Male Contraception: Which Methods Are Safe, and Which Are Still Being Tested? This urology article provides an overview of condoms and vasectomies, discusses the testicular ring and the Cocooner, and explains the current state of research on the “male pill.” It includes the Pearl Index, effectiveness, and side effects of each method.
Contraception is a shared responsibility, but so far there are only two approved methods for men. Here you can find out what is safe, what is not recommended, and what researchers are working on.
“Contraception is a matter for both partners. We want to provide men with reliable information so they can make an informed decision together with their partner—and so it’s clear which methods have actually been tested and which haven’t.”
Approved methods: condoms and vasectomy
Condom
The only male contraceptive that also protects against sexually transmitted infections (including HIV). It is readily available and hormone-free. The Pearl Index ranges from 2 to 13 (2 when used perfectly), so its effectiveness depends heavily on correct use.
Vasectomy
In this minor procedure, the vas deferens are severed. The Pearl Index is 0.04–0.15, making it one of the safest methods, with no effect on hormone balance, sexual function, or libido. It is considered permanent and should only be chosen after a couple has completed their family planning. Reversal surgery is possible, but not always successful. The vasectomy is performed at the USZ.
The Pearl Index: How Is Safety Measured?
The Pearl Index is a measure of the reliability of contraceptive methods. It indicates how many out of 100 women become pregnant within a year despite using a specific method. The lower the value, the higher the reliability. A Pearl Index of 0.1 means one pregnancy per 1,000 women per year.
Untested methods: testicle ring, Cocooner, vas deferens switch
- Testicle ring: Keeps the testicles close to the body for hours each day to inhibit sperm production through heat.
- Cocooner: a testicular clamp that uses diathermy to heat the epididymis to approximately 41.5 °C.
- Vas deferens switch (Bimek SLV): a mechanical switch that is surgically implanted in the vas deferens.
For all three methods, there is no reliable data on effectiveness and safety, nor is there a reliable Pearl Index. Pain, injuries, and permanent damage are possible. They cannot be recommended as safe methods of contraception.
A Pill for Men? The Current State of Research
“The male contraceptive pill” is a general term: The methods being researched include not only pills, but also gels, injections, and minor procedures, and they work either hormonally or without hormones. The following methods are being studied. None of them have been approved yet, and no Pearl Index is available at this time.
| Method | Mechanism of Action | Application |
|---|---|---|
| NES/T-Gel (hormonal) | Inhibits sperm production; testosterone keeps hormone levels normal. | Gel, applied to the skin daily. |
| DMAU (hormonal) | Inhibits sperm production; the effect is reversible. | One tablet daily. |
| YCT-529 (hormone-free) | Blocks the vitamin A signaling pathway in the testes. | One tablet daily. |
| TDI-11861 (hormone-free) | Immediately renders sperm immobile. | Tablet, as needed. |
| Hydrogel Block (hormone-free) | The gel blocks the vas deferens, but the procedure is said to be reversible. | Outpatient procedure on the vas deferens. |
| Silodosin (prostate medication) | Ejaculation into the bladder (“retrograde”). | Medication, taken approximately 3 hours before sexual intercourse (off-label). |
In summary, there are already several promising approaches, but no approved alternative to condoms and vasectomies yet. Studies will have to show whether they are safe, effective, and reversible.
You can find all the details, research findings, and sources in our brochure:
To the brochureFrequently Asked Questions About Male Contraceptives
Currently, condoms and vasectomies are available as safe, medically proven methods.
A condom only provides protection if it is used correctly. Keep the following in mind:
- Check beforehand: Check the expiration date and CE marking, store the condom properly, and choose the right size.
- Open the package carefully: do not use sharp objects, so as not to damage the condom.
- Put it on in time: Roll the condom onto the erect penis before any sexual contact (vaginal, oral, or anal), not just right before ejaculation.
- Use it until the end: Keep the condom on until after ejaculation and do not remove it prematurely. When withdrawing, hold the rim firmly so it does not slip off.
- Use only once, then throw it away.
Training on proper use increases safety. Common mistakes include putting it on too late, removing it too early, damaging it, storing it incorrectly, and choosing the wrong size.
Not yet. Several hormonal and non-hormonal active ingredients are being studied, but have not yet been approved.
No. There is no reliable data on the effectiveness and safety of the testicle ring. It cannot be recommended as a safe method of birth control.
Generally speaking, yes: A reversal procedure (vaso-vasostomy) can reconnect the vas deferens to restore fertility. However, the procedure is not always successful. A vasectomy is therefore considered a permanent form of birth control and should only be chosen once a couple has completed their family planning.
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