As a man it is extremely important to be informed about your options for contraception, how they work, and their effectiveness. This allows you to make safe and controlled decisions about how you have sex. The two methods of contraception specifically for men are the male external condom and sterilisation more commonly known as a vasectomy.
What is a condom
A condom is a thin rubber sheath worn over the penis. They are made from latex (rubber) plastic or polyisoprene which is an alternative to latex in case you are latex sensitive. Vegan varieties are also available which exclude an animal substance called casein. Male condoms come in a variety of shapes and sizes and all types are readily available.
What does a condom do?
Simply put, external male condoms prevent sperm from meeting the egg. Condoms are placed over an erect penis and when used perfectly they are 98% effective at preventing pregnancy (when used typically they are 82% effective). Alongside preventing pregnancy condoms are also used to help protect partners from some sexually transmitted infections including HIV.
What are the dangers?
Despite their high percentage of effectiveness condoms, like much contraception, are not absolutely perfect. However, much of the fault comes with improper use for example:
- the penis touches the area around the vagina before a condom is put on (pre-ejaculation fluid, which leaks out of the penis before ejaculation, may contain sperm)
- the condom splits
- you use the wrong type or size of condom
- you don’t use the condom correctly
- the condom slips off
- the condom gets damaged, for example by sharp fingernails or jewellery
- you use too much or too little lubricant
- You use oil-based products (such as body lotions) with latex or polyisoprene condoms- these damage the condom.
You can obtain free condoms from contraception and sexual health clinics, young people’s services, some general practices and genitourinary medicine (GUM) clinics. Enter your postcode to see your nearest provider of free condoms. Please see a list of GUM clinics in Northern Ireland on our STI page.
Male sterilisation is referred to as a vasectomy and it is the second male specific form of contraception.
What is a vasectomy?
A vasectomy is a surgical procedure that is available for free on the NHS. It works by stopping sperm getting into a man’s semen which is the fluid he ejaculates. The tubes that carry sperm from a man’s testicles to the penis are cut, blocked or sealed with heat. This means that when a man ejaculates, the semen has no sperm in it and a woman’s egg can’t be fertilised. This form of contraception is more that 99% effective.
How does it work?
A vasectomy is a quick and relatively painless procedure that is usually carried out in approx 15 minutes under local anaesthetic. It is normally a day procedure. There are 2 types of vasectomy: a conventional vasectomy using a scalpel (surgical knife) and a no-scalpel vasectomy. Your doctor will discuss both these options and decide which is best for you.
The scrotum is numbed with a local anaesthetic. Two small cuts will be made in the skin on each side of your scrotum to reach the tubes that carry sperm out of your testicles. Each tube is then cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using heat. The cuts in the skin are stitched, usually with dissolvable stitches.
Again the scrotum is numbed with a local anaesthetic and then a tiny puncture hole is made in the skin of the scrotum to reach the tubes. This means the skin is not cut with a scalpel. The tubes are then closed in the same way as a conventional vasectomy, either by being tied or sealed. There’s little bleeding and no stitches with this procedure. It’s thought to be less painful and less likely to cause complications than a conventional vasectomy.
Is it permanent?
You should only have a vasectomy if you are certain you do not want any more children or you do not want children at all. In fact, you may be more likely to be accepted for a vasectomy if you’re over 30 and have had children. Once you have had a vasectomy, it’s very difficult to reverse it, so consider all options and use another method of contraception until you’re completely sure. Vasectomy reversal isn’t usually available on the NHS.
Frequently Asked Questions
- A vasectomy does not affect your sex drive- you will continue to have erections and ejaculate however your semen will not contain sperm.
- Immediately after the operation the scrotum may become bruised, swollen or painful.
- Blood in the semen after ejaculation can also occur. This is not harmful.
- Contraception should be used until a sample is given and tested post op. The test will be carried out after approx 12 weeks after the procedure to test the semen for sperm.
- Bathing or showering after the operation is safe; the genital area should be dried gently and thoroughly.
- Tight fitting underwear for a few days’ post operation is advisable as this helps support the scrotum.
The Male Pill
There is ongoing research into a male contraceptive pill but there isn’t one available yet. The two main areas of research into male contraception are:
- hormonal contraception – where synthetic (man-made) hormones are used to temporarily stop the development of healthy sperm. As with the female pill this would not be permanent and normal service would resume once the pill was no longer being taken.
- non-hormonal methods – where other techniques are used to prevent healthy sperm from entering a woman’s vagina. An example recently tested on monkeys was a small organic compound, known as EP055 which is used to target the surface of the sperm and slow or stop its movement.
In 2016, a study analysed the effectiveness of a contraceptive hormone injection given every eight weeks. Although the drug was effective in reducing pregnancies, it was associated with a number of adverse side effects including depression, acne and altered libido (much like those of the female pill). Due to these side effects, 20 out of 320 participants dropped out of that study and it was subsequently ended.
More recently in 2018, a small study conducted on 83 men by the University of Washington, tested a pill known as Dimethandrolone Undecanoate (DMAU). This particular drug was trialled for a month and, whilst the results showed lower levels of testosterone in the participants (something associated with loss of libido) only a small number of the men reported this as an actual side effect. However, due to the study’s small sample size, more research is needed to evaluate the potential side effects of the drug in the general population.
Before you go…
Whilst it is important to know about your own contraception it is also important to be informed and supportive to your partner if she is responsible for the contraceptive method in your relationship. With 13 types of contraception for women and only two types specifically for men- the responsibility of preventing pregnancy often falls to the woman. To find more detailed information about female contraception you can visit www.fpa.org.uk
What is your preferred method of contraception? What contraception does your partner take? Have you had a vasectomy? Would you feel comfortable taking the male pill? Share your experiences, ask questions, or offer advice. Join or start the conversation below.