The device must be worn 15 hours a day, 7 days a week, for male thermal contraception (MTC). During wear, the testicles should be above the thermal ring, in the inguinal pouch. It's during this warm-up phase that spermatogenesis will be put on hold if you apply the MTC protocol correctly.
CMT is a natural, local, non-hormonal method of male contraception with a long-term duration of 4 consecutive years in clinical trials. The maximum duration is four years, since reversibility, in terms of sperm parameters and fertility, has been demonstrated for this length of time. For longer periods, please consult your doctor. Whatever your contraceptive method, it's important to change it regularly. This is a safety measure based on the precautionary principle. In agreement with your doctor, there's nothing to stop you recovering normal spermatogenesis and resuming the method after a period of inactivity.
The protocol is designed to suit as many people as possible. You can adapt it to your lifestyle, as you will have regular follow-up spermograms.
So, once your adaptations are in place, follow the recommended rhythm of spermograms to check that your adaptations enable you to stay below the contraceptive threshold of 1 million/ml spermatozoa.
Establishing a daily and monthly routine is highly recommended for a safe and serene practice.
Here are the main points of the protocol that you can play with:
Daytime wear: Many boys wear the ring at night, and this works on an individual scale. Beware, however, of involuntary movements that may lead you to sleep on your stomach with your penis pressed against your belly. This position should be avoided to prevent the ring from compressing your penis without your realizing it. It's also important to check that you're comfortable with the way it goes up, and that the ring is well adapted to your morphology to avoid any slippage or risk of a testicle going back down without you realizing it. Wearing them at night takes a little practice, but it's easy to do.
15h/24 continuous: You can split this exposure time over 24 hours.
15 hours no more, no less: The protocol speaks of an average, fluctuating between 14 and 16h, rather than a fixed duration. It seems possible for some people to lower this time to 13h/24, but only if you check that this doesn't put you back above the contraceptive threshold.
If you are unable to elevate your testicles for the full 15 hours, there is an alternative called "spermapause." This involves wearing boxer shorts with a heating pad that warms to just over 37°C for 3 to 4 hours per day. This provides the required heat without needing to reposition the testicles.
Wearing the device for 24 hours a day does not provide additional contraceptive benefits. It will not accelerate reaching the contraceptive threshold, and the potential side effects of continuous wear are not well studied. Some volunteers have tested continuous wear for two years, as noted in Shafik A.'s study (1991).
Increasing the daily wearing time can, if you wish, enable you to achieve a sperm concentration of around 0, as with a vasectomy. It's not a necessity, but if you wish you can achieve near-zero concentration just by wearing it 16 to 17 hours a day.
Hybridize the use of different tools: ring, jockstrap, slip, DIY models, spermapause, yes, you can juggle from one tool to another .
4 years maximum: For lack of funding, no studies beyond that. But remember that for the past forty years or so, boys have been practising this method, outside clinical trials and over much longer periods, without the slightest problem being reported by the health monitoring system in place. Remember, too, that this method, curbed for socio-cultural reasons, would have been banned a long time ago if the slightest concern had arisen. These 4 years can therefore be exceeded. But keep in mind that a contraceptive journey needs to be rethought on a regular basis. A method that's right for you today may not be right for you in a few years' time. My advice: After 4 years, take at least a 6-month to 1-year break. This will give you time to reflect on your contraceptive journey, to let your function resume in a physiological way, and to explore other existing contraceptive alternatives.
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