Update on Male Contraception: Do Vasectomies Still Rule?

the male pill
Wondering if there’ll ever be a “little pink pill” for male oral contraception (Courtesy Unsplash)

I know you’re wondering: What’s up with the male pill? Exactly where are we with male contraceptives other than condoms or vasectomy? Well, it’s a good time to ask as it’s now very clear that the desire for alternatives to vasectomy is great and growing. Studies of couples around the globe found that 25-75% of them would use a male hormonal contraceptive. That means that between 44 million and 130 million men in those nine surveyed countries alone would consider a male pill. That’s a need indeed!

A Storied Past

Contraception has been defined by innovations on the male side for almost 5000 years:

3000BCE: Evidence of condom use made from animal bladder or intestine or linen cloth in Crete and Egypt.

1800 BCE: Spermicides made by combining crocodile feces and fermented dough in Egypt

1830: First vasectomy performed in a human by R. Harrison in London. Its popularity rose dramatically after WWII. The first national program for vasectomy was launched in India in 1954

1855: The first rubber condom is made by…wait for it…Charles Goodyear, who later invented the rubber tire.

Over the last century, however female contraceptive innovations surpassed male contraception like it was standing still and female contraceptives are currently the preferred choice for most couples by a wide margin (5:1). What happened here? The most glaring issue is that funding has been sporadic as pharmaceutical companies haven’t been interested in developing male pills due to high development costs and the fear of lawsuits.

The Male Pipeline

Approaches to male contraception involve  stopping sperm production, rendering sperm immotile so they don’t move, or blocking the exit path from the testicle. They can be hormonal, non-hormonal or surgical in nature. There is currently one hormonal male contraceptive in clinical trials: a non-oral testosterone-progesterone gel applied to the skin daily to turn off or turn down sperm production. The goal is to reduce sperm to less than 1 million/mL in the semen. The questions are whether it can do this reliably in all men (remember the gold standard is vasectomy which is 99.99% effective) and whether hormonal side effects are tolerable: acne, moodiness, changes in sex drive or erections. After all, having significant sexual side effects from a pill that aims to take the worry out of sex kind of defeats the purpose, wouldn’t you say?

There is also good research developing on a sperm binding agent called Eppin that renders sperm immotile so they just sit there and can’t reach the egg to fertilize it. It’s being billed as “non-hormonal” and “reversible” but it has only been shown to be effective as an immunocontraceptive in monkeys (i.e., essentially a vaccine). It’s not clear to me how complete the sperm motility block generated with this pill can be, as we all know that sperm love to wiggle. Also, I am not entirely sure how reversible anything is with the human immune system as it literally remembers everything that it has ever seen. To date, this approach has not seen clinical trials. Lastly there is ADAM*, a non-hormonal, non-oral, hydrogel polymer “plug” that blocks the flow of sperm in the vas deferens without interrupting fluid flow. It is essentially a “screen door” for sperm and should be an improvement over the classic 100-year-old vasectomy, especially if it lives up to its promise of being reversible. It’s also in clinical trials right now. So, there’s a lot of window shopping in male contraceptive research right now, but no available product inventory.

Vasectomies Rule

So, it appears that we are left with the good ole’ vasectomy. Tried and true, nonhormonal and compliance-free, nothing on earth beats it in terms of reliability. In fact one of the reasons it’s so well-loved is that you don’t have to think about doing something every time sex is contemplated. All set to go, time after time after time. And, it has new and improved versions including the no-scalpel vasectomy, the Brosectomy® and the Nitrous-powered vasectomy, all developed with the goal of making the procedure as much of a “non-experience” as possible.

*Disclosure: I advise this company.

The post Update on Male Contraception: Do Vasectomies Still Rule? appeared first on The Turek Clinic.

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The Nitrous-Powered Vasectomy

A bit laughing fuel will do ya. (Courtesy: Unsplash)

During the last 25 years and a pair of,500 no scalpel vasectomies that I’ve carried out, I’ve have discovered loads about males. A well-known most cancers surgeon as soon as informed me that he thought {that a} well-done vasectomy beneath native anesthesia is “most likely the toughest surgical process in your entire discipline.” More durable than taking out a bladder? Yep! Since you’re coping with a person’s household jewels whereas he’s awake!

For the lifetime of me, I can’t consider a very good purpose for why God or Darwin put a person’s genitals out within the breeze like they’re. A lady’s ovaries are neatly tucked within the pelvis, all heat, cozy and guarded, which is smart. However the male junk hangs approach on the market between the legs, like no person’s enterprise, and is susceptible to all types of issues: a stray elbow in a basketball sport, an errant pitch in baseball, a big canine’s paw, or a 3-year previous’s head butt. Nothing buckles a person sooner than a direct hit down there.

Vivaldi of Vasectomy

A vasectomist have to be not solely expert and swift like a live performance pianist, but in addition attentive to the person squirming on the head of the desk. Telling a person to “simply calm down” when he’s spent his whole life guarding his jewels from simply this kind of assault is futile. What’s he presupposed to do?

The secret is to by no means let him get tense to start with.

My go-to tips for retaining males relaxed for the 6-8 minutes it takes to do the snip are oral sedatives and jazz. The key sauce is ‘diversion,’ which is exactly why my Brosectomy sufferers accomplish that properly—in group vasectomies, males are distracted by their mates and comforted in understanding that they don’t seem to be dealing with the problem alone. However even these bells and whistles can fail to calm within the face of utmost anxiousness, which happens virtually reflexively in just a few males.

A Laughing Matter

As I used to be pondering the best way to additional enhance the acceptability of vasectomies, I considered dentists. The mouth is one other extraordinarily delicate physique half, replete with nerves throughout. Truthfully, I nonetheless get anxious once I discover myself plastered to the dentist chair, palms gripping my garments, questioning whether or not that skinny, curved, sharp probe being caught in my chops will discover a cavity or hit a nerve.

After which it occurred to me: dentists have been utilizing “laughing fuel” (nitrous oxide) throughout their procedures for nearly two centuries! Found by Joseph Priestly in 1772, proper earlier than we grew to become a nation, nitrous oxide was first utilized by a dentist, Horace Wells, in 1844. Actually, Wells used laughing fuel to have his personal tooth painlessly extracted! Nitrous oxide is now as widespread as spitting sinks in dental places of work. And what it does very well is to interrupt down anxiousness. It’s a superb anxiolytic. And it’s so secure it’s used on kids for all types of procedures.

So, with our nitrous-powered vasectomy, I can just about assure that your rigidity and anxiousness will exit the window throughout your process. Certainly, vasectomies are actually little greater than a laughing matter.

The submit The Nitrous-Powered Vasectomy appeared first on The Turek Clinic.

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Is Attempting to Conceive Giving You Efficiency Nervousness?

Fireworks
The present should go on! (Courtesy Unsplash)

You’ve not too long ago stopped utilizing contraception. She has the timing of her cycle down and is aware of when she’s most fertile each month. Welcome to child making time!

At first look, this appears simple sufficient: All these years training the artwork implies that precisely what to do. Now it’s only a query of stepping as much as the plate. And so that you strive… however to your unlucky shock, it’s not going all that nicely. Generally there’s hassle getting an erection. At different occasions, it simply received’t keep up. Humorous factor is, it’s by no means occurred earlier than. Looks like rapidly the penis has a thoughts of its personal. Perhaps for the primary time in your life, you’ve got simply skilled efficiency anxiousness.

Houston, We Have a Drawback

I’ve had males name me urgently saying that they should see me that day, as their erection has failed them for the primary time. Actually, I’ll examine them out and ensure all methods are a go. However then, I normally welcome them to humanity, crammed with all method of vicissitude and stress.

Backside line is that for a lot of males, scheduled intercourse is disturbing. Perhaps they’re drained, fearful, worn out, sleepless, hung over or unwound with COVID fatigue. Regardless, these physiologic “stressors” on our lizard mind stimulate a “struggle or flight” response, much like operating from a woolly mammoth. Who needs an erection if you end up operating to your life?

Rocket Restored

So, efficiency anxiousness is neither a illness nor your future. It may be relieved with stress discount, however that’s no simple activity for the constantly-connected-and running-hard amongst us. Within the phrases of Sara in LA Story: “Let your thoughts go and your physique will comply with.” On a extra sensible degree, listed here are some tricks to maintain issues up:

  • Keep as relaxed as you’ll be able to throughout her fertile interval. Train extra, get good sleep, simplify your schedule, don’t journey. Breathe. Be within the second for her.
  • Reintroduce some romance to intercourse. Candles, satin sheets, oysters, silk PJs and jazz can work wonders.
  • Get some assist from fashionable drugs. Viagra and its compadres are protected and really efficient in getting and protecting issues operating onerous. Consider them as espresso for the penis.

In a phrase, the important thing to shedding stress is to let go. Heed the phrases of creator Bassam Tarazi: “The one factor that you just actually can management is learn how to react to issues which are out of your management.”

The submit Is Attempting to Conceive Giving You Efficiency Nervousness? appeared first on The Turek Clinic.

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The best way to Put together for a Vasectomy

Ice after a Vasectomy
Ice: on the brief listing of wants after vasectomy. Photograph credit score: Dirk Spijkers

The COVID pandemic has been very clarifying for you. You actually don’t need extra/any kids. She has “pulled the goalie” and it’s time so that you can step up and take management of issues. After a little bit of on-line analysis, you understand that your choices are fairly restricted: pulling out, abstinence, condoms…and vasectomy. Fortunately, vasectomy occurs to be the very best contraceptive ever, bar none. And with the snip, not like with some other male contraceptive, you don’t should do one thing to keep away from the specter of being pregnant each single time you will have intercourse.

Heat Up

So, the selection is evident and the appointment is made. Now, how do you prepare for a vasectomy? In all probability the very first thing is to get comfy with the concept that another person will likely be working down there for 5-10 minutes. And, you would possibly assume that there isn’t a extra delicate physique half than the household jewels. However, the truth is there may be.

Final yr, I noticed my dentist rather a lot. Whereas within the workplace, mouth huge open, enamel being poked and scraped, I spotted that the mouth is an especially delicate space too. However is it as delicate because the genitals? To search out out, I started to survey my vasectomy sufferers moments after ending their vasectomies by asking: “Be sincere, which is worse a vasectomy…or a dentist workplace go to?”  Unanimously, the dentist workplace go to was worse. And I don’t imply a tooth pull, root canal or cavity filling, only a easy dentist workplace go to. As well, a vasectomy is way shorter than a go to with the dentist. Good to know that my sufferers desire a vasectomy to a dentist workplace go to!

Getting into the Ring

Now that you just’re comfy dealing with your destiny, what else do you have to do in preparation for a vasectomy? Right here’s an inventory of issues to consider:

  • Cease aspirin or ibuprofen 7-10 days earlier than the process. These medication cut back platelet operate and hamper the flexibility to clot blood.
  • Put some frozen peas or combined greens within the freezer to be used for twenty-four hours after the process.
  • Don’t man shave beforehand. It’s safer if a restricted shave is finished simply previous to the process by the medical workers.
  • Put on free clothes for the process.
  • Plan for somebody to provide you a journey residence, particularly in the event you take a sedative tablet earlier than the process
  • Filter out your schedule of its ordinary “busyness” for a day or so after the process.
  • Ensure you get the contact data to have the ability to attain the physician’s workplace if that you must after the process.

Know too that after the occasion you’ll actually love the brand new you: “100% juice and no seeds.”

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