Permanent birth control isn’t a decision that only affects cisgender women. It is equally a concern for cisgender men, transgender and gender-expansive people and intersex people.
For people with testicles, a vasectomy is the most effective male contraceptive or permanent birth control option outside of abstinence (not having sexual intercourse). During a vasectomy, each vas deferens (the two tubes that move sperm) are cut or sealed off. This blocks sperm from reaching the semen and ejaculating from the penis.
“Vasectomies are highly successful and have the lowest failure rates of any other form of contraception,” said Curtis Crylen, MD, a urologist with Banner Health. “Generally, the failure rate of a vasectomy (still having live sperm present in the semen fluid greater than six months after the procedure or having a pregnancy after a vasectomy) is less than 0.5%.”
Although vasectomies are safe and very successful for preventing pregnancy, there is still some fear and misconceptions surrounding them. Could getting the “snip” affect your sex drive or ability to perform? Will it increase your risk of prostate cancer or erectile dysfunction?
Dr. Crylen helped cut through (no pun intended) some of the myths so you can move forward with your family-planning needs without fear.
Myth 1: Vasectomies can cause erectile dysfunction and affect sexual performance.
Yes, the testicles produce testosterone, but this production is not altered with a vasectomy.
“Erectile dysfunction and sexual performance are affected by testosterone levels, nerve input and blood flow to the penis, none of which are altered with a vasectomy procedure,” Dr. Crylen said. “The testicles involve only a small amount of the seminal fluid (about 5%). Most semen fluid comes from the prostate and the seminal vesicles, which are not affected by a vasectomy.”
Sex drive (AKA your libido) is primarily related to testosterone secretion and testosterone levels. These are not affected when you interrupt the flow of seminal fluid through the vas deferens.
Myth 2: Sex won’t feel as good after a vasectomy.
Quite the contrary. Once it has been confirmed that there is no longer sperm in your semen and the stress and worry of an unplanned pregnancy is eliminated, many people report that sex tends to be more satisfying, pleasurable and frequent.
Myth 3: A vasectomy can cause prostate cancer.
“This has been well studied, and there is no identified increased risk for male-related cancers (prostate or testicular) or other adverse health conditions associated with having a vasectomy,” Dr. Crylen said. “Because vasectomies have become quite common, it is possible to find someone who has had a vasectomy and then later develops other common diseases, but there is no evidence that vasectomies cause these diseases.”
A vasectomy doesn’t protect you from sexually transmitted infections (STIs). Lower your risk for an STI by using protection and other safe sex practices.
Myth 4: Vasectomies are hard to reverse.
Many people think it’s game over after a vasectomy, but this isn’t true. A vasectomy reversal is still possible.
“Vasectomies can be reversed, and the success rate in producing a pregnancy is good (typically 70% to 80%, up to about 15 years after a vasectomy,” Dr. Crylen said. “Some of this success depends on the female partner’s age, as pregnancy rates decline with age. Unfortunately, the success rates for reversals also decline dramatically to less than 50% after it has been longer than 15 years since the vasectomy.”
It’s important to remember that while a vasectomy is reversible, it is generally an expensive procedure that needs to be performed by a urologist who is fellowship trained in infertility and often is not covered by insurance plans.
“I generally recommend vasectomies to patients only if they are quite sure they desire permanent contraception,” Dr. Crylen said. “However, people’s relationship and family situations can change, so it is nice to know there are many techniques for achieving pregnancy even after a vasectomy.”
Myth 5: Vasectomies are painful.
A vasectomy is quite a painless procedure and most people recover quickly.
“It’s a pretty straightforward procedure and typically takes about 30 minutes or less,” Dr. Crylen said. “We use local numbing medicine, so you should not feel sharp pain, but may feel some tugging or pressure after the initial sting of the numbing medication.”
Most health care providers today perform the no-scalpel vasectomy method. Instead of cutting the skin, a tiny instrument pokes into the scrotal sac and spreads it open a little so there’s no actual cut on the skin. This minimally invasive procedure has a lower complication rate and a faster recovery.
Generally, home care after the procedure involves over-the-counter (OTC) pain medication and ice packs for swelling.
You can usually resume light work within two to three days, heavy work or exercise in a week and regular sexual activity after one week. (Pro tip: Recent research has shown a 50% increase in men scheduling vasectomies just prior to March Madness – the perfect excuse to relax on the couch while you recover and catch up on some college hoops.)
Your provider will perform a semen analysis and sperm count at about three months, so you know whether there is sperm left or if you’re all clear.
I’ve decided I want a vasectomy. Now what?
The decision to have a vasectomy is a personal choice. Talk with your partner and/or think about what is best for you and your family. Bring up any questions or concerns with your health care provider to ensure it’s right for you.
In addition to reviewing your overall and reproductive health and plans for a family, your provider can also discuss what to expect during the procedure so you can feel comfortable and secure about your decision.
Below are some things to keep in mind when making your decision:
- A vasectomy is more effective, safer and cheaper and has fewer side effects than tubal ligation (getting your tubes tied), a permanent birth control option for women.
- A vasectomy is not permanent, but a reversal is expensive and may not be covered by insurance.
- If you are over 65 and on Medicare, a vasectomy is generally not a covered benefit, so you may have to pay out of pocket.
- A vasectomy does not protect against STIs. Condoms offer good protection against STIs.
Make an appointment to speak with your health care provider. To find a Banner Health specialist near you, visit bannerhealth.com.
