8 Common Myths About Vasectomies It's Time to Stop Believing

From vasectomy care packages to "bro-sectomy" parties (group vasectomies) to World Vasectomy Day (on December 2), vasectomies are having a moment.

According to Google Trends, the number of searches for the term ‌vasectomy‌ soared 370 percent in the week following the overturn of Roe v. Wade, compared to the year prior. And although a 2021 study in ‌Andrology‌ found that just 5 percent of 18- to 45-year-olds assigned male at birth (AMAB) have had a vasectomy, the ‌AP‌ reported that urologists around the country have been seeing surge in bookings for the procedure.

But as more people are considering the snip-snip, the rumor mill in turn has been running rampant. "We are in the internet age, so there is a lot of education out there, but also many misconceptions circulating," says Vikas Desai, MD, urologist at Northwestern University Delnor Hospital, who regularly hears patients spouting untruths.

An April 2022 study in the ‌American Journal of Men's Health‌ assessed the quality of YouTube videos about vasectomies. Unsurprisingly, they found that the majority contained low-quality information, and 18 percent made false statements.

Here, we untangle the biggest myths about vasectomies.

Not at all. "This may have been the case 40 to 50 years ago," Dr. Desai says. "But a modern-day vasectomy is an in-office, no-scalpel procedure that most urologists can do within 10 to 15 minutes."

Although there are different techniques, here's what to expect in a "no-scalpel" vasectomy, which is the most common type: Your scrotum will be shaved and cleaned, and then your doc will apply a local anesthetic like lidocaine to minimize discomfort. Once you're numb, they'll make a tiny puncture site (less than a centimeter wide) in the skin of the scrotum. Next, they'll clip and seal the vas deferens, the tube that transports sperm. Finally, they'll close the skin with dissolvable stitches.

In the grand scheme of things, it's NBD.

What's more, a vasectomy is cheaper, more effective and safer than female sterilization, which requires general anesthesia and has a longer recovery time, according to the American College of Obstetrics and Gynecology (ACOG). In spite of this, female sterilization is nearly four times as prevalent. A October 2020 report from the Centers for Disease Control and Prevention found that 18 percent of 18- to 49-year-olds assigned female at birth (AFAB) have had the procedure.

This procedure is relatively quick and easy. "In fact, a study found that most men needed just a single dose of Tylenol and ibuprofen for pain relief," Dr. Desai says.

Rest up for the first few days. You should be able to resume light activity 48 to 72 hours post-op, but avoid working out, strenuous activity or lifting heavy things (like your child) for about a week.

If you're a sports fan, consider scheduling your vasectomy to coincide with college basketball playoffs so you can zone out in front of the TV — University of Michigan Health reports that vasectomies surge about 30 percent during March Madness.

"The main thing you'll experience is swelling of your scrotum," Dr. Desai says. "To minimize this, wear compressive undies, a jock strap or bike shorts and use ice packs or a bag of frozen peas."

According to the American Urology Association, up to one in five men may experience ongoing discomfort due to the buildup of sperm, but this improves over time. And it's much less common if you get a no-scalpel vasectomy, per a March 2020 review and meta-analysis in the ‌International Journal of Environmental Research and Public Health‌.

Freaked out that a vasectomy will take a toll on your between-the-sheets performance? You can breathe a sigh of relief: Vasectomies have zero impact on the quality of your erection.

"An erection is a two-part process consisting of mindset and blood flow," Dr. Desai says. "It is entirely unrelated to sperm."

To get it up, you first need to be in the right head space — feeling stressed, distracted or not in the mood can affect your erection. In this respect, a vasectomy can actually be helpful. A September 2020 review and meta-analysis in ‌Medicine‌ suggests that people who have had vasectomies report a slew of improvements in the following areas: sex life, relationship, desire, frequency of intercourse, erectile function, orgasms, sexual satisfaction and sexual confidence. Their partners also experienced greater arousal, satisfaction, lubrication and orgasms.

Second, blood has to flow down to the penis. While factors such as obesity, high blood pressure and diabetes can limit blood flow, a vasectomy is neither here nor there. "Blood travels through your pelvic arteries to the penis," Dr. Desai points out. "It has nothing to do with the vas deferens."

So why do some people report ED post-vasectomy? Coincidence. "One in two people AMAB have ED after age 40," Dr. Desai says. "Because most folks getting vasectomies are in their upper 30s and 40s, they have a 50 percent chance of experiencing ED as well."

Although you're shooting blanks, you can still ejaculate after a vasectomy.

"The only role of the vas deferens is to transport sperm; it is not involved in semen development or transportation," Dr. Desai says. "Reasons for lack of ejaculation include taking certain medications, advanced age, diabetes or having a prostate removal or procedure."

It might be helpful to take a deeper look at how sperm and ejaculatory fluid are produced and transported. Sperm is generated in your testicles and stored in a tube behind the testicles called the epididymis. Semen, or ejaculate, is created in seminal vesicles, structures that sit behind the prostate.

"During ejaculation, sperm travels from the epididymis to the vas deferens," Dr. Desai says. "Semen moves from the seminal vesicles into the ejaculatory duct, a juncture joining the seminal vesicles to the vas deferens."

At this point, if your vas deferens is intact, sperm continues along to the ejaculatory duct where it mixes with semen. "Muscles in your penis then contract to propel semen through the urethra and out the penis," Dr. Desai says.

On the other hand, if you've had a vasectomy, the sperm's voyage ends in the vas deferens. It's absorbed into the body in a totally harmless process and never reaches the ejaculatory duct.

Meanwhile, sperm-free semen continues along its way to the urethra, where it is expelled during ejaculation. "Ejaculate is still coming out," Dr. Desai says. "The only difference is that it doesn't contain viable sperm."

A vasectomy won't alter your hormone levels, including testosterone. "The pituitary gland in your brain sends a signal for the testicles to produce testosterone," Dr. Desai says. "Testosterone is not impacted by the vas deferens."

And because testosterone isn't affected, it also won't change your libido.

Vasectomies are reversible, but the procedure is more involved and may not be effective. "It is done in the operating room or a surgery center, and takes about 90 to 120 minutes," Dr. Desai says. "We reconnect the vas deferens by suturing together the top and bottom — abdominal and testicular — segments."

Once you've rejoined the pipes, the sperm can start swimming again. But that doesn't mean baby-making will be a cinch. "The chance of a vasectomy reversal leading to sperm production is higher than the chance of a successful natural pregnancy," Dr. Desai says.

A July 2021 study in ‌SN Comprehensive Clinical Medicine‌ found that 81 to 91 percent of vasectomy reversals restored sperm flow, but only 48 to 73 percent resulted in a natural pregnancy. The success rate drops over time.

"The longer you delay the reversal, the less sperm you make because it is absorbed into the body," Dr. Desai says. "Additionally, you get more scarring over time, which can cause sperm return rates to decline."

As for why baby-making might become a challenge, keep in mind that fertility is age-related. As time passes and you and your partner get older, it's increasingly difficult to conceive. Unrelated factors that inhibit fertility — including health conditions, medications and lifestyle — can also be at play.

"I tell people that we can reverse their vasectomy, but they still might not have a successful natural pregnancy," Dr. Desai says. "They might have to go the IVF or IUI route."

The bottom line: A vasectomy is meant to be permanent, so you should only get one if you're positive you won't want kids in the future. ACOG cautions folks against sterilization during tough times, like during a breakup or after a miscarriage.

In a September 2022 review in ‌Health Psychology Research‌ 6 percent of people report regretting their vasectomy — the sentiment is more common among those who had the procedure before age 30 to 35 or those who have gotten divorced.

Yes and no. It takes time — around 78 days, or 20 ejaculations, Dr. Desai says — for your sperm count to decrease. So you'll need to use another form of birth control for a while post-surgery.

After about three months, your physician will have you do a semen analysis to measure sperm count.

"As long as the semen analysis is negative, a vasectomy is very effective," Dr. Desai says. "The chance of pregnancy is less than 0.1 percent, or one in 2,000." (Compare that to condoms, which typically fail 13 percent of the time, per the CDC.)

Unfortunately, the Affordable Care Act doesn't cover vasectomies — and neither may plans sponsored by religious employers (these might not cover any form of birth control).

"But the vast majority of private health care plans will," Dr. Desai says.

According to Planned Parenthood, a vasectomy can cost between $0 to $1,000, including follow-up visits, depending on your health insurance policy. Even if your insurance doesn't cover a vasectomy, a vasectomy is often cheaper over time than other birth control methods, per the American Urology Association.