Birth control options for men and the ‘male contraceptive pill’

There are two types: male and female condoms. The male condom goes over the penis and the female condom goes inside the vagina.

It’s the male condom that gets most of the attention, as it’s easy to use, relatively inexpensive and up to 98% effective when used correctly. As a bonus, condoms can also protect you from some sexually transmitted infections.

Spermicide does what it says on the tin: it kills sperm. You can get it as a gel, cream, foam, suppository and even tablet, and it needs to be inserted into the vagina before sex to work. Spermicide is available at most drug stores and doesn’t require a prescription so it’s easy to get, but not the most effective type of birth control. It’s best used alongside a barrier method like a condom.

There’s also a vaginal pH regulator gel called Phexxi which is available in the US, but is looking to become a licensed treatment in Europe. Phexxi immobilizes sperm rather than killing it, but it’s prescription-only so a man isn’t able to purchase it.

The opposite of intercourse, outercourse is sexual activity that doesn’t include penetration. Though the term “penetrative sex” tends to be used for anal or vaginal penetration and doesn’t include oral, outercourse doesn’t include oral either — instead, it’s everything from kissing to cuddling to mutual masturbation.

The withdrawal method, also called the pull-out method or pulling out, is a birth control method where the penis is removed from the vagina prior to ejaculation. The idea is to have penetrative sex but keep sperm out of the vagina. It’s got a few obvious benefits: it’s free, doesn’t require supplies or a prescription and has no side effects.

The downside is it’s not particularly effective. Making sure you pull out at the right time is tricky, and pre-ejaculation fluid can also contain sperm. To make the withdrawal method safer, consider having emergency contraception available as a back-up and pair pulling out with a barrier method like condoms.

The most effective form of birth control is not having sex at all, though this isn’t exactly practical for most people. If you’re in a situation where you don’t have a condom and don’t want to forego sex entirely, sticking to activities like oral sex and avoiding penetrative sex will keep your risk of pregnancy low. However, this isn’t a great long-term solution and doesn’t protect you from STIs.

Also called the fertility awareness method (FAM) or the rhythm method, natural family planning involves monitoring a woman’s fertility throughout her cycle and scheduling sex for the days when she’s least likely to get pregnant. This might sound even riskier than pulling out, but natural family planning can actually be up to 99% effective when done consistently (and correctly).

There are three main FAMs — menstrual cycle length, daily body temperature readings and changes to cervical mucus — and someone can use one or all of these methods. The “up to 99% effective” figure requires using all three; if you only use one, the effectiveness drops to about 76-88% depending on the method you pick.

Because natural family planning is based around when ovulation happens, it’s not really a birth control method for men — but it’s always good to treat contraception as both partners’ responsibility.

The most effective male birth control is a procedure called the vasectomy. Also known as male sterilization, this birth control surgery is over 99% effective but takes time (around 3 months) and quite a bit of commitment. And although the vasectomy is often described as reversible, whether it actually is depends on several factors like how long ago you had the surgery.

Unlike the male birth control pills currently being researched (which limit sperm production) and spermicide (which kills sperm), a vasectomy keeps sperm from entering your semen. This is done by cutting or blocking the vas deferens, a tube in your scrotum that carries sperm up to the penis. The vas deferens is where the vasectomy gets its name.

Vasectomies are an outpatient procedure, meaning you don’t have to stay at the hospital overnight but rather just for the length of your appointment. The actual surgery takes less than 20 minutes.