Contraception
There are many different contraceptive methods available, but here we are focusing on options available to trans men who want to prevent pregnancy.
When it comes to choosing what forms of contraception is right for you, your personal circumstances, current drug regimens and health conditions will be taken into account.
Contraception is recommend for trans men who have frontal sex, have not had a hysterectomy and do not want to become pregnant.
Being on testosterone isn't a guaranteed contraceptive, and you may still become pregnant even without regular periods. This is also the case if you are receiving gonadotrophin releasing hormone (GnRH) analogues, often called hormone blockers.
In the sections below you will find some information about things to consider when it comes to contraception:
Certain contraceptives can safely be used alongside testosterone to prevent pregnancy. These include birth control pills, the implant, condoms, coils, injections, and the IUD.
Some contraceptives work by using hormones called oestrogen and progestogen.
However, many trans men use progesterone-only birth control as oestrogen-can counteract the effectiveness of testosterone therapy.
- Progestogen only contraception can also have the additional benefit of reducing and potentially stopping periods.
- Combination hormonal contraceptives (pills, patches or the ring) which contain both estrogen and progestogen are not recommended as estrogen could counteract the effects of testosterone on the body.18
If you would prefer a non-hormonal option, the copper coil, diaphragm, or condoms can be used.
The copper coil can have side effects such as heavy periods, if you still have them. It needs to be replaced only every 10 years, so is a very long acting contraceptive, but has to be inserted via your front hole.
The diaphragm is a circular dome made of thin, soft silicone that's inserted into your front hole before sex. It works by preventing sperm reaching your uterus. You only have to use a diaphragm or cap when you have sex, but you must leave it in for at least 6 hours after the last time you had sex.
Used properly, condoms can protect you from STIs as well as pregnancy.
No matter your circumstances, you can discuss your contraceptive options with a sexual health specialist and ensure you get the right contraceptive to fit your circumstances.
If you have had unprotected frontal sex or your contraception has been compromised (e.g. split condom) you are entitled to access Emergency Contraception.
You can use emergency contraception without it interfering with the effectiveness of testosterone and vice versa.
The most effective form of emergency contraception is the IUD or coil. The coil, which can come as a copper coil or a coil that releases progestogen, can be fitted by a GP or a sexual health clinic up to 5 days after you’ve had unprotected sex.
If you decide to take emergency contraception in the form of the contraceptive pill, it’s important to remember that this doesn’t provide contraceptive cover for future unprotected frontal sex until the course of treatment in finished.
There are two types of pill that act as emergency contraception:
- EllaOne (progestogen) – can be taken up to 5 days after unprotected sex and is as effective on day 5 as it is on day 1. You can get this pill from most pharmacies, as well as through your GP or a sexual health clinic.
- Levonelle (combination of progestogen and estrogen) – can be taken up to 3 days after having unprotected sex, but is more effective the sooner it is taken. This can also be given by a pharmacist, your GP or at a sexual health clinic.
