Testicular elevation

Lifting the testicles means moving them from the scrotum up inside the body, to the base of the penis, and keeping them there for a good part of the day. Every form of thermal contraception comes down to this. Nothing heats up: in that spot, the testicles are simply at body temperature, and body temperature is enough to slow down sperm production².

The ring, the jockstrap, the so-called “heated” briefs: they’re all just ways of holding that position. None of them does the contraceptive work. What counts is keeping the testicles up, and a semen analysis is what tells you whether it worked.

Before you start, see a doctor and get a first semen analysis, which has to come back normal¹. Then lift your testicles 15 hours a day, every day¹. It takes several months for fertility to drop below the contraceptive threshold, under 1 million sperm per milliliter of semen: 3.5 months on average in the first study, which counted motile sperm². Until a semen analysis confirms you’re below that threshold, you need another method of contraception. Once you’re there, the two of you decide whether to keep combining methods.

🍒 What goes up, and where?

Quick anatomy lesson?

The testicles live in the scrotum, outside the body, where it’s cooler. But that’s not where they started! Before birth, they were inside, and they came down through a passage on each side of the pubic area: the inguinal canal. That passage doesn’t close up. You can feel it with your fingers, just above the base of the penis, on either side.

Lifting sends the testicles back up the way they came. They settle at the base of the penis, near the opening of the inguinal canal, which is exactly the position the team at Toulouse University Hospital studied¹. After that, a light press on your pubic area is enough to check that they’re really up there.

Your body already makes this move on its own when it’s cold. The method just holds it there, hour after hour.

🌶️ Why are one or two degrees enough?

The testicles make sperm at 2 to 4°C below body temperature³. Lifted inside the body, they warm up by 1 to 2°C².

One or two degrees, that’s it? For sperm production, yes, that’s a lot: the cells that are meant to become sperm can’t handle that temperature, and production drops³. And since it takes about 74 days to make a sperm cell³, you don’t see the effect right away. It takes several months for the sperm already on their way to clear out, and for the next ones to have developed at body temperature.

How it works in detail, the history of the method since the 1930s, and what the studies show: it’s all on the thermal contraception page.

🩲 What holds the testicles up?

Three kinds of tools, all doing the same thing:

• briefs with a hole, the Toulouse design: the penis and the skin of the scrotum go through the hole, and elastic straps hold the rest in place¹
• the jockstrap, sewn by hand, with an adjustable fabric ring, which you can learn to make at sewing workshops⁹
• the silicone ring, snug at the base of the penis, behind the skin of the scrotum

The right tool? At the risk of stating the obvious: the one that fits you. It stays in place all day without squeezing, and you won’t find it on a size chart: you have to try it on. That’s what the trial kit is for, with its twelve sizes, made available after the information session⁹.

None of these tools affects fertility on its own, and no clinical trial has studied the silicone ring⁵. Our rings are prototypes cast in platinum-cure silicone: they have no CE marking and no marketing authorization, and neither their contraceptive properties nor their safety have been demonstrated.

🔥 What about “heated briefs”?

Articles on the subject, especially in French, often call the Toulouse briefs or the jockstrap “heated briefs” (slip chauffant). The name is misleading: they don’t heat any more than the ring does. Body heat, at 37°C (98.6°F), is enough.

Some devices really do heat, above body temperature. That’s a different method, with different questions, and this page doesn’t cover it.

⏱️ How many hours a day?

15 hours a day, every day, during waking hours¹. In practice, the people we support lift their testicles when they get up and let them back down when they go to bed. Taking breaks during the day is something the community does, and no study has measured it.

Skip a single day and the effect is no longer guaranteed¹, because fertility can climb back up in the weeks that follow. After a break of more than 24 hours, start the protocol over, with another method of contraception alongside it, and wait at least a month before your next semen analysis.

Fifteen hours a day can sound scary at first. With practice, it becomes as automatic as putting on your socks in the morning. In the TESTIS survey, 86% of people who had been using the method for more than six months said they were satisfied⁷. That figure is bound to be optimistic: it leaves out everyone who stopped earlier. Across studies, about a quarter of people drop out⁶.

Would you rather talk it through than read? An information session: one hour on a video call with Sam, on your own or as a couple, pay what you can.

🧪 How do you know the method is working?

Not by counting days. By getting a semen analysis.

The reference guide sets the contraceptive threshold at under 1 million motile sperm per milliliter, seen on two semen analyses three weeks apart¹. With the Toulouse briefs, people got there in 3.5 months on average². Some get there faster, some never do: in the most recent follow-up, 81.8% of the people analyzed reached it⁵.

Until a semen analysis shows a concentration below the threshold, another method of contraception is required. After that, the two of you decide whether to wait for a second test, and whether to keep combining methods. Below the threshold, the risk drops but doesn’t hit zero: a low concentration doesn’t mean sterile⁸. From then on, one check a month until month six, then one every two months¹.

Where to get one, what it costs, how to read the results: it’s all on the semen analysis page.

🩺 What about the risks?

Before you start, see a doctor to rule out contraindications. With no studies to go on, the guide advises against the method if you have or have had a testicle that didn’t descend in childhood, an inguinal hernia, testicular cancer, a grade 3 varicocele, or severe obesity¹. Then get a baseline semen analysis, which has to come back normal¹: it’s the one you’ll compare every later result to.

Side effects mostly affect the skin: irritation in 27 to 53% of people, depending on the study⁶. A few isolated, more serious cases have been reported, including penile vein thrombosis⁶. At 15 hours a day, there’s no major change in testosterone, and testicular volume drops by less than 20%, then comes back within a year of stopping⁴.

After you stop, your baseline values come back within 6 to 9 months according to the guide¹, and within 12 to 18 months in the founding study². You need another method of contraception from the day you stop¹. The guide limits use to four years, the length of time over which reversibility has been observed¹. And in the most recent follow-up, 13.6% of the people analyzed were still below normal values more than three months after stopping, with no follow-up after that⁵: no one can claim that reversibility is 100%.

With no large trials yet, the European and American andrology societies have recommended since 2024 not to use heat as contraception for now, while acknowledging the pregnancies avoided in the Toulouse studies⁸. The results are encouraging, but they still need more research behind them.

🚪 What now?

One hour on a video call with Sam, on your own or as a couple, pay what you can⁹. Lifting the testicles, the protocol, semen analyses, finding your ring size, questions as a couple, and the ones this page didn’t ask.

Book an information session

Want to try rings on for real, or sew your own jockstrap? Workshops in Paris (in French). To find a healthcare professional or a lab that knows the method (mostly in France), see the map.

Sources