The Gentleman's Guide to Birth Control

The future of male contraceptives and how knowing more about birth control makes you a better partner

Several years ago, I taught an Our Whole Lives sexuality education course for 7th-9th graders. During one of the classes, we discussed options for navigating unplanned pregnancies. After we taught the basics of abortion, one of the boys raised his hand. “I just don’t think it’s fair that if a girl is pregnant and wants an abortion, she can do that, even if the boy wants the baby.”

I considered his question before replying, “You’re right to observe that after a pregnancy begins, the girl can make decisions the boy can’t. But she’s also the one who takes on more risk and stigma. Pregnancy and birth can be physically difficult and dangerous, not to mention the challenge of teen motherhood.” 

I added, “It’s important for boys to understand that their power comes in decision-making before pregnancy begins. This is why we discuss birth control with all genders in this class. Boys who are attracted to girls need to understand how effective these options are (or aren’t) so they can do their part to prevent pregnancy before it happens.”

While family planning is a topic that concerns people of all genders, birth control is socially assumed to be a woman’s issue. Men don’t always know much about the birth control their female partners take, how it works, or what kinds of questions are appropriate to ask. This, combined with the general discomfort many people have around sexual communication in general, can lead to assumptions, misunderstandings - and unplanned pregnancies.

If you’re a male-bodied person who has sex with female-bodied people, part of being a good partner is doing your part to help manage pregnancy risk and prevention. In today’s political climate, ignorance is dangerous (particularly in the US, where reproductive rights have been reduced). Being informed about birth control options and helping bear the burden of pregnancy prevention are great ways to demonstrate your care for your partner and their wellbeing.

For this article, I interviewed Dr. Polina Kelly, a gynecologist at Midtown OB/GYN, and L.R. Fox, the CEO of NEXT Life Sciences, an organization that’s working rapidly to develop birth control options for men. I’ll outline the timeline and process of conception, and share details on current birth control options and how they work, along with their rates of effectiveness. I’ll cover what the future holds for male contraceptives. You’ll get tips on how to ask questions when discussing pregnancy prevention with a partner and the options men have for avoiding an unplanned pregnancy.

Note: If you open this article in the Substack app, you can listen to it like a podcast instead of reading it!

Human reproduction 101

If you were lucky enough to get sex ed in school, you likely learned the basics of human reproduction in middle school. But for some adults, knowledge is murky beyond “egg + sperm = baby in 9 months.” Even people who are already parents may not know the specific details, but to understand how to avoid pregnancy, it’s important to know how pregnancy occurs. 

While male bodies continuously create and replenish sperm reserves from puberty, the female body is born with all the possible eggs it will have throughout the lifespan. These eggs (or ova) are stored in the ovaries. A girl or female-bodied person usually starts experiencing menstrual bleeding somewhere around 12 years of age, give or take a few years. This signals the beginning of what is (typically) a monthly menstrual cycle: the body’s process of selecting an egg, building up the uterine lining in preparation for pregnancy, and releasing the egg into the fallopian tube where it will await fertilization. If no sperm finds or penetrates the egg, the egg and excess uterine lining are shed through the vagina and out of the body. This process happens, on average, every 28 days, though it could happen more or less frequently for each person. 

Tip: Many factors can cause a shorter or longer menstrual cycle, and if an adult with a uterus is regularly experiencing a significantly shorter or longer cycle with no medically identified cause, it may be wise to check in with a gynecological healthcare provider. 

As common an experience as pregnancy is, conception itself is a remarkably random process. When sperm are introduced into the vaginal tract, they will attempt to swim through the cervix at the back of the vagina, up through the uterus, and toward the fallopian tubes where they may encounter a waiting egg. While a single ejaculation can contain millions of sperm, only a couple hundred are likely to make it to the fallopian tubes. 

The female body creates fluid in and around the cervix (called cervical mucus), the texture of which fluctuates throughout the cycle. Around the time of ovulation (when the egg is released to await fertilization), this mucus can take on a watery texture to nourish sperm and aid their motility. Sperm’s journey to the waiting ovum can take as little as half an hour or up to a couple of days. It’s worth noting that sperm can survive in the female reproductive tract for 3-7 days, but an egg is only capable of being fertilized for up to a day. (This is why fertility experts recommend having sex as much as possible in the days leading up to ovulation to achieve pregnancy.)

If sperm and egg meet, the egg cell begins dividing and growing over the course of a week. After that point, it begins its journey to the uterine lining or endometrium, which can take 5-6 days. Once it arrives, it burrows deeply enough into the lining to continue developing without risk of becoming dislodged. This process is called implantation. The timeline from unprotected sex to pregnancy can be up to 2-3 weeks.

A pregnancy test is unlikely to yield a reliable result until after a person’s period is late. These tests measure levels of human chorionic gonadotropin, or hCG, in the urine. While some tests boast a result prior to a missed period, they’re dependent upon a detectable level of hCG, similar to how we know COVID tests need a large enough viral load to give us a positive result. In other words, a false negative result may occur if a test is taken before a missed period.

Note: If you’re a man or male-bodied person who has sex with women or people with uteruses, knowing the health of your sperm can be helpful information for you, whether you’re planning a family or not. Fertility can be impacted by high or low sperm count (meaning, how many sperm are contained in each ejaculation) and motility of sperm (how fast and easily they’re able to swim).

Abstinence and risk reduction

Of course, the only way to avoid pregnancy entirely, with 100% effectiveness, is to abstain from any form of sexual activity that involves semen in or near a vagina. Even if someone ejaculates on the vulva or anus, semen is fluid and sperm can sometimes find their way into the vagina. 

I’ll address a question that often comes up with these topics: Is there sperm in pre-ejaculate or “pre-cum”? The short answer: Maybe. The long answer: Semen and urine travel through the urethra. A flow of urine tends to be effective at flushing out any residual semen and sperm from the urethra, but if you’ve recently ejaculated and not urinated since, it’s possible there could be sperm in your pre-ejaculate.

Note: You’ll see that none of the forms of birth control I mention below will reflect a 100% effectiveness rate - not even sterilization. To increase effectiveness against pregnancy, a condom can be used every time there is vaginal or anal penetration with a penis.

Birth control options

According to Dr. Polina Kelly, birth control can be defined as “a method that can either be hormonal or non-hormonal, that decreases the chance of conception or pregnancy.” Some folks use birth control solely to manage their pregnancy risks while others use certain types to reduce acne or pain during periods.

We can categorize birth control methods accordingly:

• Long-Lasting Reversible Contraceptives (LARC)

• Hormonal methods

• Barrier methods

• Emergency contraception

• Sterilization

Note: Under each method, I’ve listed quick facts about effectiveness. There are two types of effectiveness: perfect use and typical use. Since nobody uses birth control perfectly every time, I’ve only shared typical-use statistics, as those are the most informative. I’ve also added links to learn more about each method from the Planned Parenthood website, a thorough and consistently credible resource.

Long-Lasting Reversible Contraceptive (LARC)

These types of birth control are noted by the fact that they’re placed inside the body where they can be effective for years at a time. When they’re removed, reproductive functions resume as usual. This category includes intrauterine devices (IUDs) and implantable rods.

IUDs

Intrauterine devices or IUDs are small, T-shaped devices that are placed inside the uterus where they help prevent pregnancy. IUDs are placed by medical professionals in a clinical setting. Special tools are inserted in the vagina to guide the IUD through the cervix and ultimately into the uterus, where it stays until the patient decides they’d like to remove it. IUDs come in two forms: hormonal and non-hormonal. 

The hormonal IUD (which you may hear called the Mirena), steadily secretes a small amount of synthetic hormone called progestin (similar to the naturally occurring hormone progesterone). Progestin helps the body create a thicker cervical mucus, which hinders the passage of sperm. It also may suppress ovulation and thin the lining of the uterus, helping prevent the implantation of a fertilized egg.

Note: All progestin-only methods work to prevent pregnancy in the same way, though the way they’re administered, dosages, and side effects may vary. 

Duration: The hormonal IUD can last up to eight years, depending on the brand.
Length of time to full efficacy: Up to one week
Effectiveness: Over 99%
Reduces STI transmission: No

The non-hormonal IUD (which you may hear called the Paragard or copper IUD) is the same shape as the hormonal version but lacks progestin. Instead, the IUD is wrapped in a small amount of copper. Copper repels sperm, making them less likely to swim through the reproductive tract to an egg. This IUD may also thin the lining of the uterus and lower the chances of implantation. 

Duration: The copper IUD can last up to 12 years.
Length of time to full efficacy: Immediate
Effectiveness: Over 99%
Reduces STI transmission: No

How are IUDs placed?

I talked to Dr. Kelly about her process of IUD insertion. She said her appointments usually start with a consultation and health history, followed by a manual (hands-on) exam of the vagina and uterus. Next, special tools are used to prepare the cervix for the IUD applicator. This, she said, can be painful for some patients. “That cramp, for some people: no big deal. For other people, very big deal.” The next step is called sounding and involves measuring the uterus to visualize the path from the cervix to top of the uterus. “That's usually what takes the longest, in my opinion, and what could be the hardest part.” And it’s sometimes, she said, the crampiest part of the procedure. 

Next, she said, “We use the applicator that the IUD comes in. We try to leave it in for 10 seconds, make sure [the IUD] stays up there, then pull the applicator out.” IUDs come with thin, flexible strings at the bottom, which remain outside the cervix after placement. This helps the patient or their provider check the placement of the IUD as time goes on and also aids in removing it when the time comes. After a few months in the body, the strings should soften to the point that you can’t feel them during penetration. 

Once the procedure is done, Dr. Kelly likes to save a potential future visit by doing an ultrasound right away to verify a correct IUD placement. There may be cramping or bleeding for a few days after the procedure and there may be intermittent low-level bleeding (also called spotting) for the next few months. Patients who receive a hormonal IUD may find their periods eventually slow or cease altogether. Up to 20% of patients who receive a non-hormonal IUD may find their periods become heavier or crampier.

If you know a woman with an IUD, there’s a good chance she’ll tell you the insertion process was quite painful. Many providers fail to manage patients’ expectations, but it’s important to remember that all patients are entitled to request what they need. A patient can ask for prescription pain medication to take before their appointment, request numbing medication during the procedure, or even request sedation if they’re very anxious or have a history of medical trauma. (Dr. Kelly cautioned that not all offices are equipped for anesthesia, so a patient may need to seek another clinician if that’s the case. They may also need to be prepared for a higher cost due to anesthesia medication and additional providers during sedation.)

Sex after an IUD placement is safe to happen as soon as the patient feels up for it (an exception being if a patient had an IUD placed immediately after birth, in which case, they should wait until their doctor clears them for postpartum sex). However, it’s worth noting that while the copper IUD begins preventing pregnancy immediately, the hormonal IUD can take up to a week to be fully effective, which means other methods of birth control are necessary to prevent pregnancy during that window.

Implantable rods

An implantable rod (which you may hear called Nexplanon) is a small, flexible piece of plastic inserted near the tricep on the inside of an arm, just under the skin. This is a progestin-only method.

The insertion process is far less invasive than an IUD insertion. When Dr. Kelly inserts a rod, she said, “First, we do antibacterial soap, then some numbing medicine, which is the worst part - it's a little sting and a burn - and then the applicator it comes with has a sharp tip that's placed at a 30-degree angle.” Once it’s in, she said, “it should be very close to the skin so that somebody could rub their finger over it and feel where it is.” 

Like all other progestin-based forms of birth control, the rod may result in spotting or intermittent periods after insertion. It may eliminate someone’s period entirely. 

Duration: The implantable rod is effective for up to 5 years.
Length of time to full efficacy: Up to one week
Effectiveness: Over 99%
Reduces STI transmission: No

How you can be supportive when your partner is having a LARC placed or replaced: 

• Offer to drive your partner to/from their placement appointment and care for them afterward.

• If you don’t live together, keep ibuprofen and a heating pad/hot water bottle at your home so they can manage any cramping pain when they’re with you.

• Let them be the one to tell you when they’re ready for sex again, especially after an IUD placement.

• If you still feel the IUD strings poking you during sex a few months after placement, let your partner know you can feel them. Their provider may be able to trim them shorter.

• Be kind if your partner is spotting after placement. It can’t be controlled and some people feel frustrated, embarrassed, or less sexy when it happens. Condoms and nitrile gloves can help keep blood off your skin or toys, silicone lube can make shower sex more pleasurable, and Liberator blankets can keep your linens and surfaces free of stains!

• If you know where they like to buy underwear, get them a gift card. Unexpected bleeding can wreak havoc on an underwear collection.

Hormonal methods

The shot

You may have heard of the shot or Depo-Provera. This is an injection of progestin administered in a doctor’s office that works the same way other progestin-only options do. While this method works well for many, some have significant side effects with the shot. 

Duration: The shot is effective for up to three months.
Length of time to full efficacy: Up to one week
Effectiveness: 96%
Reduces STI transmission: No

The mini-pill

The progestin-only pill (POP) or mini-pill is taken once daily. This pill is prescribed by a doctor, either in person or through telehealth options like Nurx, which facilitates a doctor consultation and ships the pills to the patient’s door.

This pill must be taken at the same time every day. Even a few hours’ delay can impact the effectiveness of this method. Unlike the combination pill, which has a built-in week off, the mini-pill must be taken daily. It’s highly advised to use another method of birth control with the mini-pill.

Note: When taking any type of birth control pill, certain factors can impact the effectiveness of the dose. Skipping doses is the most common factor, but others include vomiting or having diarrhea soon after taking the pill, leaving pills in a hot environment, or taking certain medications or supplements that might impede the pill’s absorption or effectiveness.

Duration: The mini-pill is effective for 24 hours
Length of time to full efficacy: Up to two days
Effectiveness: 91%
Reduces STI transmission: No

How to support a partner who’s taking a hormonal method:

• Ask them if they have a recurring timer to take their pill or calendar reminder to get their shot. If not, encourage them to set one.

• If your partner’s pill reminder timer goes off and they’re busy or didn’t hear it, let them know or offer to bring them their pill and some water.

• If your partner is getting the shot, ask if they’ve had it before. If they haven’t, offer to help them track any symptoms they may discover. Most symptoms will ease up after a few months, but if they don’t, switching to a different method is always an option.

Combined hormonal methods

The pill/the combination pill

What we commonly refer to as “the pill” is a combination of progestin and a synthetic form of estrogen. These two medications do what all other progestin-only forms of birth control do, but the added estrogen more effectively suppresses ovulation than progestin does on its own. It’s prescribed by a doctor and can be obtained through telehealth options.

This combo pill is taken once per day. While this one doesn’t have to be taken at the same time of day, like the mini-pill, taking it at the same time can help maintain the habit of consistency. This pill may include a week of placebo ”reminder” pills to allow a period to happen while maintaining the habit of daily pill-taking, though if a patient wants to, they can skip the placebo week to avoid their period.

Duration: The combination pill is effective for 24 hours
Length of time to full efficacy: Up to one week
Effectiveness: 93%
Reduces STI transmission: No

The contraceptive patch

The patch is a flexible square that adheres to the skin and remains there for three weeks. It secretes hormones through the skin to prevent pregnancy. It’s a combination method, so it works in the same way the combo pill does. It’s prescribed by a doctor but can be applied at home. Patches are left on for three weeks and then taken off for a week before a new patch is applied. Patches can be left on the buttock, back, belly, or arm. 

Duration: The patch is effective for one month.
Length of time to full efficacy: Up to one week
Effectiveness: 93%
Reduces STI transmission: No

How to support a partner who’s using the patch:

• Make sure you know where your partner prefers to wear their patch and avoid putting massage oils or lotions on that area.

• If you notice the patch peeling off, let your partner know. A patch that’s peeling isn’t able to administer its full dosage of medication, so if the peeling is significant, a new patch needs to be applied.

• Ask if your partner has a recurring reminder to take off and reapply their patch. If they do not, encourage them to set one.

The vaginal ring

The ring (also known as NuvaRing or Annovera) is a thin, flexible circle that contains progestin and synthetic estrogen. It’s prescribed by a doctor, though it can be inserted at home. It’s folded up (“like a taco,” Dr. Kelly said) and inserted into the vagina. The ring is worn for three weeks, removed for a week, then a new ring is inserted (though, patients can skip their period by replacing the ring immediately). It’s safe to have sex with the ring inserted, though sexual partners may feel it.

• Duration: The NuvaRing is effective for one month. Annovera is effective for up to one year.

• Length of time to full efficacy: Up to one week

• Effectiveness: 93%

• Reduces STI transmission: No

How to support a partner who’s using the ring:

• Ask if the ring affects their preferences around penetration, whether with fingers, toys, or penises.

• Do not use oil or silicone lubricants with any of the rings.

Barrier methods

Barrier methods are options that help prevent sperm from proceeding into the reproductive tract. They include condoms and cervical barriers.

Condoms

Condoms come in two forms: external or male condoms, worn by people with penises, and internal or female condoms, placed inside the vagina or anus. Notably, condoms are the only type of birth control that helps reduce the transmission of STIs. Condoms do not require a doctor’s prescription and external condoms can be found for purchase at most drugstores or grocery stores, or might be free at health clinics.

External condoms

External condoms are a form of birth control most sexually active people have experienced. They’re made of different materials and come in different sizes. When placed over the head of the penis and rolled down the shaft, condoms help contain semen during sexual activities. 

Effectiveness can vary, and condom breakage is almost always a user error. Breakage is more likely if you:

• Choose a size that’s too small or too big.

• Don’t leave enough room in the reservoir tip.

• Put on two layers of condoms, also known as “double bagging.” This is sometimes done in an attempt to double the effective rate but, ironically, makes them more likely to break.

• Use incompatible lube. (Never use oil-based lubricants with condoms, though water- and silicone-based lubes are safe.)

• Leave condoms in too hot or cold a climate, like your car, or in your wallet, where they’re more likely to tear.

Duration: External condoms are designed for one-time use.
Length of time to full efficacy: Immediate
Effectiveness: 87%
Reduces STI transmission: Yes

Internal condoms

Internal condoms may be harder to find than external condoms, but you can always find them online. Like external condoms, they have a shaft, but differ in that they have two rings on either end: one that slides into the vagina or rectum to help anchor the one end and one that sits outside the vagina or anus. 

Some people enjoy wearing these because they feel more autonomous and empowered by not having to rely on someone else to wear an external condom. Some don’t like them because the material they’re made of can be noisy, and the external ring must be held in place during sex.

Duration: Internal condoms are designed for one-time use.
Length of time to full efficacy: Immediate
Effectiveness: 79%
Reduces STI transmission: Yes

Cervical barriers

While they’re not used as often in modern day, cervical barriers include things like diaphragms and cervical caps (soft, flexible discs or cups that are folded and placed into the vagina, blocking the cervix). Both of these must be prescribed and fitted by a doctor and are inserted at home, before sex. Spermicide must be used to make this method most effective and must be reapplied each time a couple has sex.

Duration: A diaphragm or cervical cap must be inserted no more than 2 hours before sex and left in for at least 6 hours after sex.
Length of time to full efficacy: Immediate
Effectiveness: 83% for diaphragms, 71%-86% for cervical caps
Reduces STI transmission: No

Spermicide can be used by itself as a contraceptive, but it’s highly recommended that you use other forms of birth control along with it. It’s safe to use with condoms. Spermicide works by slowing down sperm before they can reach the egg and comes in many forms: a gel, a suppository, a foam, cream, or even a thin gel sheet that dissolves in the vagina. Some women and people with vaginas find spermicide to be irritating.

Duration: Spermicide must be used each time, before vaginal penetration.
Length of time to full efficacy: Immediate
Effectiveness: 79%
Prevents STI transmission: No

Natural family planning

Natural family planning (you may have heard it called the fertility awareness method or the “rhythm” method) involves a woman or person with a uterus using a combination of tools to monitor their body’s cues and predict ovulation and menstruation. It can include:

• Using a basal body temperature thermometer (which shows decimal points) each morning, as body temperature may dip slightly prior to ovulation.

• Inserting a finger into the vagina to check the consistency of cervical mucus (remember, it may fluctuate throughout someone’s monthly cycle).

• Using a calendar to monitor the length of one’s cycle.

• An app in which one can enter all these details, which offers predictions about when ovulation and menstruation will occur and insight into which days are more or less likely to result in pregnancy.

Lately, influencers have been recommending this method on social media, along with a paid app, to suggest a type of birth control that is more “natural,” since it doesn’t involve putting foreign objects or hormones into one’s body. Some people rely on this method specifically to help them achieve pregnancy, but regardless of why it’s used, it’s crucial to put at least two months’ worth of cycle data into the app before using it as a birth control method. Some doctors recommend tracking for up to a year to get a big-picture view of your cycle’s natural variability before relying on it to prevent pregnancy.

While this is a great way for someone to learn more about their body, many factors challenge its effectiveness as birth control. (As a former gynecologist of mine liked to joke: “What do you call people who use the rhythm method? Parents!”) The risk of trusting an app to tell you when it’s “safe” to have unprotected sex is that people with uteruses cannot control when they ovulate and no app can predict ovulation with 100% accuracy. Even someone with a very reliable and consistent cycle may ovulate a day or two earlier than predicted, and remember, sperm can survive up to seven days in the female reproductive tract. 

When I asked Dr. Kelly about the effectiveness of the fertility awareness method, she said, “[With] natural family planning, we say [there’s a] 25% failure rate, because there's so many things that can affect your temperature if that's the only thing that you're going off of, and [factors that can] change your hormonal levels in general. That will include sleep patterns, travel, being sick with an upper respiratory infection…there's going to be variability in people's cycles and that's normal.” Additionally, if someone is using any type or LARC or hormonal birth control, their bodies will not reliably produce the signs these apps track, and the apps are only as good as the data they’re given. 

It’s highly recommended that you use another form of birth control along with this method, like condoms or withdrawal, if you’re trying to avoid pregnancy.

Duration: The fertility awareness method must be tracked daily.
Length of time to full efficacy: Two months to a year
Effectiveness: 75%-77%
Reduces STI transmission: No

Emergency contraception

If a birth control method fails, emergency contraception or EC (which you may have heard called “Plan B” or “the morning after pill”) can be taken within 3-5 days to prevent pregnancy if ovulation has not yet occurred. One type can usually be obtained over the counter at a drugstore or pharmacy for anywhere from $11-$45, depending on the brand, while another requires a prescription. There are two types of EC medication and variables for each one. Be sure to check the details on the box before choosing one, as body weight is a factor that can impact effectiveness.

Emergency contraception should not be used as regular birth control. It’s important to emphasize that emergency contraception does not terminate an existing pregnancy - if a person is already pregnant, EC will not affect it.

Note: If inserted within five days after unprotected sex, certain types of IUDs can be used as emergency contraceptives to prevent pregnancy. They’re the most effective form of EC.

Sterilization

Voluntary sterilization is a way for people of all sexes to have ultimate reproductive autonomy.

For people with uteruses, this could be called a tubal ligation (or you may hear it called “having your tubes tied”). Most commonly, this is a laparoscopic surgery performed under anesthesia. The doctor will insert tools through three small incisions on the abdomen and perform one of these two functions:

• Severing and cauterizing each fallopian tube, preventing eggs from becoming fertilized.

• Severing and removing the end of each fallopian tube, preventing eggs from ever entering the fallopian tube while significantly lowering the risk of ovarian cancer.

Ovulation and menstruation will continue as normal until menopause.

Duration: Permanent
Length of time to full efficacy: Immediate
Effectiveness: Over 99%
Reduces STI transmission: No

For people with penises, sterilization is called a vasectomy. This is a procedure performed with numbing medicine while the patient is awake. There are a couple of different methods to perform a vasectomy, but ultimately, the vas deferens (the tube that carries sperm from the testes) will be severed and cauterized.

Duration: Permanent
Length of time to full efficacy: At least two months
Effectiveness: Over 99%
Reduces STI transmission: No

Note: While, in some cases, sterilization can be reversed (more easily in men), folks considering it should assume it will be permanent, as no guarantees can ever be made about reversals.

The future of male birth control

Except for external condoms and vasectomy, most forms of birth control are chosen and maintained by women. Women and people with uteruses may have to pay out of pocket for their family planning methods, and any side effects are theirs to bear.

But maybe not for long. I had the opportunity to do an email interview with L.R. Fox, the CEO of NEXT Life Sciences, who plans to market as the world’s first non-hormonal, long-acting, and reversible male contraceptive. I’ve been following this method for many years and have watched all the trial results as they’ve been published. Fox said men are truly eager to explore contraceptive options for themselves. “Insurance data has shown that there’s an increase in younger men and men without children getting vasectomies, now that Roe v Wade has been overturned, indicating men’s willingness to participate in family planning. A recent study by Male Contraceptive Initiative (MCI) showed 17 million men would be early adopters of a new male birth control option, especially one that is long-lasting, reversible on-demand, and non-hormonal, such as Plan A™.”

And what is Plan A™? Fox wrote, “Plan A™ involves delivering a special hydrogel into the vas deferens with a quick outpatient visit; in our design, this hydrogel acts as a flexible filter that stops the flow of sperm and can be easily reversed through a simple follow-up. This well-researched and revolutionary hydrogel, Vasalgel®, coupled with our new, minimally-invasive delivery and reversal methods, comprise the contraceptive system known as Plan A™.” He called it a “set-it-and-forget-it method of birth control for men and couples who want to plan pregnancy, while not limiting their ability to someday have children in the future.”

He assured me that they’re working to bring Plan A™ to markets as soon as possible. “With decades of pre-clinical and clinical research under our belts, we’re gearing up for the final stages of clinical trials before the end of this year.” Rest assured that the second Plan A™ is on the market, I’ll be writing all about it!

Talking about it

Now that you’re well-versed in birth control options, how do you go about discussing them with a potential sex partner? Some men say they don’t want to be too forward or ask questions that are too personal or medical, but I’ll counter: sex and pregnancy are personal acts that carry significant short- and long-term medical risks. What both parties do to prevent pregnancy is relevant to everyone involved.

It can be easier to broach this topic during a safer sex conversation. As you’re discussing your sexual health histories and dates of your last STI panels, you can ask questions like:

• Here’s what I do to try to prevent pregnancy: [always using a condom, etc.]. What about you?

• [If the other person is using a LARC] How long have you had that? Do you have any side effects, like bleeding or cramping, that I should be sensitive to?

• [If the other person is using a pill or hormonal birth control method] How long have you been taking that? What time of day do you like to take it?

• [If the other person is using a method that involves spermicide] Would it be helpful if I set timers on my phone to remind us that spermicide should be reapplied? 

• [If the other person is using the fertility awareness method] Do you take your temperature every morning? Should I keep a thermometer here for you to use if you stay over? I know sleep can interfere with accuracy - how can I support you in getting enough sleep?

• [If using condoms] What material of condom do you prefer? Do you have any allergies to latex? If we’re having sex at your place, how would you like me to dispose of them?

• If the condom breaks, are you open to taking emergency contraceptives? [Be a gentleman and offer to pay for it, since condom breakage is far more likely your fault than anyone else’s.]

If your partner uses a lower-effectiveness birth control method, it’s ok to say, “By itself, the effectiveness of that method is a little too low for my comfort. I’d prefer to use condoms each time we have sex.” 

It’s also important to discuss what would happen if an unplanned pregnancy did occur since there’s always a chance of it with vaginal sex if everyone’s reproductive organs are intact.

• If you were to become pregnant, what would you want to do about it?

• Here’s how I feel about abortion: ____. What about you?

• Would you be open to telling me if you became pregnant? Would you like my input on the decision?

While your partner isn’t required to notify or discuss with you if they become pregnant or have an abortion, offering your support before it happens is a great way to make your hopes and preferences known.

Trying it out

Whether you have a long-term partner or are considering sex with a new person, I hope this information gives you a new way to support your partner’s health and empowers you to engage in meaningful discussions about family planning. Everyone deserves to be able to choose if, when, and how they become parents, and the more men work with their partners to do what they can to prevent unplanned pregnancy, the closer we get to that ideal.

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Special thanks to Dr. Polina Kelly from Midtown OB/GYN, and L.R. Fox from NEXT Life Sciences.