Male Birth Control: Vasectomy and Beyond

By: Paurush Babbar, MD

Birth control is not just for women. Men also have several options to avoid an unplanned pregnancy. If you haven’t already, maybe it’s time for a conversation about sharing the responsibility for preventing an unplanned pregnancy equally, with male birth control. It could be a much-loved Valentine’s Day gift.

One of the most effective forms of contraception is in fact made for men. And thanks to ongoing clinical trials, new options are being explored.

And they should be. An estimated 65% of girls and women (ages 15 to 49) use some form birth control, according to the Centers for Disease Control and Prevention (CDC). Many endure uncomfortable side effects ranging from headaches and weight gain (the pill) to ovarian cysts (IUD). 

Your Male Birth Control Options

Today, 85% of men want to avoid an unplanned pregnancy, and an estimated four in 10 men are “very” interested in new methods of male contraception, according to research by the Male Contraceptive Initiative. If you are among them, one of these options might be right for you. 

Vasectomy (AKA Male Sterilization)

A vasectomy is among the most reliable and permanent forms of birth control because it cuts the passage sperm take to reach the penis. This approach is nearly 100% effective at preventing pregnancy  More than 500,000 U.S. men choose to have the procedure every year.

During the procedure, the surgeon snips off and seals the tubes your sperm travels through from the testicles to the penis (the vas deferens). This typically requires two small incisions in the scrotum, which are typically closed with two or three stiches.  Some urologists use a no-scalpel, puncture approach.

All of this is performed as an outpatient procedure, most frequently in your doctor’s exam room. A vasectomy takes less than 30 minutes to perform and is pain-free, thanks to localized numbing agent. The Urology Group also offers the option of mild conscious sedation (nitrous oxide, or “laughing gas”) if you expect to be anxious during the procedure. 

After the vasectomy, you can recover at home for a few days before returning to work, but avoid strenuous activity for about two weeks. Do not have unprotected sex for a few months because after the vasectomy, some live sperm remain in your system for a period of time. Use back-up birth control until a semen analysis kit and your doctor confirm you are free of mobile sperm. This is an important distinction: Your body can carry up to 100,000 immobilesperm and be considered safe; but any number of mobile sperm can cause pregnancy. 

Learn more about what to expect if you get a vasectomy here.

Condoms (the Sheaths of Kings)

The earliest record of condoms dates to 3000 BC and the mythological King Minos, of Crete, who used them not to prevent pregnancy, but to protect against illness. Back in the Bronze Age, a condom, or “sheath,” was made of goat bladder. 

Today, condoms remain highly effective at preventing the spread of sexually transmitted disease and pregnancy because they are designed to capture ejaculation and protect against bodily fluid exchange. If used perfectly, condoms are 98% successful. Bonus: Condoms are affordable (as low as $1 each).

However, a condom can slip off, leak, or tear, so be diligent about application. Nearly 15% of people who use condoms as their sole mode of birth control und up with an unexpected pregnancy in any given year, according to the Cleveland Clinic. 

Spermicide (the Sperm Killer)

Spermicide, or nonoxynol 9 (N-9), is a chemical that kills sperm so they can’t fertilize an egg. It is available as a cream, foam, jelly, suppository, or tablet. Spermicide can be used alone but only with 72% effectiveness. It’s more effective if used in combination with a condom or other device that blocks sperm (such as a spermicide condom or cervical cap).

Spermicide condoms (condoms coated with N-9) can prevent pregnancy 87% to 98% of the time, depending on how perfectly used, research shows. N-9 also can act as a lubricant. 

However, spermicide can contribute to urinary tract infections (UTIs) in some women. So if your partner is prone to UTIs, you might want to consider a different option. 

What May Come Next: NES/T Gel (Male Hormone Gel)

Research into male hormone treatment for birth control is pushing forward with a topical gel known as NES/T Gel. 

NES/T Gel is a contraceptive cocktail made of testosterone and a synthetic hormone called Nestorone. When rubbed daily into the shoulder over time, the combination has been able to reduce sperm production while maintaining healthy testosterone levels.

Researchers have been testing NES/T since 2005. The latest (2024) tests produced an 86% success rate at reducing sperm to “safe” levels after 15 weeks. Researchers are seeking the U.S. Food and Drug Administration’s approval for a trial, which could allow the final phase of testing as early as 2025. Still, that testing could take another few years, and will rely on funding.

Your Male Birth Control Options Are Your Choice 

The male birth control method you choose depends on your lifestyle and plans. If you have sex only occasionally, condoms might be your best bet. If you are 100% certain you do not want children, you should talk to your doctor about a vasectomy. If you have sex with different partners and do not want kids, use both methods to prevent both pregnancy and STDs.

Ask your urologist about how these different male birth control treatments might fit into your life. 

The Urology Group physicians are trained to discuss male birth control options discreetly and frankly. Contact us to request an appointment for a consultation.