Current contraceptive choices for men?

Dear Alice,

What about male contraceptives?

— Equal responsibility

Dear Equal responsibility,

Though many contraceptives are female-directed, both men and women share equal responsibility for contraception! Unfortunately, the list of currently available male-directed contraceptive options is significantly smaller; methods include external (male) condoms, vasectomy, and withdrawal (a.k.a. "pulling out"). When picking the best contraceptive fit, there are some factors to consider about each.

The most common form of contraception of this kind is the male or external condom. These condoms fit over the penis and are made from latex, polyurethane, polyisoprene, or lambskin. Using condoms correctly and consistently can yield an effectiveness rate of about 98 percent. Beyond that, you may be happy to know that they're inexpensive (free in some places) and widely available. They also come in many sizes, colors, and flavors, and — best of all — they can help reduce the risk of sexually transmitted infections (STIs), too (though the lambskin condom doesn’t provide as much STI protection as the other types of condoms). Further, condoms must be used every time sex occurs in order to be effective. However, putting a condom on with a partner can be a fun element of foreplay!

Another option is vasectomy. This method is a permanent contraceptive choice, appropriate for those who have decided to forgo having children in the future. A vasectomy is a surgical procedure where the vas deferens, the tube through which sperm travels, is cut. With 99 percent effectiveness, this procedure eliminates the need to think about birth control in the heat of the moment. As vasectomies are not easily reversed, they are meant to be considered as a permanent method of birth control. Other potential downsides include the cost of the procedure and that it doesn’t provide any STI protection.

Finally, there's the withdrawal method. This is a behavioral method that prevents conception by removing the penis from a partner’s vagina before ejaculating during sex. The benefits of withdrawal include that it is always available and free, and it can be up to 96 percent effective with perfect use, meaning that the penis is withdrawn from the vagina before ejaculation occurs every time during sex. However, with typical use (meaning sometimes, removal of the penis from the vagina doesn't occur prior to ejaculation), this method has a 22 percent failure rate, far higher than either condoms or vasectomies. The withdrawal method also provides no STI protection, requires thought beforehand, and some planning during sex.

Based on this information, you can see that a male who wishes to retain his fertility, use a more reliable method of birth control, and reduce the risk of STIs may determine he is best served by condoms. At the moment, other birth control options involve cooperating with a female partner in the use of hormonal methods, fertility awareness, or non-hormonal methods such as an intrauterine device (IUD). For more information about those methods, check out the Go Ask Alice! Contraception category.

It's also worth noting that a number of newer male-directed methods are in clinical trials in the United States and other countries; however, it will likely be some time before any are on the market. In the meantime, anyone who would like to prevent pregnancy can work with their partner(s) to identify the best method(s) for them and to share any associated costs and responsibilities! 

Last updated Nov 04, 2016
Originally published Feb 16, 1995

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