Dudley S. Danoff, MD, FACS
Couples who enjoy a healthy sex life but are at a point where they no longer wish to have children may consider vasectomy. Vasectomy is a safe, effective method of birth control for men that involves severing the vas deferens, which contains the two tubes that carry sperm from the testicles. If you and your man are considering this step, you may have concerns about how a vasectomy would affect your partner and your sex life. The following information will help allay your concerns.
Q: Surgery is a big step to take—how hard would it be on my man?
A: Vasectomy sounds more intimidating than it actually is. The procedure is performed in a doctor’s office under a local anesthesia through a tiny nick in the scrotum (the “no scalpel” technique). It usually doesn’t take more than ten minutes. Discomfort after the operation is minimal and rarely requires painkillers.
Q: If the tubes that carry sperm from the testicles are severed, does that mean he won’t be able to ejaculate? And how will it affect his testosterone levels?
A: The only difference after a vasectomy is that your man will release no sperm. Sperm makes up only a miniscule portion of the seminal fluid, so the amount of semen ejaculated will remain essentially unchanged after the procedure. Most of the seminal fluid comes from the seminal vesicles and the prostate gland, which are located directly under the bladder. These glands are safely above the severance point, so snipping the vas deferens blocks only the sperm.
Vasectomy will have no negative effects on your man’s machismo—the testicles will still produce testosterone at the same levels as before, and that testosterone will be carried to other parts of the body through the blood vessels. Your man’s hair distribution, the pitch of his voice, his overall strength, and his sex drive will not change.
Q: Will the vasectomy make him less interested in sex or make it difficult for him to perform?
A: A vasectomy causes no loss of sensation, no lowering of desire, no loss of ability to get or keep an erection, and no less satisfaction when having an orgasm. A vasectomy actually has the potential to enhance your sex life because you and your man no longer have to worry about pregnancy. You won’t have to pause in the middle of your bedroom activities to deal with diaphragms or condoms, and you may feel heightened sensations during sex because there is no latex between the two of you. If you and your man are a longtime couple, you may even find yourselves becoming more spontaneous in the bedroom.
Q: Sounds nice—can we start having sex without additional birth control right away?
A: You can return to having sex within five to seven days afterward, as long as your man’s not feeling any discomfort. However, some sperm can remain in the upper portion of the vas deferens for a while after the vasectomy, so you will need to keep using another form of birth control for at least a couple months until a semen analysis confirms that your man’s sperm count has dropped to zero.
Q: Are there any other alternatives for male birth control that don’t involve surgery?
A: Besides the use of condoms or other prophylactics, withdrawal, or abstinence, no effective and practical alternatives for male birth control exist at this time. However, medical science is advancing quickly enough that we predict that there will soon be a pill for men!
Q: Is a vasectomy permanent? What if we change our minds about having kids later on?
A: A vasectomy is a serious step to take—you and your partner should be very sure that you do not want children in the future before scheduling the procedure. However, some couples do eventually change their minds about having children and request a reversal. This procedure, called a vasovasostomy, is more difficult than a vasectomy, but most men are able to conceive children afterward. Just as with a vasectomy, the reversal does not impair men’s sexual performance. In fact, there is a potential bonus—after a vasovasostomy, sex is often more romantic than ever because the couple is now purposely trying to conceive a child.
Generally, vasectomy is a safe, simple, time-tested method of male birth control with virtually no long-term downsides. Without the prospect of unwanted pregnancy to worry about, you and your man can enjoy a sex life just as satisfying as before, if not better!
Dudley Seth Danoff, MD, FACS, is president and founder of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, a Diplomate of the American Board of Urology, a Fellow of the American College of Surgeons, and the author of The Ultimate Guide to Male Sexual Health.