For years, the burden of birth control has largely fallen on women. The “Why Not Him?” series is here to shift that conversation—bringing a more balanced, medically informed perspective to couples making decisions about long-term and permanent contraception.
I’m Dr. Matthew Zerden, and my perspective is shaped by training and experience on both sides of this discussion. I earned my MD from Harvard Medical School and a Master’s degree from the Harvard T.H. Chan School of Public Health. I completed my OB-GYN residency and subspecialty training in Complex Family Planning at the University of North Carolina at Chapel Hill, where my research focused on IUDs, contraceptive implants, long-acting reversible contraception (LARC), and female surgical sterilization.
Here’s me with my daughter (now graduating high school) at my Harvard graduation (with a lot more hair than I have now).
Today, I’m a high-volume, minimally invasive vasectomy provider, performing hundreds of procedures each year.
This series brings that full perspective together—helping couples move beyond that default assumption and ask a simple, important question:
If the goal is effective, long-term birth control… why not him?
This is the first in our “Why Not Him?” series—focused on rebalancing the conversation around contraception and helping couples make informed, shared decisions.
When couples reach the point where their family feels complete, the conversation about birth control often defaults to options for women—like an IUD. But there’s a bigger, more important question that deserves attention:
That means I’ve seen this decision from both sides—and I can tell you:
For many couples, the better answer is often overlooked.
A Unique Perspective on Both Sides of the Decision
I bring a perspective that’s uncommon in this space. I’m a board-certified OB-GYN with subspecialty training in complex family planning and a background in research on female surgical sterilization and LARC methods (IUDs & Implants). I’ve spent years counseling women on contraception—including IUDs and tubal procedures.
Today, I also perform hundreds of vasectomies each year at His Choice Durham Chapel Hill and Raleigh locations.
Understanding the Options
IUD (Intrauterine Device)
An IUD is a small device placed inside the uterus. Depending on the type, it can last 3 to 10 years and is a highly effective, reversible form of birth control.
Vasectomy
A vasectomy is a permanent birth control procedure for men that prevents sperm from being part of semen. It’s done in-office with local anesthesia using a minimally invasive approach.
Both are excellent options—but they serve different goals.
Effectiveness: Slight Edge to Vasectomy
- IUDs: Over 99% effective
- Vasectomy: Even more reliable, with failure rates around 0.15%
For couples who are truly done having children, vasectomy is one of the most effective forms of birth control available—period.
Invasiveness and Risk
This is where the difference becomes much clearer.
- IUD placement: Requires insertion through the cervix into the uterus
- Vasectomy: A small, in-office procedure using local anesthesia
It’s a simpler path to the same outcome.
Side Effects vs. Simplicity
With IUDs, some women experience:
- Cramping
- Irregular bleeding
- Hormonal side effects (for hormonal IUDs)
A vasectomy, on the other hand:
- Does not affect hormones or testosterone
- Does not impact sexual performance
- Typically involves mild soreness for a few days
- Is permanent
For many couples, it’s the more straightforward solution.
I often hear from men that their partners have been dealing with side effects for years. Now that they are done expanding their family, it is time for the man to Step Up!
The Real Question for Couples
If:
- You’re done having kids
- You want the most reliable long-term solution
- You want to minimize the medical burden on your female partner
Then the conversation should shift from:
“Which birth control should she use?”
to:
“Why not him?”
A Better Way Forward
At His Choice Durham Chapel Hill, we’ve designed the vasectomy experience to be:
- Efficient (single-visit for most patients)
- Minimally invasive (no-needle, no-scalpel technique)
- Transparent (clear pricing, no surprises)
We see patients from across North Carolina and beyond who are ready to take this step—and often say the same thing afterward:
“That was much easier than we expected.”
Learn More
Learn more about our vasectomy.
See common concerns answered: Vasectomy FAQs
This is just the beginning of the “Why Not Him?” series.
Because when it comes to birth control, shared responsibility isn’t just fair—
it’s often the better medical decision.
