1
|
Perrin J, Joubert S, Tcherdukian J, Mieusset R. P-014 Thermal Male Contraception: A Study Of Users’ Motivation, Experience And Satisfaction. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
What are the motivations, experience, and acceptability of thermal male contraception (TMC) in men using TMC as the only couple contraceptive ?
Summary answer
Men wished to share the role of providing contraception in a couple and to avoid the use of hormones. Sexual satisfaction was significantly improved.
What is known already
Two male contraceptive methods inducing spermatogenesis suppression have achieved contraceptive efficacy, on a large population for hormonal contraception and a smaller one for thermal contraception (TC). The suppression of sperm counts to below 1 million/mL results in fertility rates commensurate with female pills. TC is obtained by wearing 15 hours/day a contraceptive underwear (CU) inducing a 2°C increase in testicular temperature (Mieusset & Bujan 1994). As no commercially available male thermal contraceptive exists, little information regarding the acceptability of this approach to men has been reported and only one publication analysed the hypothetical acceptability of TMC (Amouroux et al. 2018).
Study design, size, duration
We contacted 72 men who had started the CU testing phase between June 2011 and September 2019. The participants completed an anonymous online survey of 93 questions exploring population characteristics, contraceptive histories, motivations for choosing TC, patient experience at the successive phases of use, relations with partner and environment, and satisfaction with TC. Sexual life was evaluated by rating (1 to 4): frequency and pleasure of sexual intercourse, sexual desire, morning and intercourse erections.
Participants/materials, setting, methods
Among men who had reached the contraception use phase, the quality ratings of sexual life were compared over time, from the contraceptive method used before TC (“N-1” method) to the 2 previous methods (“N-2” and “N-3”)): “N-3” versus “contraception use phase”, “N-3” versus “CU testing phase,” and “CU testing phase” versus “contraception use phase.” These comparisons were made for all 5 sexual life parameters by a paired samples Wilcoxon signed rank test.
Main results and the role of chance
Sixty-seven men responded (93% response rate);63 participated in the survey (94% participation rate). The median age was 31 [21-52], 30 men (48%) had a Master’s degree or more, 49 (78%) had no child and 24 (38%) no parental project. Among the men whose couple's contraception method immediately before TC (N-1) was a female method (n = 36/63, 57%), the 2 main reasons for switching to a male method were the wish to share the role of providing contraception in a couple (n = 31/36, 86%) and the willingness to take responsibility for contraception (n = 21/36, 58%). The main motivations for choosing TC were “not using hormones” (n = 59/63, 94%) and using a method regarded as “natural” (n = 49/63, 78%). Most of men (68%) adopted the method in less than 2 weeks. During the contraception use phase (n = 59 men), they described: i) significantly improved sexual satisfaction (3,49±0,29/4) compared to that experienced with previous contraceptive methods (3,27±0,58/4;p<0,01); ii) high female partner confidence (100% rather/totally confident partner) and support (88% rather/totally supporting partner); iii) improved self-esteem (n = 35/59, 59%). The main negative point was discomfort, reported by 24% of the men.
The overall satisfaction score of using TC was 3.78±0.46/4, and 100% would recommend TC to other men.
Limitations, reasons for caution
The study population may seem small (63 men). However, it is not different from that of the previously pubished studies on men using hormonal contraception, which included 20, 38, 79 and 57 men, respectively. Our study also lacked a similar questionnaire for the female partners.
Wider implications of the findings
Men using TC successfully assumed the responsibility for and performed a daily task to provide couple contraception. This positive evaluation of TC together with its previously published contraceptive efficacy and reversibility on a small population, should encourage the development of this method.
Trial registration number
IRB No. 2020-09-10-005
Collapse
Affiliation(s)
- J Perrin
- Ap-hm Aix Marseille University, CECOS Centre clinicobiologique d'AMP CHU La Conception / IMBE, Marseille Cedex 5 , France
| | - S Joubert
- Departement of General Medicine, Faculty of Medicine Jacques-Lisfranc- Saint-Etienne CHU-,42270 Saint-Priest-en-Jarez- , France
| | - J Tcherdukian
- Aix-Marseille University, University Department of General Medicine- Faculty of Medicine of Marseille , Marseille, France
| | - R Mieusset
- INSERM Montpellier-Toulouse, Développement Embryonnaire- Fertilité et Environnement DEFE , Toulouse, France
| |
Collapse
|
2
|
Perrin J, Tcherdukian J, Netter A, Lechevalier E, Bretelle F, Mieusset R. P–047 Knowledge, professional attitudes and training of health professionals on male contraceptive methods. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Among health professionals involved in contraceptive prescribing, what are the knowledge, professional attitudes and training on male contraceptive methods?
Summary answer
The health professionals involved in prescribing contraception are not sufficiently trained in male contraception and almost all of them want more.
What is known already
The most recent large-scale studies show that 70% of couple contraception is provided by women and that the majority of men and women would be willing to adopt male contraception as couple contraception. The medicalization of contraception places the medical profession at the forefront of the acceptability of and information regarding a contraceptive method. However, only one study have evaluated health professionals’ knowledge of the various methods of male contraception (MC), including male hormonal contraception (MHC) and male thermal contraception (MTC).
Study design, size, duration
Between April 2020 and June 2020, we carried out a descriptive prospective multicentre study in a medical population of 2243 prescribers of couple contraception in France.
Participants/materials, setting, methods
The participants were obstetrician-gynaecologists, medical gynaecologists, general practitioners or midwives. They completed a three-part numerical questionnaire, including i) sociodemographic characteristics and personal experiences with contraception, ii) knowledge and professional attitudes about male contraception and iii) training on male contraception.
Main results and the role of chance
The overall participation rate was 19% (340/2243). Condoms and withdrawal were known by 98% and 89% of the population, respectively. Vasectomy was known by 75% of the population and significantly better known by obstetrician-gynaecologists than by medical gynaecologists and general practitioners (p = 0.026). Male hormonal contraception (MHC) and male thermal contraception (MTC) were known by 10% and 23% of the population, respectively, and were significantly better known by medical gynaecologists and general practitioners than by other specialties (p < 0.001). More than half (55%) of the population never or infrequently offered MC during a couple’s contraceptive request consultation. Female practitioners offered MC significantly more often than male practitioners (48% vs. 26%; p = 0.033). Only 14% of the population had ever participated in training on MC, 96% wished to be better trained on MC, and 86% expressed a willingness to participate in such a training.
Limitations, reasons for caution
The population was mainly representative of medical health practitioners of southeastern France. There was an over-representation of women in all medical specialties, except for midwives.
Wider implications of the findings: Our study shows that health professionals involved in contraception have limited knowledge about MC and are eager to have more information about it. To advance the acceptability and dissemination of such contraceptive methods, it seems imperative to provide health professionals with an adapted training program on male contraception.
Trial registration number
2020–01–23–03
Collapse
Affiliation(s)
- J Perrin
- Ap-hm, CECOS Centre clinicobiologique d’AMP CHU La Conception, Marseille Cedex 5, France
| | - J Tcherdukian
- Aix Marseille University, University Department of General Medicine, Marseille, France
| | - A Netter
- AP-HM, Department of Gynaecology and Obstetrics- Gynépole- AP-HM La Conception University Hospital, Marseille, France
| | - E Lechevalier
- AP-HM, Urology Department- La Conception University Hospital, Marseille, France
| | - F Bretelle
- AP-HM, Department of Gynaecology and Obstetrics- Gynépole- La Conception University Hospital, Marseille, France
| | - R Mieusset
- University Toulouse III-Paul Sabatier, Human Fertility Research Group- Andrology-Reproductive Medicine- Paule de Viguier Hospital- CHU de Toulouse, Toulouse, France
| |
Collapse
|