What to know about male contraceptives

Contraception is often associated with women based on the belief that women bear the physical and social consequences of pregnancy and therefore should take primary responsibility for preventing it.

Also, the majority of contraceptive methods developed and marketed are designed for women. This includes birth control pills, intrauterine devices (IUDs), and hormonal implants. But experts say contraceptives for men exist. They are effective and equally important.

Taiwo Alabi, a urologist at Grandville Medical Centre in Lagos, said male contraceptive tools are an effective way to reduce the risk of unplanned pregnancies.

Mr Alabi also identified that contraceptives allow men to take active control over their reproductive future.

The UK National Institute of Health defines contraceptives as methods, devices, or medications used to prevent pregnancy by interfering with the normal process of ovulation, fertilisation, or implantation.

The World Health Organisation (WHO) also stated that contraceptives are crucial to reducing maternal ill-health and the number of pregnancy-related deaths.

Weeks ago, PREMIUM TIMES, in a report, detailed the existing contraceptive methods for women and how they function. In this report, based on an interview with Mr Alabi, a Nigerian urologist and health professional, the focus shifts to the existing contraceptive options for men and the reasons why these methods should be embraced.

Contraceptives method

Mr Alabi divided the methods of contraceptives for men into three. That is, the withdrawal method, the barrier method, and vasectomy.

The barrier method involves the use of physical devices to prevent sperm from reaching the egg during sexual intercourse.

According to Mr Alabi, one of the main ways to create a barrier is the use of condoms. It is a sheath typically made of latex or polyurethane that is worn over the penis.

Condoms act as a barrier to block semen from entering the partner’s body, thereby reducing the risk of pregnancy, while also protecting against sexually transmitted infections (STIs).

Mr Alabi stated that condom is the most commonly used contraceptive by men around the world. It is also a contraceptive recommended by most health professionals.

According to a Cambridge study, multiple surveys have shown that in many countries where data exist, condoms make up over 50 per cent of all contraceptives.

UNAIDS also reported that about 52 per cent of men aged 15-49 use condoms with non-regular partners.

However, despite generally increasing trends in condom use over the past two decades, substantial variations and gaps remain, according to UNAIDS.

Mr Alabi also noted that a condom is the only contraceptive that prevents both unwanted pregnancies and sexually transmitted diseases.

He, however, noted that although condoms are very practical, issues with counterfeiting and sub-standard products are now highly prone to failure.

“The failure could be expiration, unprofessional practices by vendors, and deliberate sabotage of the barrier by a partner,” he adds.

The withdrawal method

The withdrawal method, also known as coitus interruptus, involves the man withdrawing his penis from the partner’s vagina before ejaculation occurs.

The aim is to prevent sperm from entering the vagina and thus avoid fertilisation.

According to Mr Alabi, it is the oldest form of contraception, but with a high rate of failure.

“This is because even before ejaculation, a fluid known as pre-ejaculate can be released, and it may contain sperm,” he explained. “As a result, there is still a significant risk of pregnancy, even if withdrawal occurs before climax.”

He noted that this does not prevent infection or STIs.

Vasectomy

The third form of contraception is vasectomy. This is a surgical form of male contraception that prevents sperm from entering the semen during ejaculation, thereby avoiding fertilisation.

It is a safe and straightforward procedure that involves a doctor numbing the scrotum, then cutting and sealing the tubes, called vas deferens, that carry sperm from the testicles.

According to Mr Alabi, men who get a vasectomy still ejaculate, but the semen won’t contain sperm, so it can’t cause pregnancy.

Although Vasectomy is regarded as the most effective form of contraception for men, it is the least accepted of all methods.

He further noted that it is the least accepted form of contraception in Nigeria.

Although there are no available data on the general prevalence of vasectomy in the country, several studies have shown that there is low acceptance.

A survey conducted over 16 years showed that only 10 men volunteered for a vasectomy compared to 3,585 female sterilisations.

That gives a prevalence among those presenting for sterilisation of about 0.28 per cent for vasectomy.

Another study in Edo State showed that only 1.6 per cent agreed to vasectomy unconditionally, and another 5.2 per cent conditionally with the study group.

“In my years of practice, I have only done vasectomies about five times, and I can tell you that I will rank as one of the urologists that has done it the most. Some urologists have not done a vasectomy throughout their career,” he said.

The urologist also noted that a vasectomy is not effective immediately.

“It takes about three months for the remaining sperm beyond the area where his tubes were blocked to be cleared. Within this period, another contraceptive must be used,” he said.

Mr Alabi also noted that the awareness about vasectomy in Nigeria is very low.

Most men, he noted, don’t know about the procedure, and those who do are often not interested.

Some, according to him, are concerned about doing a surgical procedure, while others have a general fear of hospitals or medical interventions.

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“We need more awareness. We need more education,” he said.

Health professionals also attribute this to widespread misconceptions, fear of permanent sterility, and cultural or religious beliefs that associate masculinity with fertility.

Why contraception matters for men

To improve contraceptive use and family planning, there’s a need to debunk the misconception that contraception is only for women, according to Mr Alabi.

He stated that it gives men greater control over when and if they want to become fathers.

He identified that when male partners are involved in contraception decisions, it builds better communication and supportive relationships.

“Also, there are peculiarities in women that sometimes make men better fit to adopt a contraceptive method.

“This relieves and makes the men more involved in family planning,” he added.

He urged that families considering adopting any contraceptive method should discuss contraception and reach a conclusion on the most preferred choice.