Low Testosterone

Myths about having a vasectomy

Birth control is an essential part of family planning, but it is full of myths and misconceptions.

You can get false information about every method, from condoms to vasectomy. That’s why it is so important to talk about male birth control with your doctor instead of trusting what people say.

All of these methods have something in common: they prevent or delay pregnancies. But most of them apply to women and not men. Birth control pills (hormonal birth control), tubal ligation, intrauterine devices, and the rhythm method are all meant for women. Only condoms and vasectomy are available for men, and a few others are under research.

Men often avoid vasectomy after hearing false information about the procedure. They do not look for the answers in a reliable source and stay with the myth. That’s why we’re writing this vasectomy myths article in an effort to dispel the false information and give you more accurate information to make your decision.

What is a vasectomy?

Vasectomy is the name of a straightforward surgery performed in an outpatient modality. This procedure involves your testicles and the small ducts around them, which join in a single canal known as vas deferens. This is also known as ductus deferens, and what it does is transporting the sperm cells to the ejaculatory ducts. The name vasectomy comes from “vas deferens” and describes the procedure of cutting or blocking this duct.

That is precisely what happens. During a vasectomy, doctors will simply cut or block the passage of sperm in the vas deferens. No sperm cell reaches the ejaculatory ducts, and pregnancy won’t happen. This is a quick procedure, and right after that, you can go back home to rest. No hospital admission is required, and the effectiveness is exceptionally high. It reduces male fertility to zero.

In most cases, vasectomy is permanent. Thus, your doctor will make sure that you don’t want any more children from your current partner or any other. Still, some cases can be reverted, and we have new techniques to restore the vas deferens (1).

What happens during a vasectomy?

During a vasectomy, you will be in the doctor’s office, a hospital, or a clinic. The doctor will administer local anesthesia to the scrotum. So, the only pain that you will probably feel during the procedure is the anesthetic injection. 

After you’re adequately anesthetized, your doctor will perform one of two types of vasectomy (1):

  • Traditional vasectomy: It requires one or two incisions in the scrotum skin. Then, the doctor locates the vas deferens and either cuts or blocks the duct. When it is cut, the doctor will probably remove a part of the vas deferens. When it is blocked, the procedure is completed with surgical staples or with electrocautery. 

  • No scalpel vasectomy: This is a new type of vasectomy that does not require a cut with the scalpel. Instead, the doctor performs a small puncture. Then, it does the same blocking or cutting procedure through a tiny hole. This method has a lower risk of infection and bleeding and does not require suturing back the skin.

After the procedure is done, patients are free to go home for recovery. The doctor will hand out some recommendations and instructions for home care. 

As you will see in the next sections, most myths and misconceptions about vasectomy start after the patient return home.

Myths

Myth 1) Does a vasectomy lower testosterone levels?

One of the most common misconceptions about vasectomy is that the procedure affects a man’s testosterone levels. This myth was dispelled a long time ago by a group of researchers in Australia. They took 54 men who went through vasectomy and followed them up for five years.

Every year, they measured the patient’s levels of testosterone. They also measured another hormone known as LH or luteinizing hormone. They are both associated with the endocrine function of the testes. They wanted to know if vasectomy affected the pituitary-gonadal axis, which is fundamental to release testosterone.

Similar studies with conflicting results preceded Their study. These researchers were the first ones to perform a 5-year follow-up study to assess long-term testosterone levels after a vasectomy procedure (2).

What they found was impressive.

They found an increase instead of a decrease of LH levels in the blood one year after vasectomy. This was the second time this group of researchers saw a rise in LH levels one year after vasectomy. However, LH levels went back to normal after one year, and testosterone remained unchanged.

In simple words, these men did not change their testosterone levels over the course of 5 years. LH levels went up, probably to compensate for the testis that initially did not respond as before. However, everything returned to normal, and they never showed deficiency symptoms (2).

So, does a vasectomy lower testosterone?

In a nutshell, you won’t have low testosterone levels after a vasectomy. What is cut is the vas deferens, which only serve to transport sperm cells. Your testicles will not be affected. The blood flow to the testicles and hormone levels will remain the same.

So, you should not feel worried about erectile dysfunction, low libido, and other problems of insufficient testosterone production. However, keep in mind that if you were under low testosterone treatment before vasectomy, you still need testosterone replacement therapy after the procedure.

After dispelling one of the most common myths about vasectomies, we have a few others to address:

Myth #2. You won’t experience ejaculations

Ejaculation is a very complex process, and different organs intervene. The testicles are perhaps the most important in nature because they carry our sperm cells. Ejaculations without testicle secretions will not get anyone pregnant. That’s precisely what you’re looking for after a vasectomy.

But besides sperm cells, the ejaculatory fluid contains many other components. Different organs contribute to ejaculation. Among them, the prostate and the seminal vesicles are not cut and still produce their secretions. If they were functional and could ejaculate before vasectomy, you will preserve this function after the procedure. 

Actually, we would be impressed after measuring the volume of ejaculatory liquid that comes from the testis. If your ejaculatory volume is 5 mL, only 0.05 mL comes from your testicles. The rest comes from the prostate and the seminal vesicles. Sperm cells do not take a lot of space. What takes space in your semen is the nutritional substances and enzymes provided by other organs (3).

As you can see, you will barely notice a difference in your ejaculatory volume after a vasectomy.

Myth #3. You will have prostate cancer

Every myth has an origin, and it is interesting to know why people believe that vasectomy gives you prostate cancer. This is outdated medical data, and doctors once thought this was the case over 15 years ago.

It all started with a study suggesting a link between prostate cancer and vasectomy. However, this outdated medical fact was corrected years later, after completing more research.

To understand the reason for this change, we need to know a bit of how medical facts are discovered and then confirmed. We have different types of studies in the medical literature. Everything starts with observation, which is the first step. Then, the second step is trying to reproduce what we see in a controlled environment. Finally, the third step is repeating once and again to contrast data in different settings. It is only after reaching the third step that we make solid affirmations based on science.

The initial medical data were no more than observations in specific populations. Researchers simply gathered people who went through vasectomy and evaluated what happened after a while. Some of them developed prostate cancer, but it could be a high-risk population. Maybe the researchers didn’t have a reliable methodology. That’s why reproducing the initial findings is so essential, and the hypothesis that vasectomy procedures increase the risk of prostate cancer didn’t reach the second step in the investigation process. It was postulated but never confirmed.

Moreover, if you look at it closely, it won’t have any sense because the production of semen does not interfere with prostate cancer. Anatomically, the vas deferens and the prostate are very far away from each other. Physiologically, they only join forces for sperm production, which has nothing to do with cancer (4).

If you still have doubts and a tendency to believe this myth, check this out. The reason why patients who undergone vasectomy had more cases of prostate cancer is very easy to explain. They were in closer contact with their urologist and the medical community. They were screened for prostate cancer more frequently than regular patients. They had a tendency to report urinary symptoms more regularly and were often diagnosed with this condition.

So, you don’t have a higher prostate cancer risk. You just have closer contact with the urologist, and prostate cancer screening is more likely (4).

Myth #4. You won’t produce new sperm cells 

As noted in the explanation of myth #2, sperm cell production is located in the testicles. More specifically, in specialized cells called Sertoli cells. These cells will continue working after a vasectomy.

Cutting the vas deferens does not cut blood flow or affect these cells in any way. So, your testicles will continue producing sperm cells. The only difference is that these sperm cells will not go through your urethra and definitely won’t be expelled in ejaculation.

Just think about men who practice abstinence or do not have sex in a few weeks. What happens with sperm cells in the testicles? Do they build up waiting for the next ejaculation? Not really, because they only last around five days before being replaced by new sperm cells. They just die, are absorbed by the body, and get replaced.

The same happens after you get a vasectomy. Your Sertoli cells continue producing sperm cells, but they won’t go anywhere. They stay in the testicles and get reabsorbed after dying. 

Myth #5. Tubal ligation is easier than vasectomy

Doesn’t it sound like an excuse to avoid a surgical procedure? You don’t really need to give it much of a thought to dispel this myth. Your testicles are in the scrotum, which is literally hanging outside of your body. Woman’s tubes are found deep inside the pelvis.

A vasectomy requires cutting the skin of the scrotum and handling your testis and vas deferens. It is performed with local anesthetics. Tubal ligation requires a very complicated surgical procedure that opens the skin, goes through the fatty tissue, the muscle tissue, and the peritoneum. After reaching the pelvis, doctors need to locate the tubes and block them. Such a complex procedure requires general anesthesia or epidural anesthesia.

Post-operative complications represent another issue. Vasectomy complications are infrequent. You still need to be careful and report symptoms such as fever or changes in your wound. Tubal ligation recovery is often completed as an inpatient in a hospital or clinic. Women need very close follow-up, and the risk of infection, bleeding, and other complications are higher (5).

Myth #6. You can promptly resume sex after vasectomy

Vasectomy is an outpatient procedure but requires a recovery time of around one week. During this week, you need to avoid physical exercise, working or sitting for too long, and having sex. You can’t have sex during the first week or a few days. Follow the instructions given by your doctor, and if you still feel pain after resuming sexual activity, wait a few extra days.

You also need to know that the birth control effects of vasectomy are not immediate. If you start having unprotected sex right after vasectomy, you could get someone pregnant. So, you need a few tests to make sure that the birth control effects are in check. You will need sperm samples for sperm count tests to make sure that the procedure was effective. It will be one week without sex and around three months using additional contraceptives just to make sure (1,3).

Myth#7. Condoms are no longer required after vasectomy

As noted above, you may need condoms for a while after vasectomy, even with a stable partner. Keep in mind that vasectomy only works to avoid pregnancies. It does not protect you from sexually-transmitted diseases.

Transmission only requires skin-to-skin contact or fluid contact, depending on the disease. Doctors will always recommend against unprotected sex, and vasectomies do not make an exception.

Myth#8. Vasectomy is always an irreversible procedure

Vasectomies are designed to be irreversible and cause male infertility. That’s why doctors will ask many questions and make sure that you don’t want to get anyone pregnant in the future. However, some cases can be reversed without a guarantee. 

The capacity to reverse your vasectomy depends on the type of vasectomy you got and the time since. In some cases, your organism develops antibodies against sperm cells after a vasectomy. If that happens in your case, it will compromise the capacity to reverse the procedure (6).

If you’re worried about having an irreversible procedure, vasectomy is probably not the best birth control for you. Talk to your doctor if you have any doubt or prefer a truly reversible birth control method. Other vasectomy alternatives include condom use, non-penetrative sexual intercourse, intrauterine devices, the calendar method, and more.

Conclusion

Vasectomy is a family planning procedure meant for permanent contraception. It is a simple outpatient procedure that only requires local anesthesia. Similar to other birth control procedures, people say a lot about vasectomy that is simply not true.

One of the most common myths is that vasectomy reduces your testosterone levels. This is not true, and studies show a transient increase of LH that goes back to normal after a while. You won’t have a reduction of sexual desire and will experience the same ejaculatory function as before. However, keep in mind that vasectomy does not have an immediate effect. Thus, you need around one week of recovery without sexual intercourse and three months using additional contraceptives.

Another important myth is that vasectomy increases the risk of prostate cancer. This was formerly postulated in the scientific evidence. However, new studies show that vasectomy patients screen for prostate cancer more often. Naturally, screening more often identifies more patients, even if their risk is the same as the rest of the population.

If you have further doubts or concerns about vasectomy, the best source of information is your doctor. Talk about him and receive direct advice from an expert instead of trusting what people say and what is posted in forums and non-scientific sources.

Sources

  1. Weiske, W. H. (2001). Vasectomy. Andrologia, 33(3), 125-134.
  2. Whitby, R. M., Gordon, R. D., & Blair, B. R. (1979). The endocrine effects of vasectomy: a prospective five-year study. Fertility and sterility, 31(5), 518-520.
  3. Stormont, G., & Deibert, C. M. (2019). Vasectomy.
  4. Bhindi, B., Wallis, C. J., Nayan, M., Farrell, A. M., Trost, L. W., Hamilton, R. J., … & Karnes, R. J. (2017). The association between vasectomy and prostate cancer: a systematic review and meta-analysis. JAMA internal medicine, 177(9), 1273-1286.
  5. Sung, S., & Abramovitz, A. (2019). Tubal Ligation.
  6. Hayden, R. P., Li, P. S., & Goldstein, M. (2019). Microsurgical vasectomy reversal: contemporary techniques, intraoperative decision making, and surgical training for the next generation. Fertility and sterility, 111(3), 444-453.

 

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