Guía de anticoncepción masculina

Curious about male contraception? We’re in the business of helping people have children, but not everyone who wants kids has baby-making on their mind right now. Lots of people may be sure they want kids in the future, but aren’t ready at their current stage in life – and that’s where contraception comes in. 

Whilst there are a tonne of options of birth control for women, there aren’t many male contraceptives out there right now, but the future looks bright! Here we’ll run through current methods, exciting prospects on the rise, and how these may impact fertility.

What are current male contraception options?

Condoms

The classic contraception. Condoms (well, specifically male condoms) are sleeves that go over the penis to prevent mixing sexual fluids. They’re typically made of very thin latex, but there are also plastic and lambskin alternatives for people with latex allergies.

Pros:

• condoms prevent both STIs and unwanted pregnancy
• condoms are easily available in most supermarkets or pharmacies
• you can also get condoms free in most sexual health clinics, LGBT centres and some GP surgeries
• condoms have no biological impacts on the wearer or partner

Cons:

• condoms are not always effective, and many people like to use them alongside another form of birth control (like the hormonal pill) for added security 
• they can’t be used with oil based lubricants such as vaseline or coconut oil as these will dissolve the condom
• when used incorrectly, condoms can break

If there’s anything we’ve learnt from 90s TV, it’s that condoms don’t always protect from accidental pregnancy. Even when used perfectly condoms are only 98% effective. Which means 2 in 100 couples using condoms correctly will get pregnant over time. One aspect of this is that people aren’t perfect. Condom effectiveness can be impacted by human error – think putting them on incorrectly (even forgetting to put them on), or ripping them as you put them on – and problems with the condoms, such as ripping during intercourse.  

Natural contraception 

Natural contraception is just strategic sex to try and avoid getting pregnant. One of the methods is  the infamous ‘pull-out’ method . Which is when a male takes their penis out before ejaculating, so sperm doesn’t get inside. However, we do not recommend this method, as you can release sperm cells before ejaculation. Natural conception has become big again after the launch of Natural Cycles, which instructs the woman on how to track their fertile window. Unprotected intercourse can then be done during the non-fertile window, which is actually around 21 days per cycle (An average cycle is 28 days).  This method is also described by the NHS as the  Fertility Awareness Method (FAM), which involves timing sex around the fertile window and only having sex when your partner is not ovulating.

Pros of pull-out method:

• it’s free and convenient
• requires no medication or medical procedures
• some people report that they don’t like the feel of condoms

Cons of pull-out method:

• It doesn’t prevent STIs such as HIV, gonorrhoea, chlamydia
• it requires a lot of control and concentration
• the other partner has no power in the situation
• men can still release sperm before orgasm

Pros of FAM:

• natural family planning can be up to 99% effective when followed perfectly
• requires no medication or medical procedures
• most faiths and cultures allow for this form of contraception

Cons of FAM:

• it doesn’t prevent STIs such as HIV, gonorrhoea, chlamydia
• it requires abstinence or using condoms during fertile windows
• not everyone has predictable or reliable menstrual cycles, which can lead to unexpected pregnancies
• It takes time to properly establish your partners fertile and non-fertile days.

So while it’s better than nothing, couples should only use natural conception after they have made their  STI screenings. The efficacy of natural contraception depends heavily on the compliance to your partner’s fertile window. If she does have her fertile window or her cycle starts to be irregular it is better to use a condom during those times to be safe, if you’re not ready for kids right now.  

Vasectomy 

A vasectomy is a surgical procedure to cut or seal the tubes that carry sperm. This makes it (almost) impossible to impregnate a partner. It’s a quick procedure done under local anaesthetic – meaning you’re awake for the surgery – and takes around 15 minutes.

Pros:

• it’s more than 99% effective
• It’s a one-off procedure, meaning you don’t have to worry about contraception
• Your hormone levels are left unaffected, so your mood, sex drive and erections will be left unscathed

Cons:

• It comes with all the difficulties of surgery – pain, lack of movement during recovery, risk of infection
• A vasectomy does not stop you from catching or giving STIs, so protection is still necessary in many cases
• While vasectomies are reversible, the reverse surgery is very difficult and not always successful.

Ultimately vasectomies are for people who are 100% done with their baby-making. They’re a bit more permanent than most forms of contraception, and really aren’t ideal for anyone who just isn’t ready to be a parent now.

What does the future look like for male contraception? 

Since the current state of male contraception isn’t the most effective, women usually carries the burden of extra contraception. This is often with birth control pills, coils and implants, and all the side effects that come with them. But since sperm is the thing that actually causes the pregnancy (and the fact that there’s no shortage of it), then it makes a lot more sense to focus on male contraception. Sort of like putting a cap on a bottle of ketchup instead of wearing a plastic sheet over your white clothes.

Why is it taking so long for male contraceptives to become available?

It’s been more than 60 years since female contraceptives became publicly available, and yet research into male contraceptives has only taken off in the last few years. And even with so many breakthroughs, there are still no male hormonal contraceptives available.

A lot of this is down to the side effects of lowered testosterone. Many male contraceptives in the works come with the guarantee of zero side effects – the big ones being weight gain, developing acne and lowered sex drive. On the flip side female contraceptives have all of these side effects, and more. At this point many women are still waiting for a side-effect free contraceptive, while male contraceptives won’t be released until they’re reliably free of side-effects.

Right now, there are no male contraceptives available (apart from condoms). So let’s look at the options currently in the works.

The Male Contraceptive Pill 

What if men could take a contraception pill? Estrogen/progesterone birth control – or ‘The Pill’ – is one of the most common contraceptive methods, and is also used to manage painful or irregular menstruation. For many people however, the pill causes many uncomfortable, painful and even life threatening side effects. And with no reliable male contraceptive, the burden of these symptoms lies on women. The female pill has been around since the 1960s, so why is there still no male version?

According to YouGov, one in three (33%) of sexually active men are open to taking hormonal contraception. This is also the percentage of British women already using hormonal contraception, so it’s a significant amount. 8 in 10 of those taking the survey also said that contraception should be the responsibility of both partners, not just the man or woman. The attitudes towards a male pill are therefore pretty positive from both men and women.

Research into a male contraceptive pill has rocketed in the last few years, and with new funding from the Bill and Melinda Gates foundation, development and clinical trials may only be a few years away.

However, According to Professor Barratt at Dundee University’s School of Medicine, male hormonal contraception is more difficult to get around than female. “Men produce 1000 sperm in a heartbeat, so they’re producing more than 100 million sperm every day, and they do that continuously, 24/7.” An affective and reliable pill will need to stop that entirely, without impacting hormone levels severely or causing erectile dysfunction (after all, there’s no need for contraception if you can’t have sex). The trials have shown a lot of other side effects which delays further development, but these are the same side effects that female contraceptives have had for 60 years.

Heat Contraception 

You may have read our blog: Temperatura testicular: Cómo influye el calor en la fertilidad. But what if this could work as contraception? That doesn’t mean you should take a hair dryer to your balls, but there may be some exciting solutions on the horizon.

The way heat contraceptives could work is with nanoparticles injected into the bloodstream which are then moved and heated by magnets. The nanoparticles would heat up male testicles to prevent sperm production and kill any sperm. In their experiment, researchers injected citric-acid coated nanoparticles into the bloodstream of rats, guided the particles to the testes with magnets, then applied an alternating magnetic field for 15 minutes. This heated the testes to 104°F (40°C), stopping the production of sperm.

For 7 days the mice could have sex but not get any female mouse pregnant. In humans, sperm fully regenerates every 70 or so days. It’s similar for mice, and within 30 to 60 days after the experiment they recovered their normal sperm counts. 

Now this is a pretty innovative idea. The prospect of being injected with nanoparticles for days before sex also isn’t the most appealing, but it’s breakthroughs like this that can lead to more suitable solutions.

Gels

Once again one of the big barriers to figuring out male hormonal contraception is balancing a reduction in sperm and maintaining normal testosterone levels. And Nestorone/Testosterone gel may be the ticket.

Testosterone gel is already widely used by men who need to up their T levels. It’s a gel to apply daily into the shoulders. The gel absorbs into your system, giving you the hormone boost you need without any injection. Segesterone acetate (Nestorone) suppresses sperm production. The contraceptive gel will contain Nestorone to keep your sperm count low and Testosterone to keep hormone levels high.

Outlook 

Timing is everything when it comes to starting a family, which means contraception can be vital for those who want kids in the future. Not just in preventing surprise pregnancies, but also preventing STIs. Some of the most common STIs can harm your chances of conceiving. You can read all about it in our blog “STIs and Male Fertility – Is There A Link?”

And finally for guys hoping to be dads in the future, it’s never too early to check your sperm quality. It’s easy to assume that when the time comes, it’ll be all-too easy to make a baby. But that’s not always the case. With an ExSeed kit you can test your sperm count and quality from home, and get detailed information and advice about your results. You can put to bed any concerns and get some reassurance for the future. Or if your results aren’t so great, you have plenty of time to make a big difference to your sperm.

Finding out about your swimmers is one of the best ways you can plan for fatherhood, and give you a head-start on trying to conceive.