Use & Notes

No method is 100% efficient.

Boys and girls using contraception together are protecting Life.

Girls will continue using it. So-called male contraception 

isn’t about taking something away from them. It’s about learning what bearing life entails. 

 

 

Seek guidance for your contraceptive journey

 

 

The first placement needs to be done with your general practitioner. A pre-contraceptive visit paired with a seminogram are absolutely necessary before you start applying the testicular thermal contraception protocol.

 

I am available for informative consultations during your practice. If you are facing any difficulties, you can easily reach me or seek medical advice. Remember that there is no obligation to get contracepted with the ring. This is your engagement and yours only – for yourself and your relationship, in partnership with your general practitioner. Birth control is an effort that requires you to shoulder great responsibilities. Keep in mind that the risk at stake is that of an unwanted pregnancy that you will not be the one carrying in your body. I encourage you to rigorously apply the protocol and to CAREFULLY READ the documents provided before you start practising.  

 

All explanatory videos are to be found under the TUTORIALS tab.

 

What is contraceptive consent?   Just like with sexual consent, no one can force you to use birth control. Contraceptive choice should be intimate. It should be a free and informed decision for yourself and/or a decision shared with someone you trust, with your partner(s), in order to be able to have intimate relationships freed from the act of procreation. Birth control may, however, entail high risks if it involves intimidation, coercion or even violence. If you are not prepared to take on a contraceptive practice or are unable to consent to it, there is an increased risk of not following the method rigorously, which implies a high risk of unwanted pregnancy.   The cup of tea analogy is pretty striking, here is an excerpt: “If you offer a cup of tea to someone who’s not sure they’d like to have it, you may not decide for them or force them to drink it. Just because you made them this cup of tea does not mean you are entitled to watch them drink it.” I invite you to watch the video and read this article from madmoiZell.

Finding a doctor to guide you

 

First of all, keep in mind that doctors have a code of ethics according to which their freedom of conscience may not be questioned. This is actually one of the levers that made it possible for abortion to be legalised in France. According to article L2212-8 of the Public Health Code, “no doctor may be required to perform an abortion”, just like “no midwife, nurse or medical assistant of any kind may be required to participate” in this medical act.

In short, they cannot be made to assist you in your thermal contraception journey either. What you can do is tell them about the annual DPC (Continuing Education) training on male contraception for medical staff organized by the SALF (French-speaking Andrology Society) and, of course, find another GP that is willing to guide you through this.

In view of the medical protocol, it is not necessary to see an andrologist, gynaecologist or urologist if you do not suffer from any associated pathologies that would require a specialist’s opinion.

Here is the process to find the right medical course of action:

1. Make an appointment with your general practitioner. Bring the protocol included in the Andro-switch Pack as well as the thermal ring or the testicle-lifting device you intend on using. Simply explain your decision. Usually, they should agree to assist you. If they refuse or ask you to see a specialist, whatever the reasons, proceed as follows.
2. Get in touch with your nearest Family Planning Centre and ask if they can see you for your first consultation and/or refer you to another general practitioner.
3. Contact one of the doctors mentioned on this participatory list or on the map of practitioners trained in and/or educated about natural contraception methods, on Sabrina Debusquat’s page, "J'arrête la pilule" (Quitting the pill).
4. Reach out to me (contact@thoreme.org) or ARDECOM.

 

Simplicity and ease: wearing the thermal ring on a daily basis

 

• To put the thermal ring on and take it off, you do not need to touch the testes directly. When you slide it on, they will naturally move upwards for lack of space. When you slide it off, they will naturally go back down from the inguinal sac to the scrotum.

 

• Andro-switch can be placed and removed in any position.

 

• You do not need to shave or wax your pubic hair to wear it. Its internal release surface and the qualities of the silicon we use are specifically designed to adapt to you.

 

• You do not need to use a lubricant for placement and removal or while wearing the ring.

 

• The thermal ring can be covered with standard underwear. You can urinate, have sexual intercourse, get erections and go about your daily and professional business just like you normally would.

 

• One of the major assets of the testicular thermal method and the regular seminogram checks it implies is that men and couples can easily make sure the protocol is efficient and correctly applied.

Side effects of the testicular thermal contraception method DOES NOT CAUSE   Acne / detectable gynecomastia Mood swings (aggressiveness / depression / asthenia) Excessive libido Weight gain Change in lipids or hematocrit Hypertension Aphtosis Acute prostatitis

 

 

How long to you need to keep the contraceptive ring on?

 

 

To practice male thermal contraception (MTC), the device must be worn 15 hours a day, 7 days a week. The testes must be resting above the thermal ring, in the inguinal sac, while you are wearing it. During this heating phase and if you correctly apply the MTC protocol, spermatogenesis will enter into standby.

 

MTC is a so-called male contraception method that is natural, local, non-hormonal et long-lasting (up to 4 years according to clinical trials). The method can be used for up to four years maximum, as the reversibility in terms of sperm parameters and fertility has only been acknowledged for this period of time. If you want to remain contracepted after that, please see your doctor. Whatever the contraceptive method, it is important to regularly change them. This is a security measure taken out of precaution. With your doctor’s approval, you might want to go back to your normal spermatogenesis cycles and start using the method again after a period without it.

The protocol is designed to fit as many profiles as possible. It adapts to your lifestyle since you are regularly doing check seminograms. 

Once it fits into your routine, follow the advised seminogram rate to ensure your particular adjustments still allow you to stay below the contraceptive threshold of 1 million spermatozoa/ml. 

 

Here are the parameters of the protocol you can adjust to your situation or preferences:

 

Day use: Lots of boys wear the ring at night, which is an individual preference. Please beware of involuntary movements that can cause you to sleep on your stomach with your penis squeezed against it. This position must be avoided to prevent the ring from compressing your penis without you even noticing it. You must also make sure you are comfortable with your testicles being lifted and that the ring fits your morphology to keep it from sliding off and keep your testicles from moving back down without you noticing it. Night use does take some getting used to but it works perfectly fine.

 

15 hours out of 24 in one go: You can split and spread your wearing time as you wish within the 24 hours.

 

15 hours, no more, no less: The protocol uses an average time ranging from 14 to 16 hours rather than a fixed duration. Some may be able to reduce this length of time to 13 hours out of 24, but if you wish to do so, you will first need to make sure it does not make your sperm count surpass the contraceptive threshold.

 

10 hours one day, 20 hours the next day to compensate: No, that doesn’t work. The time you lost on a given day cannot be made up for. You must be very rigorous when it comes to daily exposure periods.

 

For several reasons, I cannot lift my testicles up 15 hours a day for a few days: There is an alternative to testicle-lifting called SpermaPause. These boxer shorts come with a heating pad that brings the temperature just above 37°C. No need to lift the testicles up with this method, as the heat comes directly to them. Exposure time is lower as well, from 3 to 5 hours out of 24.

 

24/7 exposure: Irrelevant from a contraceptive perspective. This will not make you reach the contraceptive threshold quicker but won’t increase the risk of developing side effects either. It has actually been tested by some volunteers over a two-year period with a stitch in the vas deferens. See this study for reference:

Shafik A. Testicle suspension as a method of male contraception: technique and results. Adv Contr Deliv Syst. 1991;VII:269–79.

 

Increasing daily use can, if you so wish, enable you to reach a sperm count as low as 0, just like vasectomy would. However, this is not necessary. But if you wear the ring just 16 to 17 hours a day, you can reach a concentration that is close to zero. 

 

Mingling different tools: The ring, the jockstrap, the briefs, the DIY models, the SpermaPause – yes, you can juggle tools.

 

Up to 4 years: No studies have been conducted beyond that for lack of funding. But keep in mind that boys have been using this method outside of clinical trials for about forty years and during much longer periods of time without any problems being pointed out by health monitoring services. Also remember that this method has been held back for sociocultural reasons but that it would have been banned altogether long ago if any flaws had been found. You can go beyond 4 years. But a contraceptive journey is meant to evolve continuously. A method that fits your needs today may not suit you in a few years’ time. My advice: After you’ve completed 4 years on the method, allow yourself a 6-month to 1-year break. This time off enables you to reflect on your contraceptive journey, to let your physiological functions get back to normal and to explore existing alternatives.

 

How to deal with a feeling of discomfort when first using the ring?

 

The upward position of the testicles is a very natural one. Remember, it probably already happened to you when wearing snug-fitting rompers for instance. Lacking space, the testicles migrate towards the inguinal sac at the root of the penis. You are familiar with the feeling. No worries, it is painless but can be surprising when you feel it for the first time. This is the exact position where the testes need to be maintained for the protocol to be efficient. The qualities of the silicone, the shape of the thermal ring and the structure of its internal side create a push-up effect that maintains the testes upward so that they cannot go back down into the scrotum.

 

When you first start wearing the contraceptive ring for several hours a day, you may feel some discomfort.

When the testes are in the scrotum, the vas deferens are twisted like spaghetti. But when the testicles are maintained in this upward position, i.e. above the scrotum, the  vas deferensloosen up a bit, which can sometimes cause uncomfortable feelings of heat in the testes at first.

This is completely benign and normal. Just take the ring off for a few minutes, then put it back on. Testicle lifting should be painless. If it is not the case for you, stop and seek medical advice. We are all different and the physical features of your pelvis, the shape and size of your scrotum and of your inguinal sac may be incompatible with testicle lifting.

 

If you are using the method for the first time, remember that it is advised to start wearing the ring as follows:

Day 1 and 2: 2 hours out of 24
Day 3 and 4: 4 hours out of 24
Day 5 and 6: 10 hours out of 24
Day 7 and onwards: 15 hours out of 24

 

A few pieces of advice:

Lightly shearing your hair in the area may help with maintenance and avoid hair pulling.

When you urinate, make sure the ring is still in place and don’t hesitate to adjust its position if necessary.

The ring must not slide down and the testes must remain above the ring. When you receive your ring, try it on and e-mail me if you feel like the model is not right for you. Do not wait for the 15-day return period to be over. You will quickly notice if the model is not right for you.

Just like with a new pair of shoes, it may take a few days before it feels natural and comfortable to wear. Here is a small trick if you feel like your ring is still a bit too rigid or not stretchy enough: you can machine wash it at 90°C. Use caution though, since the process is still pretty experimental.

First-use irritations: Not everyone will have rashes or irritations but if you experience them, here is what you should do. Between two wearing sessions, apply a natural moisturising lotion such as oleo-calcareous liniment. Wash yourself and the ring daily: there’s no need to overdo it but hygiene is an important part of the method.  

 

“Oleo-calcareous liniment or liniment lotion is a blend of equal parts olive oil and limewater. Historically used to treat burns, it is also used for babys’ hygienic care, and the staff at Cochin Hospital in Paris even considered using it for the care of premature infants. It is particularly adapted to allergic children and helps prevent nappy rashes (red bottom). Liniment is a yellow-ish or white-ish oily emulsion that separates into two phases between uses. It needs to be shaken before use.” Excerpt from Wikipedia. Natural, suitable, affordable and easily available: I encourage you to try it out.

 

First trial & fittings

You can just lightly shear you hair with scissors as in a brush cut, but no shaving – this helps with the gripping effect.

Keep in mind that there are two positions:

1. The resting position, in which you only slide the penis and scrotum (the part just below the penis) through the ring. This is perfect at night or when you're not moving around too much.
2. The second position, when you are active, in which you also need to place the groin skin inside the ring. In this position, you need to secure this portion of skin with the inguinal canals inside the ring on both sides. I explain this very clearly in the placement and removal protocol.

Too large or too small?

A ring is considered too large when despite those moves, it doesn't stay in place and a testicle slides back down below the ring. As long as they are above or at the same level as the ring, the testicles are exposed to the heat of the body.

A ring is considered too small when it marks your skin just like a tight sock would mark your calf skin, and also when erections don't subside by themselves. This means your penis remains filled with blood due to excess compression. In this case, take the ring off.

Fitting:

Whether too large or too small, email me the following information at customer.service@thoreme.org:

1. Ring too large or too small?
2. Erect width:
3. Resting width:
4. Order number:
5. Confirmed delivery address:

I'll get everything you need for your fittings ready. Upon reception, you have 7 days to do them and call me if needed. When you know for sure which model fits you best, email me to let me know and organize the return.

Perspectives once fitted: 

• Some guys like to keep two different sizes, one tighter and one looser to be used for various daily activities.
• As an alternative, you can try a hybrid between different thermal-method tools. Contact me to discuss this option if needed.
• Another alternative would be to try a hybrid between different natural methods (symptothermal method, diaphragm, thermal method...). Contact me to discuss this option if needed.
• When going for this practice, you have two main goals: one is about mastering the technical aspects of testicle lifting, and the other is about the need to have a contraception method. You can achieve both at the same time, but you can also dissociate them. Contact me to discuss this if needed.

Wearing a contraceptive ring: basic precautions

 

 

You will need to check that the testes are in the inguinal sac with a light palpation. In other words, they need to be resting above the thermal ring, at the root of the penis, otherwise you will not reach the contraceptive threshold of 1 million spermatozoa/ml (OMS 2010).

It may be useful to always carry 2 thermal rings or another testicle-lifting device with you, in case you lose one for instance.

The thermal ring must be washed before and after use during sexual intercourse with soap and lukewarm water to limit STI-transmission risks.

 

 

Side effects of testicle lifting

 

Identified side effect reversible within 2 to 3 spermatogenesis cycles: reversible testicular volume reduction by 10 to 15% or 2 to 3 grams per testis.

 

You will still be able to have erections and orgasms while wearing the ring and practising MTC, just like before.

 

The amount of sperm you will ejaculate will stay the same, but it will contain no or a few spermatozoa (contraceptive threshold: spermcount < 1 million/ml OMS 2010). No change in sperm appearance was reported.

 

If you feel pain or experience any other adverse effect while wearing the thermal ring: Stop wearing it immediately. Try again a few hours later. If pain persists, ask your general practitioner or pharmacist for an opinion.

 

Potential adverse effects of thermal contraception

 

Identified adverse effects reversible within 2 to 3 spermatogenesis cycles: Reversible alteration of the chromatin’s integrity & reversible alteration of the number of chromosomes.

 

Self-andrology: rediscovering your own body

 

Observing their own bodies is not common practice among boys even though their genitals are external and thus easier to feel, see and touch. But it’s what it takes to have a better understanding of your body. It also helps prevent underlying conditions upstream by seeking medical advice if you observe anything unusual.

Remember that regular STI screenings are necessary for you and your partners.

Once a month, you can follow these simple instructions to quickly check in with yourself:

• Self-palpation, caress, discovering this part of your body: take some time to explore your body, its layers, the density of the organs you’re touching, the mobility and elasticity of each part.
• Self-palpation of the testes: this is the easiest method to identify any changes and detect testicular cancer at an early stage.
• Self-exam of the penis: Is there any redness or rash on the glans? Any tingling or itching in the genital area?
• Self-exam of erections and orgasms: this is very personal, but given your habits, do you notice any significant changes?
• Self-exam of the urogenital system: do I have trouble urinating? Is it painful? Do I need to urinate very frequently? Do I feel like I can never really empty my bladder?  What does my urine look like, is it clear, yellow, does it have residue? Are there any clear vesicles on the area?

This is non-exhaustive list.

If you’d like to dig deeper, do read the following documents included in the  Andro-switch Pack: "ANDRO-SWITCH & MTC infography"  and "A practical guide to hormonal and heat-based male contraception techniques (R. Mieusset & JC. Soufir)"

If you can't find the answer to your question, e-mail our Customer Service at customer.service@thoreme.org or get in touch with ARDECOM.

Click here to access the complete Andro-switch user manual.

Download the Andro-switch Pack (PDF version) for free.