I Made My Own Birth Control By Pushing My Balls Into My Body

Dec 02, 2023

A version of this article originally appeared on VICE Belgium.

Male contraception is one of those medical products that always seems on the verge of being put on the market, but never quite gets there. Although scientists have been working on it for as long as female contraception, we are still far from a reality where those in possession of a penis can share the psychological and financial burden of birth control, as well as the health consequences.

“The short answer as to why there isn't a male contraceptive yet is priority,” explains John Reynolds-Wright, clinical lecturer in sexual reproductive health at the University of Edinburgh and researcher at the MRT Center for Reproductive Health. “Women are the ones who get pregnant, so being able to prioritise them has always been important.”

Multiple studies have shown that cis men would like to share birth control responsibilities with their partners. But creating an effective and reversible contraceptive for them is technically more complicated, since you’d would have to stop the production of millions of sperm cells every hour, instead of one egg a month.

Many drug trials have also reportedly been halted at early stages of clinical testing because the side effects were considered too risky for men, even though they’re generally accepted in contraceptives for women. Some believe this to be evidence of medical sexism – while women have to accept that their contraception may entail serious health consequences, men get to walk away at the earliest sign of risk.

Reynolds-Wright thinks things are more complicated. “I don’t think it is accurate to say that men’s experiences are the sole reason drugs have not been successful,” he says. Research ethics committees are generally more risk-averse when it comes to male contraceptives, especially because cis men don’t technically “need” them, since they can’t get pregnant. Still, participants in clinical trials have often wanted to continue with the testing, even after the experiment was shut down due to its side effects. Research is often complex and expensive, meaning that pharmaceutical companies also aren’t particularly incentivised to invest in these drugs.

Nevertheless, studies on male contraception have delivered some important results. We now know that you need to have a sperm count below 1 million per millilitre to be considered infertile (normally, it’s between 15 and 200 million). The studies also developed and popularised the foremost male contraceptive method besides condoms: the vasectomy.

The latest wave of studies, the one Reynolds-Wright is working on, looks at a hormonal gel that has made it to Phase IIB of testing, the furthest of any male contraceptives before it. If this phase is successful, there is still one more step – Phase III, where the drug is tested on a very wide sample of people. If that’s cleared too, the product should be available to consumers.

But in the past 70-odd years, some research teams have also looked into unconventional ways to bring the sperm count down. A few years ago, I was talking to a friend of mine who decided to write her Master’s thesis on male contraception. While reading her work, I was surprised to discover some French research teams previously looked into a potentially hormone-free alternative to block sperm production.

Heat-based contraception, also known as the thermal method, involves raising the temperature of testicles from their usual 34-35 degrees up to a toasty 36-37 degrees. One way to achieve that is by pushing them back into the inguinal canal and keeping them there for several hours a day. The team from the Toulouse University Hospital also developed a device to do just that – the hilariously named but absolutely real “Toulouse ball lifter”.

The ball lifter is a pretty simple tool: a tight pair of underwear with a hole at crotch height. You slide your penis and scrotum through it, so that your balls are pushed back into your body, where they need to stay for 15 hours a day. At that temperature, their ability to produce sperm is inhibited, and after three months – the length of a full sperm regeneration cycle – your sperm count should fall below what is considered fertile. Illustrator Guillaume Lion made a full comic explaining this principle in detail.

From the comic "Tiny Lil’ Balls" by Guillaume Lion, published in Médor. Courtesy of the author, editing by VICE.

Last summer, I stumbled across these ideas again when I met Samuel Flambard at the feminist festival Queen Classic in Biarritz, France. Dressed in Thai boxing shorts and a sequinned jacket, Flambard told me about Otoko Contraception, his workshops aimed at helping people DIY their own thermal contraception device, something similar to the Toulouse ball lifter. “It takes 30 minutes, it’s free, it’s fun and you can wear it for years,” said Flambard, who was about to organise one of these workshops in the middle of the city’s promenade.

During Flambard’s workshops, participants can make a contraceptive ring that was also prototyped by the Toulouse University Hospital as an alternative to their ball lifter. In initial experiments, the ring was made out of rubber and held in place through the use of straps. In Flabard’s version, it’s made out of silicone and it stays in place by itself.

Just like the ball lifter, the ring separates the scrotum from the testicles, which are lifted up into the pubis. Since the method is purely physical, Flambard said there are no real complications.

Some of the contraceptive rings made during Flambard's workshop.

The ring has to be worn for 15 hours a day, preferably when awake, so it can be moved back in place if it moves or causes discomfort. It has to be washed regularly with soap and water and fitted to your individual anatomy. If you want to reverse the effects, you can stop wearing it and your sperm will bounce back after four to six months.

According to Flambard, the ring is not as cumbersome as it looks. “After a few days, you won’t feel it anymore,” he told me. He also claimed the method has a Pearl index rating – the number of pregnancies that occur in 100 people using it over one year – of 0.5, making it as reliable as the pill and IUDs.

Reynolds-Wright said that generally, the science behind the contraceptive seems correct, although he cannot comment on any specifics since he hasn’t personally researched this topic – except for this last part concerning its reliability. “I can't see that in the literature,” Reynolds-Wright cautions. Some studies found this method safe and effective, but their sample size was usually very small. That doesn’t mean the ring is unsafe – we just don’t have enough information about it to be sure.

Reynolds-Wright says that medical practitioners and potential users in France seem to have high hopes for the method. Recently, another study on mice in China also found that raising testicle temperature returned promising results. But overall, he believes other methods have probably received more funding because they seemed like a safer gamble. “I would love more research in thermal contraceptive methods,” Reynolds-Wright adds, “but it has to be of a high quality standard.”

The fact that clinical research is still incomplete hasn’t stopped people from using it, though. According to GARCON, an NGO promoting male contraceptive research in France, between 5,000 and 10,000 people are using thermal contraception in the country. As far as Flambard knows, the people he’s personally followed up with also haven’t encountered any problems.

He does recommend that anyone interested check their sperm count throughout the process – before starting with the contraceptive, three months in and then every one or two months just to be sure. If you forget to use the ring for more than 24 hours, you should start from scratch, as 24 hours is enough to reach above a million in sperm cell count.

Flambard at the workshop in Brussels.

Ever since the launch of the project in 2021, Flambard’s workshops have been running almost weekly in different cities in France and Belgium. The project is mostly self-financed, although he does ask for voluntary donations at the end of a session.

Since I’ve recently started dating someone, I decided to attend one of the workshops in Brussels, at the anarchist bookshop Le Zotte Morgen. My partner came with me, and I noticed a few other couples among the 15-odd participants.

Some of the people there were already on this contraceptive, either using one of Flambard’s rings or another model made by a company called Andro-Switch. This small business used to sell the product online, but was suspended for not complying with European health and safety standards. They now sell silicon decorative objects, or “reversible talismans” as they call them, in a familiar ring-like shape.

Some of the materials used at the workshop.

At the top of the workshop, Flambard introduced the idea behind heat-based contraception and answered questions from participants, some of whom also their own experiences with it.

After the discussions, Flambard passed around 30 colourful rings of different sizes and invited us to try them on, the bookshop’s toilets and the back of the store serving as impromptu changing rooms. Then Flambard brought out a suitcase full of small bottles of silicon, machines, moulds, clamps, syringes, coloured dyes and glitter. “You have to wear it all day, it might as well make it look nice,” Flambard added cheekily.

For the next half hour, we played chemist, injecting various silicone mixtures into moulds. Each participant could make one, two, even three perfectly fitting rings. We then waited about an hour for the silicone to set. As night drew in behind the curtains of the shop, the moment to de-mould them had arrived, and I was pleasantly surprised by the result.

Participants injecting their moulds.

I’ve now been wearing the ring for about two months and I can say I’m pretty happy with it. I do a lot of intense sports, including Muay Thai and surfing, and I was a little concerned about whether the ring would stay in place or become uncomfortable. So far, though, I haven’t experienced any major problems. Soon I’ll be able to check if my sperm count is safe and if I can rely solely on this method for contraception.

Only time will tell if the ring will really work for my partner and I. As my partner rightly pointed out, even getting to experience this as a form of novelty is still a form of privilege on my part. Others must bear the burden of contraception by default, to the vast indifference of everyone else, and it’s understandably often a point of contention between partners – all of which means I’m stoked to finally share responsibility for birth control in this relationship. Watch this space.

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