Male contraception: what are the effective and reversible methods?

“My girlfriend took the pill for years, and it didn’t suit her to take hormones anymore”, Says Johann. It is now this 23-year-old young man who takes care of contraception in the couple. For almost a year, he opted for thermal contraception.

Between 44 and 83% of men would be ready to adopt a method of so-called long-term male contraception, reversible and reliable as a couple’s contraception, according to a french study 2017. However, only 28% of couples use it in France, according to theFrench Association of Urology.

Condoms, vasectomy or withdrawal: the top three

The best-known male contraception is the use of condoms. But it is not always comfortable and some couples prefer to find contraception of longer duration. The withdrawal method is unreliable: 27% of women get pregnant while using it.

Vasectomy is also a solution, which can be reversible by surgical reconstruction in 80% of cases, but only half of couples manage to have a child after this reconstruction.. So what other reversible contraceptives can men turn to?

To read also: Male contraception: where are we?

The thermal method

This method consists of artificially raising the testicles closer to the body, using a special underwear or a silicone ring. In this way, the temperature of the testes, usually around 34 or 35 degrees, rises to 37 degrees. This warming makes spermatogenesis, that is, the production of sperm, impossible.

For Dr Hupertan, andrologist, urologist and author of the book The Encyclopenis, this method becomes effective from six months, “provided you use it every day for 15 hours”, Or the wake-up times. Before you start, you need to do a semen analysis, called a spermogram. Then it is necessary to make a new one after a few months to certify the state of infertility.

“It took me a while to adapt”

In France, Dr Roger Mieusset prescribes this method with suitable underwear and this contraception remains fairly artisanal. It is possible to order silicone rings on the internet, called androswitch. Otherwise, tutorials allow you to make an underwear that will lift the testicles.

Johann chose to wear a ring. “At the beginning I wore the ring from time to time, one or two hours a day, and little by little I increased my hours”, He says. “From the day I did my first spermogram I wore it continuously”, Specifies the young man. “It took me a while to adapt because it is not a usual position for the testicles. It’s quite scary, but over time it fades. It took a short week to get used to the ring”, Adds Johann.

But be careful, in any case, this method is not sustainable and must be limited to four years, explains Dr Hupertan. Otherwise the patient risks testicular atrophy.

The hormonal method

Another solution: the hormonal method, accessible only in family planning centers. It makes it possible to achieve a state of infertility by injecting the patient with “a large amount of testosterone”, Explains Dr Vincent Hupertan.

“After six months, the excess hormones block the production of testosterone and sperm. If we stop the injections, their manufacture starts again after six months”, Adds this doctor.

But here again, this method should not be used for too long: “Beyond a year and a half, there is testicular atrophy which can be permanent and irreversible.“, he specifies.

Soon a “male pill”?

The idea of ​​a “pill for men”, the equivalent of female oral contraception, is regularly the subject of studies and advertisements in the media. But no laboratory has marketed it in France.

For Professor Hupertan, it is not only because of an alleged lack of public interest that laboratories are not interested in this contraception. This is because the functioning of the ovaries is cyclical, while the testes continuously produce sperm. Blocking the production of an egg therefore requires much less hormones than blocking the production of sperm, he explains.

In addition, because the menstrual cycle starts over completely each month, most side effects in women go away the first cycle after stopping contraception, while men have to wait longer.

The fear of “losing your manhood”

In all cases, male contraception is a source of apprehension. Even Johann who took the plunge was not immediately convinced by this method.

“A man who goes into contraception has the false impression that he is losing his masculinity”, Explains the young man. According to him, a man assumes that he will never be in “contraceptive status“, so when he starts one, he fears for his comfort.

“A chauvinist country”

For Dr Hupertan, this fear of losing his masculinity also explains why very few men bear the burden of contraception in their marriage. “We are a very macho country, very conservative“, he declares.

“All men fear consequences for virility, sexuality and well-being. Men are more selfish than women“, adds the doctor. As he specifies, the side effects of so-called male contraception are very similar to those of so-called female contraception. An observation which does not therefore justify that women are always the only ones to be concerned about contraception. in their couples.

* Our editorial staff have chosen to use the terms “male / male” and “female / female” to make this article easier to read, but there are men who have a menstrual cycle and women who do not.