Thoreme

male contraception thermal penile ring testicular verge testicles contraception for men andro-switch Labrit Maxime

how to better share the contraceptive burden

understanding male contraception

On this page you will find all the information about male contraception. 

Do you still have questions? Maxime Labrit answers them !

Free, no information required to connect! 

You can connect to the spermanence whenever you want between 7 and 8:30 pm every Tuesday to ask your questions, give your feelings or simply talk about contraception with the designer of the ring.

 

How likely is it to become pregnant despite correct use of contraception?

Test your current method, you'll be surprised...

CC-BY https://risquometre.fr, developed by Alan Charissou and Arnaud Zeler,

Male contraceptive methods

Methods you can use today :

Tomorrow's methods :

Contraceptive equity, a taboo subject.

In France, contraception in couples currently relies solely on women in 2/3 of cases (Le Guen et al 2017). Some women find it hard to cope with their contraceptive methods, others remark on the mental load concerning the lack of choice women have regarding contraception. It is high time this changed!

In 2022, it is still not officially possible for men to use the male thermal contraceptive method through testicular lifting, even though it is natural, safe, effective and reversible. However, both internationally and in France, a majority of men are ready to use a male contraceptive method (Heinemann et al. 2005).  

Methods exist and are reliable, but their distribution is limited for two major reasons:

  1. A general lack of knowledge
  2. Lack of training of the medical population involved in contraceptive prescribing (Mieusset et al. 2022 - Travers and Wanda 2022).
 

Male thermal contraception.

Since the 1990s, the thermal method has been available.

It is based on the temperature dependence of spermatogenesis. It has been clinically demonstrated that the thermal contraceptive method meets the criteria of official contraceptive methods: effectiveness, reversibility, absence of side effects and acceptability. Environmental, social and economic criteria are also important in the choice of contraceptive modalities. See the studies

Thermal male contraception is one of the accessible alternatives, so that men can shoulder their part of contraceptive responsibility in a shared and mutual way. This approach makes it possible to finally address these issues relating to sexuality, fatherhood and fertility.

State of affairs

In 2023, the safe, effective and reversible thermal contraception method is still not officially available.

1979

Creation of ARDECOM (association for the research and development of male contraception)

A group of libertarians set up ARDECOM, which for the next ten years attracted around 200 members to its men's discussion groups.

At the same time in Germany, the Zuricher Hodenbader collective was formed. They explored the same methods of contraception, one of which involved a heated chair:

@dermuger.blogspot 1980 Züricher Hodenbader collective

1985

Dr Roger Mieusset highlights the possibility of contraception by testicular ascent

As part of experiments carried out in conjunction with ARDECOM, Dr Roger Mieusset carried out a study highlighting the impact of testicular lift on male fertility.

A dozen trials were carried out, but the AIDS crisis and other factors put an end to the movement and research.

The wave of AIDS and other factors led to the disappearance of ARDECOM and the Zuricher Hodenbader collective.

2012 - Publication of the book "Contraception masculine" by two doctors to encourage the medical profession to practice the methods and offer them to their patients.

2015 - Ardecom is reformed, some actors like thomas boulou, spermapause appear :

[
@SpermaPause JEMAYA Innovations Thermal boxer shorts
 
2015 New Jock-strap from Thomas Bouloù
 

2017 - Maxime Labrit invents the Andro-Switch and the thoreme website to guarantee everyone comprehensive information and a device adapted to the practice. Tens of thousands of users start using testicular contraception in just a few years.

2021 December - The authorities suspend the sale and distribution of Andro-switch until it complies with European regulations. At the same time, they acknowledge the existence of these practices and their benefits in terms of public health.

2022 January

LSF artist supports free access to contraception

To show their support for the cause, LSF designs decorative objects: the REVERSIBLE TALISMANS.

2022 April

Creation of the Entrelac.coop cooperative

A small team decided to set up a cooperative bringing together all interested parties to support Andro-switch in its regulatory and marketing activities. This is the only way of guaranteeing a secure, non-discriminatory supply to all.

2022 May

Direct action by the Slowco movement to raise awareness during the ICMC congress

Petition: For contraceptive equity, now! Launched by the activist media Slowcontraception , over 20,000 signatories, SIGN HERE

2022 September 

Entrelac calls for members. 250 people responded, including many doctors

Join the members' team on their website: ENTRELAC.COOP

Libération launched its petition and gathered 30,000 signatories.

2023 March

Entrelac wins the $300,000 Male Contraceptive Initiative MCI Award 2023.

2023 June

Entrelac wins first prize for its practical guide to male thermal contraception, and Thoreme takes second prize for its DIY Andro-swatch applied design research in the International Innovation Prize of the UNESCO Chair in Sexual and Reproductive Health.

@androswatch 4 CC-BY-NC-SA 2023
 

2023 September

Internationalization of research. One trial is nearing completion at the CHU de St Pierre in Brussels, involving around 100 volunteers. Another is starting at the HUG in Geneva on 35 volunteers.

@HUG Study on the experience of people using a thermal testicular contraceptive device 2023
 

2023 October 

Installation of the Thoreme micro-industry low-tech module for the manufacture of future certified Andro-switches.

2024 Spring

Pre-clinical testing of Andro-switch followed by launch of safety trial.

2024 Winter

Numerous publications in international scientific literature are produced.

2026

Launch of multicenter trial on andro-switch.

2028

Submission of the certification file to the certification body for CE certification within the year.

Practice tools :

@Alter-Echos-male contraception
@Alter Echos

The "Mieusset" briefs or The Toulouse ball lifter (RCT in French)

Designed by Dr. Roger Mieusset of the Toulouse University hospital, these adapted briefs enable testicular lifting.

male contraception thermal testicular penis ring testicles contraception for men andro slip up ball jockstrap

The Andro-Switch ring

The lightest device for male contraception is no longer available for sale pending CE certification.

Support the project by discovering the artist LSF’s reversible talismans!

male contraception thermal testicular penis ring testicles male contraception andro ring

The Andro-Swatch bracelet

Entirely open source and licensed under Creative Commons, the adjustable do-it-yourself tool is the ultimate applied design research project.

The spermapause or "heated boxer".

As an alternative, if testicular lifting is not an option, these boxer shorts are equipped with a heating element that warms up the testes locally.

male contraception thermal testicular penis ring testicles contraception for men andro slip up ball jockstrap

DIY testicular jockstraps

A variation on the contraceptive slip, the jockstrap is comfortable and easy to make yourself or order.

male contraception thermal testicular penis ring testicles contraception for men andro slip up ball jockstrap

Contraceptive process

In a nutshell:

Check list:

  1. Make an appointment with your GP for the consultation: the interview takes place in 3 stages (data collection - palpation of the testicles - prescription for the spermogram). To help you, this site is also designed for professionals (protocols - practical guide - consent form). If he refuses, that's his prerogative, but use harm reduction medicine and ask to be referred to a professional who can help you. If this is not the case, contact family planning for support.
  2. Contact the laboratory near you. A map is available in the footer. Schedule your spermograms every three months as far ahead as their schedule allows.
  3. Choose the jockstrap you wish to wear. Test it to be sure you understand the movements of the lift and that the model is suitable. Test it on a few activities of daily life. Do not wear it regularly before the first spermogram.
  4. Plan how you're going to organize your average 15 hours a day. Imagine your day as a 24-hour block. Wearing time should be between 14h and 16h over 24 hours. Day, night, split, continuous, it doesn't matter. The important thing is to find your own rituals that suit you. Of course, there's only one validated wearing protocol, but that doesn't mean that others aren't possible, just that it would be too costly to try out all the possibilities.
 
Post it:
  • People with testicles are currently under-medicalized and people with ovaries over-medicalized in the field of sexual and reproductive health. Use this soft medical follow-up to do some screening and ask for a complete health check-up. This will enable you to do a little screening.
  • Spermograms are reimbursed by social security in France. They can also be done over the counter for around 30 euros in France. To date, there is no self-test for thermal monitoring. In the resources section, you'll find a link to sperm@home. Developed with the help of doctors, it enables you to make your own laboratory for independent monitoring. It does not replace laboratory monitoring.
  • To date, no testicular lift device has been CE marked. This doesn't mean that they aren't effective or safe. It simply means that there has been a lack of interest in developing and offering methods for boys for 40 years. Steps are underway with Andro-switch, which is supported by Entrelac, and will be the first officially recognized and available device by 2028. In the meantime, it's up to each and every one of us to take our responsibilities and get involved in practice to continue to justify the collective interest in wanting more methods for people with testicles.
  • The thermal method is based on what no other method has. 40 years of practice, tens of thousands of users, and dozens of medical theses and clinical trials, each more reassuring and promising than the last.
  • Remember that you are free to do what you want with your body, it's one of the last real freedoms, and access to contraception and sexual and reproductive health is a fundamental right!

Aids :

Your attending physician

Family Planning - CeGIDD - CPEF

The thoreme team

Spermanence every Tuesday night

User committees

Social networks

 
  1. If you are eligible for the method, you can start.
  2. During a good week, wear your device progressively, to reach 15 hours per day. If a discomfort appears remove your device, and put it back a little later. Massage your pubic area to relax the pubic pouch, cream yourself with liniment oleo-calcaire between two ports. Go slowly, it can take a little time to get used to this new ritual.
  3. Then start your 15 hours every day. Until you have a follow-up spermogram in 3 months, you are not on birth control. So use another method in parallel.
  4. Refine your ritual, during the launch until it becomes a habit like wearing a pair of glasses.
  5. It's okay if you wear your device more than 15 hours a day, and you forgot it. It is better to wear it too much than not enough.
 

Need to go faster?

You can schedule a spermogram at two months. Chances are you're already contracepted. To do this, increase the number of ejaculations to one every two days, as recommended post-vasectomy.

 

Tips :
  1. You can wear the device day or night, continuously or fractionally, it doesn't matter. The important thing is that you find the rituals that suit you.
  2. On the take-off phase, try to wear the 15h device, which is the median between 14h and 16h. This will determine your thermosensitivity over a period of two to three months.
  3. You can hybridize the tools. For example, the ring in the morning, the jock strap in the afternoon. The important thing is to have your testicles up by 15h.
 

Aids :

Your attending physician

Family Planning - CeGIDD - CPEF

The thoreme team

Spermanence every Tuesday night

User committees

The entire ring community

The contraceptive threshold :

Since 2007, it has been defined by a concentration of less than 1 million ml for all mobilities combined. Below this level, you are considered to be contracepted.

 

Contraceptive threshold not met:

  • If you have not reached the threshold, check that your tool is suitable, increase the exposure time a little, and check with the team or a health professional to adjust your practice. We are not all thermo-sensitive in the same way, for some people 15 hours is enough, for others 17 hours is necessary. Schedule a spermogram in 30 days once the adjustments have been made, and continue to use another method of contraception.
  • You can play on the choice of the tool, the wearing time, the distribution over the 24 hours.
  • It's still very rare, but for some people this method just doesn't work. Body heat isn't enough, a recurring discomfort doesn't stop, and so on. In this case, turn to another method and contact the thoreme team.
 
Contraceptive threshold reached :
  • Upon confirmation from the spermogram that you are below the contraceptive threshold of 1 million-ml sperm, you can, if you and your partner wish, use only this method.
  • Continue wearing your device as usual.
  • Have a control spermogram every 3 months.
  • Keep a "sperm jocker" for the day when you have doubts. Sometimes, even with rigorous practice, there is a doubt about the effectiveness. Keep the possibility to check at any time if you are below 1 million-ml.
  • 4 consecutive years maximum: Simply because we have no scientific trial of more than 4 consecutive years. This does not mean that it does not work afterwards or that it is risky. It's just that scientifically we don't know.
 

Protocols if you forget to wear your ring:

Don't forget to wear your device. Exposure to body heat must be daily. But mistakes are human, so here are a few unofficial recommendations based on the experience of several thousand users over 5 years.

- 1 full day of non-wear per month: Acceptable, and let your partner know.

- 2 consecutive or non-consecutive full days per month: Notify your partner, schedule a spermogram in 30 days' time and use a second method of contraception until you receive the results. If you are below 1 million-ml, you can go back to using only the ring as a method of contraception. If you are above 1 million-ml, continue to double your contraception and schedule a spermogram in one month.

- 3 or more consecutive or non-consecutive days per month, consider that you're starting the protocol all over again. Schedule a spermogram in two to three months, and use a second contraceptive method until your sperm concentration drops below the contraceptive threshold.

 

Post it:

  • 4 consecutive years, then take a break of 3 to 6 months and start again if you wish. Take the time to ask yourself questions at this point, is this method still suitable for me, what about my desire for parenthood, what does my partner want? Whatever the method, varying and changing regularly is a guarantee of effectiveness and risk reduction in the long term.
  • It is possible if you wish to stop sperm production. To do this, wear your device one or two hours longer each day to go below the contraceptive threshold of the vasectomy, which is 100,000 spermatozoa all immobile.
  • You can hybridize the tools, from the jock strap, to the andro-switch etc., the tools are complementary. What's important is daily, optimal exposure of the testicles to body temperature.
  • If you forget to pump your testicles for more than a day, use another method for 30 days and schedule a spermogram at the end of the 30 days.
  • If an unplanned pregnancy occurs : The method has many advantages and also its risks. Heat acts at different levels of spermatogenesis, but there's one that doesn't interest us. This is the alteration of the genetic capital, reversible of course when stopped. These alterations are similar and common to therapies such as chemotherapy or acne treatment. Here's what an embryologist, member of the Centre de Référence sur les Agents Tératogènes (Crat) and of the Académie Nationale de Médecine, recommends to consider this risk proportionately:
 
 

"In reading the elements described on spermatic DNA in the context of testicular hyperthermia, the possible risk in case of fertilization with an aneuploid gamete is that of finding this aneuploidy in the product of conception. However, this is a very theoretical risk since the possibilities of development of eggs carrying chromosomal missegregations are very limited. This has not been described for example in other situations where aneuploidies are possible in spermatozoa (paternal chemotherapy). A priori, in this context, if fertilization takes place during the period when sperm chromosomal changes are most marked, there is no reason to propose termination of pregnancy because the risks are very limited. It is only necessary to consider a prenatal diagnosis specifically designed to detect chromosomal abnormalities in numbers (blood marker assays coupled with an early ultrasound at 12 SA), or even an INFP if the result is positive or doubtful."

 
 

Aids :

Your attending physician

Family Planning - CeGIDD - CPEF

The thoreme team

Spermanence every Tuesday night

User committees

The entire ring community

 

Whatever your reason for stopping, do not consider a pregnancy right away.

  • As explained above, the risk due to the teratogenic effect of the method is not zero, but must be taken into account.
  • Use an effective method of contraception when you stop for a few months.
  • So let your body get rid of the altered sperm. This usually takes 3 months, and up to 6 months. Assume that when your sperm count comes back within the WHO standards, you can consider that the poor quality sperm is gone. 
  • Once your spermogram is done and back to normal you can consider a baby project.
 
Reassuring data on the relationship between heat and testicular cancer:
The group of doctors who are members of the Entrelac.coop cooperative will soon be publishing the conclusions of their research on this subject:

2022 - Is there evidence of a link between exposure of pubertal testes to supra-scrotal temperatures equivalent to body heat and the risk of testicular cancer? A narrative review.

 

"Studies on the pathogenesis of testicular cancer do not identify heat exposure as a risk factor. Prospective studies observing the effect of testicular heat show no increase in testicular cancer."

 

Aids :

Your attending physician

Family Planning - CeGIDD - CPEF

The thoreme team

Spermanence every Tuesday night

User committees

The entire ring community

associations and representatives on the ground

Family Planning, associations and groups offer the public a range of tools for finding out about male contraception about male contraception: experience-sharing, discussion groups, group consultations, workshops, networking.

ENSC

The ENSC Association aims to facilitate the creation of user committees throughout Europe, and to train professionals.

Join us on the Mind Your Sperm Tour!
A unique adventure that sails the canals and rivers of Europe to promote the sharing of contraception.

Cartography

Find in the footer of thoreme.com all the maps to find professionals to accompany you in your steps: doctors, advisor, spermogram...

ARDECOM

Since the 70s, the Association pour la Recherche et le DEveloppement de la COntraception Masculine has been campaigning against patriarchal injunctions and supporting the emergence of male contraception.

Find a self-fabrication workshop near you by contacting them.

Movement supported by :

For doctors

Why accompany?

Risk reduction

The doctor does not prescribe the ring or other devices.

It must provide information on all existing methods, including those currently under development.

If the person freely chooses to use this method, he or she must be informed that it is not yet recognized, and that safety and performance cannot be guaranteed to be equivalent to a certified method.

The conscience clause allows him to refuse to treat a patient, but obliges him to refer the patient to a colleague.

Pre-contraceptive consultation and the prescription of spermograms are part of her role.

At certification

The Andro-swtich ring is currently undergoing certification. Safety testing begins in 2024, with certification scheduled for 2028.

After 40 years of stalemate with pharmaceutical companies unwilling to develop these methods, Entrelac.coop has successfully taken the regulatory steps needed to provide a medico-legal framework for these devices.

A mutual consent form, a doc'éthique and the Hyppocratic oath are available if you wish.

"I will respect all people, their autonomy and their will, without any discrimination according to their condition or beliefs."

Un doute sur le protocole ou l’accompagnement à réaliser ?

Pour bénéficier d’un accompagnement entre professionnels par un des médecins du groupe de travail “Contraception Masculine” du CMG, 

écrivez à [email protected] (sans données identifiantes du patient car adresse non sécurisée).

A 3-step pre-contraceptive consultation:

Anamnesis:

Testicular descent anomalies (cryptorchidism, ectopia), treated or untreated; 

Testicular cancer; 

Inguinal hernia treated with mesh to prevent ascension;

Testicular torsion treated by fixation of the testicle in the scrotum, preventing ascent;

Altered sensitivity of the pubic area, groin, penis or scrotum;

Reduced hand strength; 

Presence of severe obesity: Body Mass Index (BMI) ≥ 30 kg/m2;

Testicular palpation:

Presence of a grade 3 varicocele to be treated before starting;

Edema of the penis;

Intra-scrotal lump;

Large hydrocele;

Cutaneous filariasis, Elephantiasis;

Local skin infections of the penis, scrotum, groin and pubic area; Contact dermatitis of the penis, scrotum, groin and pubic area to be treated before starting;

Assess initial fertility :

Prescription of a simple spermogram which must be within the WHO standards of 2021:

Concentration > 16 million-ml

Total count > 39 million-ml

Gradual mobility (A+B) > 32%.

Normal head shape > 4% (Krüger) or 23% (modified David)

If this is not the case, reschedule a spermogram at 3 months by modifying lifestyle habits (sleep, stress, diet, sport).

3 key values

1 million-ml :

Concentration below which the risk of pregnancy is greatly reduced.

The contraceptive threshold was defined in 2007:

10 th Summit Meeting Consensus: Recommendations for Regulatory Approval for Hormonal Male Contraception

Journal of Andrology, Vol. 28, No. 3, May/June 2007
Copyright E American Society of Andrology

15h :

This is the median time between 14 and 16 hours of device use, to ensure that the majority of people reach the contraceptive threshold.

Depending on your individual heat tolerance, you may need to increase the daily wearing time if necessary.

Protocol applicable for 4 consecutive years, renewable after a break of 3 to 6 months.

3 months :

This is the length of the spermatogenesis cycle. Once contraception has been established, checks are carried out every three months.

For the start-up phase, we recommend an initial check-up at two months, with an increase in ejaculations to one every two days. Then one month later, if the contraceptive threshold has not been reached, modify the wearing time and the tool as required.

Around 3% of people are thermo-resistant. If after 6 months of use the threshold has not been reached, suggest other methods of contraception.

Efficacy: 99.5% - Complete reversibility in 3 to 6 months

Clinical trials

15 tests from 1985 to 2019 :

On cohorts of 10 to 30 volunteers, one over 4 consecutive years.

Followed by over 122 volunteers between 1985 and 2019 for up to 48 months.

Of the 122 volunteers, only one pregnancy was reported due to misuse of the method.

1 unplanned pregnancy out of 1331 exposure cycles.

Excellent reversibility in all tests.

 

Medical theses
Some thirty over the last 5 years.
From 1979 to 2022, work shows increasing acceptability.

 

Side effects & benefits

Data extracted from a retrospective cohort of over 900 users who had been in practice for more than 6 consecutive months.

2023 Guidarelli Cross-sectional study on testicular ascent contraception methods: safety, acceptability, effectiveness

Reassuring recommendations on grey areas:

Risk of malformation in pregnancy

2022 - Member of the Centre de Référence sur les Agents Tératogènes (Crat) and of the Académie Nationale de Médecine

"The risk is highly theoretical, since the development possibilities for eggs carrying chromosomal missegregations are very limited.

There is no need to propose termination of pregnancy, as the risks are very limited. The only thing to consider is prenatal diagnosis specifically designed to detect chromosomal number anomalies (blood marker assays coupled with an early ultrasound scan at 12 weeks' gestation), or even PND if the result is positive or doubtful."

Risk of testicular cancer

2022 - Entrelac.coop medical task force

Is there evidence of a link between exposure of pubertal testes to supra-scrotal temperatures equivalent to body heat and the risk of testicular cancer? A narrative review.

"Studies on the pathogenesis of testicular cancer do not identify heat exposure as a risk factor. Prospective studies observing the effect of testicular heat show no increase in testicular cancer."

Protocols if you forget to wear your ring

Don't forget to wear your device. Exposure to body heat must be daily. But mistakes are human, so here are a few unofficial recommendations based on the experience of several thousand users over 5 years.

- 1 full day of non-wear per month: Acceptable, and let your partner know.

- 2 consecutive or non-consecutive full days per month: Notify your partner, schedule a spermogram in 30 days' time and use a second method of contraception until you receive the results. If you are below 1 million-ml, you can go back to using only the ring as a method of contraception. If you are above 1 million-ml, continue to double your contraception and schedule a spermogram in one month.

- 3 or more consecutive or non-consecutive days per month, consider that you're starting the protocol all over again. Schedule a spermogram in two to three months, and use a second contraceptive method until your sperm concentration drops below the contraceptive threshold.

Training in testicular contraception

 

L’offre de formation sur la contraception masculine s’est étoffée ces dernières années :

Elle fait désormais partie des orientations nationales prioritaires de DPC 2023-2025 (fiche n°18) de l’ANDPC

Ressourcerie

Scientific publications on male contraception

  • Clinical trials of the thermal method
  • Theses and articles on acceptability

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