A Testicle Bath: Let's Talk Male Contraception

Image Credit: Wuz on Unsplash

Andrea Beyer and Miranda Bauer sit down with UCD students to discuss COSO, a new ultrasound-based and hormone-free male contraceptive

Male contraception is long overdue in reproductive health. Women are pushed to take responsibility for safe sex and contraception, with biology as the scapegoat for why male contraception is essentially unattainable. Currently, the only options for male contraception on the market are condoms or a vasectomy. We can all agree that condoms, although excellent, have their apparent faults; a high rate of failure due to sizing issues that most people are unaware of (consider girth rather than length when evaluating what size you may need). There have also been complaints about the sensation and the experience not being as enthralling as having skin-to-skin sexual intercourse. COSO, a new ultrasound-based and hormone-free male contraceptive developed by German researcher Rebecca Weiss, could be the market's next best contraceptive. Dr Weiss was eager to develop safe male contraception after being diagnosed with cancer precursor cervix as a side effect of the contraceptive pill. After receiving her diagnosis, her partner stepped up to share the contraceptive responsibility. However, they discovered limited options were available.


Regarding vasectomies, they are a type of permanent male contraception that involves cutting or blocking the tubes that carry sperm from the testicles to the urethra. While vasectomies are highly effective at preventing pregnancy, they don't come without risks and drawbacks. Infection, bleeding, and chronic pain in the testicles are all potential risks of vasectomy. Furthermore, while vasectomies are generally reversible, the success rate of the reversal procedure varies and is not guaranteed. 


The Irish government recently made contraception free for young women aged 17 to 26. This includes all medications and devices used to prevent pregnancy and GP consultations regarding contraception. However, if you are on the latter, you will not be eligible for free condoms, a vasectomy, or a free consultation concerning your contraceptive options. A vasectomy in Ireland costs "from as little as €450", as advertised by Primary Care Solutions. Although the government's recent effort to provide free contraception to women is welcome, we can't help but notice that it seems counterintuitive, as it requires females to take responsibility for protective sex. In an interview with Thomas West (he/him), a final-year History and Politics student, he revealed the relief he feels when a sexual partner uses birth control: "I would never ask a partner to go on birth control, but if they do happen to be on birth control, then that is something that I don't have to worry about."

“If it works out and is rolled out to be a wise and safe contraception, all you are doing is putting your balls in a bath; it is not too much to ask for."

COSO was designed by men for men, with 422 participants between the ages of 20 and 30 providing their input for the design. The result is a small portable bath-shaped device. The product works on a user-friendly level, and the usage method consists of only three steps. The user must fill the device with water up to the level mark. The water is then heated, and the testicles are submerged in the bath. The last step takes several minutes and can be controlled via an app. After enough time has passed, the device switches off automatically. Therefore, the contraceptive provides a non-invasive approach. In a conversation with Joseph Dillon (he/him), a final-year Economics and Politics student, he discussed his opinion that men frequently get away without taking responsibility for safe intercourse: "I am definitely of the mind that as men, we get off scot-free with not having to do much compared to what women have to do with birth control; women put their bodies through hell to have safe sex without having kids. If it works out and is rolled out to be a wise and safe contraception, all you are doing is putting your balls in a bath; it is not too much to ask for."

The contraceptive consists of two parts: the top, which looks like a bowl/mini-bath and is where the testicles are to be submerged, and the base, which contains the technical parts that work on sterilising the user's male gametes. COSO makes this possible by transforming the warm water bath into a bath of ultrasonic waves. The waves are absorbed by tissue, which increases the testicles' temperature. This increase in temperature prevents germ cells from developing haploid spermatozoa, which means that sperm regeneration is halted for six months starting from the moment of usage.

"For a lot of female contraception, there are a lot of hormonal consequences; if this method does not affect hormones whatsoever, then there should be no reason to be sceptical about it."

The device offers several benefits, including a lack of side effects and sustainability, as it is reusable and does not require a prescription. Although there are still no human trials, the device has been tested on animals and proven highly successful. Dr.Weiss wishes to proceed with human testing in a clinical setting as soon as it is safe. 


A significant question stemming from this new contraceptive is whether this technique of contraception is overall superior to those now in use. To try to answer this question, COSO can be compared to our beloved contraceptive pill. The main difference between these methods is that the pill is a hormonal contraceptive, and COSO works with ultrasonic waves. COSO is less invasive than the pill since it must be used only once every six months to prevent pregnancies. In contrast, the pill must be taken daily for at least 21 days. When we sat down with final-year Classics, English and History student Josh Fortune (he/him), he expressed his support for COSO, "For a lot of female contraception, there are a lot of hormonal consequences; if this method does not affect hormones whatsoever, then there should be no reason to be skeptical about it." 


Anybody can use COSO, whereas the pill has usage limits, including if the user is pregnant, a smoker over 35, or using a particular medication. COSO has not yet exhibited any side effects in contrast to the pill, which can cause mood swings, nausea, breast soreness, headaches, and, in more extreme cases, cervical cancer and blood clots. Moreover, adverse effects from missing a pill might include vomiting and diarrhea. Óg (they/them), a final-year Classics, English, and History student, mentioned how COSO would help destigmatize the shame associated with females having sex and the responsability they bear. "It helps address the idea of the culture of shame addressing women's bodies, for example, having to go to get the morning-after pill where you have to sit down in this private room with a GP or pharmacist having to talk about everything you did the night before, men don't have that experience."  

We are excited to see how COSO develops over the next few years and hope to see its successful market launch, which will allow for an increase in contraceptive methods available to men worldwide. COSO has the potential to revolutionise our approach to contraception, aiming to offer safer alternatives free from hormonal interventions. By doing so, it aims to change the conversation around contraception, moving away from viewing it solely as a woman's issue but rather as a shared responsibility.