Vasectomy vs. Other Male Birth Control Options
There is no currently available contraceptive that has a higher success rate than vasectomy. There is a progesterone-coated intrauterine device (IUD) that has recently become available for women that approaches the 1/600 published failure rate of vasectomy.
Comparing Vasectomy to Other Male Birth Control / Contraceptives
A list of other potential contraceptive choices is given below. All of these have a higher failure rate than vasectomy. Currently, condoms, rhythm method, withdrawal and abstinence are the only other options for men.
Table 1. Table of Birth Control Methods Besides Vasectomy
Another reason to choose an alternative to vasectomy is if the male partner is anxious or concerned about what a vasectomy will do to his sexual performance. Concern about this issue may lead to stress, and stress is likely to impair a man’s ability to have an erection or ejaculate, even though the production of sperm and the male hormone levels are unchanged.It may very well be that the risks associated with female contraceptive measures, like oral hormone contraceptives or tubal ligation, are at least or more significant than that associated with vasectomy. That said, a vasectomy may not be the best contraceptive choice for couples who want to increase the time between pregnancies, or who have even the slightest reason to believe that they may might want to have children in the future.
Finally, a vasectomy is not the answer to a problem of failing erectile function. If a man is interested in getting a vasectomy in hopes of improving the female partner’s attitude toward sex or to increase his own sexual powers, then disappointment is likely. On the other hand, the freedom from the fear of producing unwanted children might significantly increase the couple’s mutual enjoyment of sex.
Issues with the Female Birth Control Pill
The female oral contraceptive pill was developed in the 1950’s (after vasectomy) based upon the premise that a single egg per month is a worthwhile target for contraception; the pill has met with wide commercial success. However, despite its widespread use, the female pill is far from an ideal contraceptive product. Why? For one thing, 1/3 of women discontinue it for method-related reasons during the first 6 months of use. This increases to 60% of women after 2 years of use. Side effects were the most frequent reasons given by women for discontinuing oral contraceptive use, with as high as 51% reporting at least one side effect. In addition, based on the recent reevaluation of the effectiveness and risks of long-term hormone replacement in menopausal women in the Women’s Health Initiative study, reproductive age women have recently become more concerned about the long-term side effects of oral hormone contraceptives. Dr. Turek has seen this play out as more men seem to be considering vasectomy because of this open ended issue with female hormone supplements.
New Contraceptive Pills for Men
Male contraceptive pills have been the subject of ongoing research for years, but to date none are commercially available. Approaches to male contraception that seek to manipulate male hormone (testosterone) levels to lower sperm production: 1) do not work consistently among individuals, and among different ethnic groups, 2) have the potential for long term side effects, and 3) demand regular compliance among men who use them.
It has been debated for years whether men are ready to accept the male as the responsible partner for birth control. However, a recent marketing study indicates that the developed world may be ready for this. A study of 9,342 men aged 18-50, from Argentina, Brazil, France, Germany, Indonesia, Mexico, Spain, Sweden, and the United States found that over 55% of men were willing to try a new male contraceptive method. This study also described 3 market clusters of potential male contraceptive users: 1) informed men interested in a safe and easy-to-use contraception, but also concerned about potential risks and side effects; 2) the sex-oriented individual mainly interested in a positive effect on sexual life (enhancement of libido, sexual performance, and satisfaction); and 3) religious men who have a negative attitude toward any male fertility control method. Thus, there may in fact be substantial numbers of men worldwide who would be interested in trying new contraceptives.
References:
- Lete I, Pérez-Campos E, Correa M et al. J Womens Health. 2012, 21490-5.
- Heinemann K, Saad F, Wiesemes M, White S, Heinemann L 2005, Hum Reprod 20:549–556.
