I never imagined walking into a doctor’s office with a cup of my husband’s semen, but there I was, handing over his “sample” for testing a few months after his vasectomy. We had two kids, I was done with oral birth control, and another pregnancy could have put me—and a potential baby—at risk. So we decided our family was complete and chose a vasectomy to make our decision permanent.
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We’re not alone: Roughly 500,000 men get vasectomies every year. Some of those men and their partners shared their experiences in a survey conducted by The Everymom, disclosing why they decided to have a vasectomy, how it actually felt, and what they’d tell other guys considering the snip. Dr. Justin Dubin and Dr. Kevin Chu, urologists and co-hosts of the Man Up podcast covering men’s health topics, also shared their expertise and addressed some of the most common concerns patients have about the procedure. Read on to learn everything you need to know about getting a vasectomy.
What are the most common concerns about getting a vasectomy?
Both doctors expressed that patients come to see them with a lot of incorrect assumptions about getting a vasectomy. “There’s so much information out on the internet,” said Dr. Chu. “It’s important to get it from reputable sources. I can’t tell you how many patients come in with misconceptions about the vasectomy, which may have prevented them from getting the procedure done.”
Most men are concerned about whether everything will continue to work the same “down there” as it did before. Good news—it will! Here, Dr. Dubin and Dr. Chu address some common worries for those considering the procedure:
- The procedure is minor and only involves the scrotum, not the penis.
- The risk for prostate cancer does NOT increase in patients who’ve had vasectomies.
- Your sex drive and erections will remain the same after a vasectomy.
- Testosterone and hormones are not affected.
- Ejaculate consistency and volume should stay the same. “Sperm only makes up five to 10 percent of ejaculate,” Dr. Dubin shared. “The only difference [in their ejaculate is] that they’ll be shooting blanks.”
- Vasectomies are covered by insurance.
Dr. Dubin also stressed that sterilization does NOT take effect immediately after the procedure. Additional contraception needs to be used for two to three months, after which a semen sample needs to be tested to confirm the absence of sperm in the ejaculate.
How painful is a vasectomy?
Many prospective vasectomy patients also worry about the pain level of the procedure. “Patients may feel a very mild pain from the initial needle for the local [anesthesia],” said Dr. Chu, “but otherwise the patient should not feel much or any pain at all.”
Overall, survey respondents said it was much less painful than they’d anticipated. “I was surprised at how quickly I was able to recover and return to work,” said one respondent, while another kept it short and sweet: “It didn’t hurt.”
When’s the best time to have a vasectomy?
The short answer is when you know with certainty that you don’t want children—or any more children. Both doctors stressed that men and their partners should go into a vasectomy thinking of the procedure as permanent birth control. “If you’re unsure whether you want children or more children, I do not recommend a vasectomy,” said Dr. Dubin.
The most popular time of year to schedule the procedure is during the NCAA March Madness basketball tournament—what better time to sit on the couch all day? There’s also a rush for vasectomies at the end of the year when insurance deductibles have been met and people have more time off work.
What happens during a vasectomy procedure?
A vasectomy is a common, minimal procedure wherein a urologist closes off the vas deferens so sperm cells are blocked from getting into the semen, thus preventing sperm from making it outside the body. A vasectomy typically takes 20-30 minutes and are most often performed in a urologist’s office. Doctors want to make their patients comfortable and may play music or a TV show in the background.
The basics of the procedure:
- Urologists offer various pain control methods to help the patient feel comfortable. “For my patients,” said Dr. Chu, “I offer the option of small dose valium (an anti-anxiety medication) or self-administered inhaled nitrous gas. Every patient will get local anesthesia injected in the area of the scrotum where the vasectomy will be performed.”
- A doctor will make one or two incisions in the scrotum to disconnect the vas deferens, cutting or burning the ends of the tube and essentially “closing the highway that takes sperm from the testicle through the urethra to the outside world,” said Dr. Dubin.
- During the procedure, patients should expect to feel some slight pressure or tugging.
Some doctors offer scalpel or no-scalpel vasectomies, but Dr. Dubin said both have the same outcome. The most important thing patients should consider is the doctor’s preference—you want to go with the procedure the doctor has done most often.
Vasectomy recovery
Patients should plan to take at least two days for a vasectomy—one for the procedure, one for recovery. They made need more time off work if regularly lifting more than 15 pounds is part of their job.
How will vasectomy recovery feel? “Afterward, I tell my patients that they may feel like they were ‘kicked in the scrotal area,’ except dialed down a bit,” said Dr. Chu. “This usually lasts 24-48 hours but is very amenable to NSAIDs and an ice pack to the scrotal area. By the end of the first week, patients should be feeling back to their normal selves.”
Men from our survey who’ve had vasectomies also provided some tips for the healing process:
- “Listen to the doctor’s advice on very tight underwear post-surgery to help with swelling.”
- “Have a rotation of frozen bags of peas ready and take a marijuana gummy (where legal) that first night.”
- “I purchased a jock strap that held ice packs. It was the perfect position to help minimize discomfort and swelling in the area.”
Undergoing a medical procedure on a sensitive area of the body is going to make anyone a little bit anxious. As one man mentioned, “[I was worried about] lying on a table naked with [my] most vulnerable parts being cut.”
How can partners offer their support? You may have seen vasectomy recovery care package ideas on on Tiktok or cheeky vasectomy cards on Etsy, which are some (amusing) ways to support your healing partner. But simply allowing them the necessary time to rest and heal will also suffice.
Vasectomy complications
As with any medical procedure, there are risks. Rare complications occur in approximately one to two percent of patients, including:
- Post-vasectomy pain syndrome (PVPS)
- Infection
- Bleeding that leads to hematoma formation
- Sperm granuloma (a pea-sized ball of scar tissue on the vas deferens that generally heals by itself and can be treated with ibuprofen)
How effective is a vasectomy?
The biggest risk of the procedure is vasectomy failure resulting in a pregnancy. However, according to Dr. Chu and Dr. Dubin, vasectomies are more than 99 percent effective. Consider comparing that to oral birth control; when taken perfectly, the latter is equally effective. However, once you take the human fallibility factor into account, its effectiveness is really more like 93 percent.
How do you know your vasectomy worked?
Doctors don’t consider men sterile until they test their ejaculate and find no sperm. This testing typically happens about two to three months after the procedure—or after 20-25 ejaculations.
“The timing of the post vas semen analysis is surgeon-dependent,” said Dr. Chu. “If there is no live sperm in the ejaculate and other parameters are met, then he’s cleared, with the understanding that the sterilization efficacy rate is 99.99 percent.”
He also mentioned that some patients don’t want to bring samples into the office (e.g., my husband), so now many companies offer at-home post vas semen analysis that can be mailed in for assessment.
Vasectomy vs. other permanent birth control options?
“Unfortunately, the only contraception options for males are vasectomies, condoms, or the pull-out method—which I tell patients works until it doesn’t work,” said Dr. Dubin. “Of course, you can rely on a female partner, but oral birth control needs to be taken at the same time daily, IUDs can be painful, and a permanent tubal ligation is more invasive, not to mention expensive.”
In addition, tubal ligation is a surgical procedure while a vasectomy is a clinical procedure, said Dr. Chu. “I tell my patients that women go through a lot with pregnancy, time for the men to step up!” he added.
What about vasectomy reversals?
Vasectomy reversals are much different than vasectomies, said Dr. Chu. “A vasectomy reversal is typically performed by a male infertility specialist who’s received extra surgical training to microscopically connect the vas together again. While a vasectomy procedure is typically 15-20 minutes, the vasectomy reversal can be up to three or four hours.”
When it comes to effectiveness, Dr. Chu said a vasectomy reversal has approximately a 90-95 percent chance of returning sperm back to the ejaculate. But patients should also keep in mind:
- Insurance does not cover vasectomy reversals
- A vasectomy reversal can be effective but is not a guarantee
- Without a reversal, sperm retrieval for IVF is possible
How soon can you have sex after a vasectomy?
“I recommend patients wait a week after their vasectomy before having sex,” said Dr. Chu. “One reason is to allow for the blockage to fully form at the testicular end of the vas deferens. The other reason is to allow for healing and to minimize the chances of any post-procedure complications.” Again, patients should use a back-up contraceptive method until the medical team tests their ejaculate and verifies it to be clear of sperm.
If your partner needs another reason to have a vasectomy, all 30+ respondents to our survey said sex stayed the same or got better after their vasectomy—and there have been other studies to back up our results. Dr. Chu said results from a survey published in 2017 showed increased sexual satisfaction in men who’d gotten a vasectomy when compared to those who hadn’t.
“Additionally, there are some published results in more sexual satisfaction amongst couples,” he said. “This may be related to increased spontaneity in sex, condom-free sex (for monogamous couples), and decreased concern for unwanted pregnancies.”
What can you do if your partner doesn’t want a vasectomy?
Sometimes partners don’t agree about whether their family is complete and may not want to make a permanent decision, or a male partner may have his own reservations about the procedure. The first step is open communication: Start with an honest conversation about what’s best for you and your family (you can also forward them this article).
Dr. Dubin recommended scheduling a consultation together with a urologist to answer any questions. Hearing from other men—guy-to-guy—who’ve had the procedure also helps. He and Dr. Chu talk frankly with a post-vasectomy patient in this informative and entertaining episode of the Man Up podcast, a great resource for someone who doesn’t know or isn’t comfortable personally talking to anyone who’s had a vasectomy.
Overall, partners can reiterate that “a vasectomy is common, low-risk, and effective,” said Dr. Dubin. “It’s a considerate procedure for your partner that benefits you both.” And, if it helps their decision at all, say you’d be happy to drop off (or mail in) their post-vasectomy sample like I did.
