Monthly Archives: February 2018

Sexual changes post-vasectomy | Minneapolis & St Paul

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One of the reasons many men are hesitant to undergo a vasectomy is fear of reduced sexual function. It’s definitely not unreasonable by any means- most men value their sexual ability highly. After all, vasectomies are ultimately a form of sexual contraception for men. So, does undergoing vasectomy affect sexual function?

In a survey done by Dr. Doug Stein, vasectomy patients from an secure database were asked to rate their sex drive, ability to obtain and maintain erections, stiffness of erection, strength of orgasm, semen volume, and frequency of testicular discomfort compared to prior the vasectomy. 119 responses were obtained. The table below outlines the results:

Since your vasectomy, how have the following changed? Much Less Slightly Less No Change Slightly More Much More
Sex Drive (Libido) <1 (1%) 6 (6%) 81 (75%) 18 (15%) 4 (4%)
Ability to obtain and maintain erections 1 (1%) 6 (6%) 96 (89%) 5 (5%) 0
Rigidity (stiffness) of erections 1 (1%) 5 (5%) 94 87%) 7 (6%) 1 (1%)
Strength of orgasm (climax) sensation 0 3 (3%) 95 (88%) 6 (6%) 4 (4%)
Semen volume (the amount of fluid that comes out when you ejaculate) 0 17 (16%) 80 (75%) 7 (7%) 2 (2%)

The majority of those that responded to the survey reported no change in sexual function, which is expected. Detrimental effects to sex drive, erections are incredibly rare. In these cases, it’s probably the vasectomy that caused the effects, and it could be psychological. Vasectomy only prevents sperm from entering the semen- the other functions of the testicles which regulate sexual drive are not affected. Likewise, those that reported higher sex drive, stronger orgasms, stiffer erections, etc, were probably not linked directly to vasectomy, as there is no physical reason for vasectomies to effect these things. Most likely, it was a result of no longer having to worry about the fear of pregnancy.

Sperm Banking | Minnesota

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Around 500,000 vasectomies are performed a year in the United States. For many men in the US, vasectomy is the most effective method of contraceptive due to its permanent, hands-off nature. However, it’s not uncommon for people have regrets when it comes to permanent procedures such as vasectomy. Maybe you remarried and want more kids, or maybe you decided that living child-free wasn’t for you after all.

Vasectomy reversals are very effective (~97%) when performed within three years of the initial vasectomy. This drops to 91% from three to eight years, 82% from nine to fourteen years, and 69% beyond fourteen years. For those who decide that they want kids much later in life after a vasectomy, there’s some uncertainty as to how effective it might be. One way around this is sperm banking.

The role of a sperm bank is to take healthy sperm and freeze it in a process called cryopreservation. The sperm is stored at very low temperatures, around -196 degrees. Once frozen, sperm can be stored almost indefinitely, though it may not be as effective after 12 years depending on how it was frozen.

Before freezing, a sample of the semen is analyzed to determine the quality of sperm. If the sperm count and motility is good, it will be divided into batches and frozen. One ejaculation is about 1-6 vials of frozen sperm, and most opt to save multiple ejaculations. This process costs $500-700, and storage is about $300-$1000 per year.

When it’s time to use the frozen sperm, the patient notifies the bank, who release it to the patients physician. The sperm can also be destroyed or donated. The sperm can then be used for artificial insemination, where the sperm is transferred to the uterus in a process called intrauterine insemination (IUI).

A vasectomy is one of the best ways to prevent pregnancy without sacrificing physical well being and sexual pleasure. Because it’s permanent, its probably a good idea to have a back up plan. A vasectomy reversal is usually very effective but as time goes on, its effectiveness goes down. Sperm banking is a viable, if costly, alternative that allows one to save their sperm for future use should a vasectomy reversal prove to be impossible.

Why don’t More Men in the World Get Vasectomies? | Minnesota

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Vasectomies have the potential to be a powerful tool to curb population. By nature, they serve as a more effective, long-term solution than other methods of contraception. The procedure is a one time ordeal, as opposed using a condom or birth control pill, and avoids the negative side effects of hormonal birth control for women while have very few side effects itself. This could be especially effective in areas with low resources that have poor access to other contraceptives. However, despite being the most effective form of male contraception, only 2.4% of men use vasectomy worldwide. Why are vasectomies so unpopular? And how can we change that?

For one, many people are simply uninformed about vasectomy as a birth control method. Studies of vasectomy awareness in Ethiopian, Nigerian, and Turkish men and women range from a lowest of 15.6% to highest of 39.6%. This extends to doctors as well- many care providers in low resource areas are not well informed about vasectomy, and do not provide the service. This lack of awareness is a major barrier to making vasectomy a more popular form of birth control.

Another reason is negative attitudes toward vasectomy. Surveys showed that some participants felt that a vasectomy results in a loss of masculinity, or that they would be judged by others if they found out about the procedure. In India, men felt that a vasectomy would make them subservient to their wife, and that female sterilization is preferred because men contribute more economically (note that tubal ligation is far more invasive, costly, and dangerous that a vasectomy). These attitudes ultimately stem from deeply ingrained sexism. Getting rid of these erroneous notions would go a long way in making vasectomy more prevalent. In Africa, 0.1% of men have undergone vasectomies. Myths and misconceptions stop African men from going for a vasectomy, and vasectomy is often associated with de-masculinisation, framing it in terms of castration.

One of the most effective ways of both increasing awareness and correcting negative attitudes toward vasectomy is through education, both within the community and through mass communications. Programs such as the ACQUIRE Project’s “Get a Permanent Smile” campaign sought to address myths regarding vasectomies in low resource areas in Bangladesh and Ghana through posters, radio and television broadcasts. These types of campaigns are quite effective, and have been shown to cause spikes in demands for vasectomies.

Employer based promotion is another method of making vasectomies more popular. Once again education is key here. In one Indian study, employees from several workplaces were allowed to attend educational workshops on long acting birth control methods. Companies also trained health coordinators, provided health service desks, and providing a family planning hotline. Participants were reportedly more likely to discuss family planning, as well as make the switch from short-term contraceptives to long term ones. Incentivising employers to provide such services to their employees would encourage more men to get a vasectomy.

Vasectomies have been sorely underutilized as a form of contraception. It may be a long road ahead before worldwide adoption of vasectomy as a birth control method is reached, but as information becomes more widely available, more men will opt for vasectomies.