There was hope around ten years ago that a temporary form of vasectomy might be developed using a clip.¹ This procedure was associated with high failure rates and stopped. Another method of temporary vasectomy used a rod, and this got to the development stage only.²
So Guys essentially have a choice of Vasectomy or Condoms.
Some couples chose vasectomy as their first line preferred contraception.
Others get to vasectomy by default because of exhausting the other options. The following table gives an overview of female contraceptive options & failure rates³. Rather than being an exhaustive list of every possible benefit or risk, it’s a balanced overview of the most common issues affecting couples.
|Main Benefits||Main Risks||Practicalities|
|Combined Pill||Low Failure Rate, can reduce period bleeding, can have cycles back-to-back. Often Beneficial for conditions like acne or hirsutism.||Deep Vein Thrombosis & Cardiovascular Risk Factors to evaluate include Body mass index, Smoking, Migraine with aura, Family history, increasing age, high BP, Cholesterol, Diabetes, kidney disease etc.||Can forget to take the pill.|
|Progestogen Only Pill||Used as a 2nd line oral contraceptive when the combined pill is not recommended. No increased cardiovascular or thrombotic risks.||Australian licensed mini pills need to be taken in a 3 hour window each day.||The minipill is unforgiving when forgotten – failure rates are high.|
|Progestogen Injection||No increased cardiovascular or thrombotic risks. Periods often disappear completely within 12 months.||Progestogenic side effects are usually manageable but women may sometimes report weight gain, mood or changes. Periods often erratic to start with.||3 monthly visits to your doctor & practice nurse to get the injection. Need a pregnancy test if late for your next injection.|
|Progestogen Implant (rod)||Periods often disappear completely within 12 months.||Persistent bleeding beyond 6 months in around 15% of women may require the implant to be removed.||3 yearly implant in the inner side of the left upper arm.|
|Intrauterine Device – Mirena||Periods usually disappear completely within 12 months – often good for heavy or painful periods.||Risk of uterine perforation is around 1 in 1000. Rarely infection or migration of the device.||5 yearly re-insertion. Few GPs currently provide this service & most women need a referral to a gynaecologist.|
|Local Methods||Caps, Diaphgragm & Vaginal Ring.||no systemic risks. Higher rate of failure than many other methods of contraception.||Suits only a few women and couples – comes down to personal preference & guidance on use from a health practitioner.|
|Female Sterilisation||Low failure rate at around 1 in 200||Small risk from a General Anaesthetic & Infection.||Day Case in a hospital.|
|Vasectomy||The lowest failure rate at around 1 in 2000 after the all-clear. Hormone-Free. Men can step up.||Post vasectomy pain affects around 1 in 50 guys.||The most important thing is to continue contraception until you get the all-clear after the semen analysis.|