the same procedure on the other scrotum. Even though a vasectomy can be reversed, the surgery is difficult and expensive and is not usually covered by insurance. Furthermore, although the man can ejaculate sperm after surgery, those sperm are rarely 'good' enough to fertilize an egg.

vasectomy cartoon

Reversible Vasectomy Anyone?

A new operation which has been developed in India and heralded as the answer to a reversible vasectomy is currently undergoing testing in the U.S. Called reversible inhibition of sperm under guidance (RISUG), and recently rebranded as Vasalgel it involves injecting a polymer gel into the vas deferens. While the gel does not block sperm it disrupts their chemical balance making them inert. One of the obvious benefits is that it does not involve cutting the vas deferens tube, which should make a reversal easier and more successful. Created by a foundation called Parsemus, Vasalgel still needs to be tested in the U.S. and gain the funding of a large pharmaceutical before it is ever likely to be a realistic option for most men.

Contraceptive Implants

Birth control implants have proven a very successful form of contraception for women. Now a contraceptive implant for men is being trialed by the Population Council and Universities of California and Los Angeles. The implant is the size of a matchstick and is implanted under the skin of the arm. It contains a modified synthetic steroid that is similar to testosterone but does not have the same side effects. It will be a while before we hear the results.

Bottom Line: Most of the new alternative forms of contraceptives for men are geared towards men in long term relationships. These are men who are looking for a reliable and reversible form of contraception and who would like to share the burden of contraception with their partners. This is particularly true in relationships where the woman cannot for whatever reason handle the side effects of female contraceptives. For some, side effects of contraceptive pills do not make these a practical option, IUD devices can cause severe cramping and female condoms and contraceptive diaphragms (less so) can kill spontaneity. It is clear that there is an unmet need. Until that time, the male condom is the man's only realistic option.

 

Related Articles on Contraceptives

STD Prevention: How condoms can save your life.

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