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Sex After Vasectomy: What to Expect

While there are more male birth control options in development, vasectomies and condoms are currently the only available contraception methods for men. Vasectomy is a safe and highly effective surgical procedure. Many men have questions regarding how a vasectomy will affect their sexual function. In this article, urologists who specialize in performing vasectomies explain what you can expect from the procedure as well as its implications on your sexual health.

What is a vasectomy?

A vasectomy is a minimally invasive outpatient surgery, typically performed under local anesthesia, that blocks sperm from leaving the testicle. In the most common type of vasectomy, the 'no-scalpel method,' the urologist pokes a tiny hole in the scrotum and cuts and seals the vas deferens. The vas deferens is a long muscular tube in each of the testicles that transports sperm from the epididymis, where the sperm are stored prior to ejaculation.

A vasectomy blocks the sperm from reaching the semen ejaculated from the penis during sexual intercourse. Semen will still come out after a successful vasectomy, but it will not contain sperm. The entire procedure only takes about 15 minutes.

“Vasectomy is the only reliable, consistent birth control method that puts the control in the hands of guys,” said Rick Taylor, M.D., a urologist with Central Ohio Urology Group. “It’s the only way that we can ensure that we are not fathering children when we’re at a point in life that we don’t want to.”

A vasectomy is over 99% effective in preventing pregnancy. A vasectomy failure, in which the man’s partner gets pregnant, occurs in one of 2,000 vasectomies, according to the American Urological Association (AUA).

Complication rates are very low, and the potential complications are less serious than those of tubal ligation, the surgical sterilization for women.

One of the possible complications of vasectomy is scrotal hematoma, the collection of blood in the scrotum. The incidence of hematoma is around 2%, according to research.

Approximately 1–2% of vasectomy patients develop post-vasectomy pain syndrome, which is characterized by constant or intermittent testicular pain that lasts longer than three months.

How soon after a vasectomy can you have sex?

Most urologists recommend abstaining from sexual activity in the first 7–10 days following the vasectomy. The soreness or discomfort will usually be at its most severe on day two or day three following the vasectomy, according to Darshan Patel, M.D., an assistant professor of urology at UC San Diego Health.

“After that, every day is going to get better and better,” Patel said.

In the first week, avoid strenuous activities like hiking and weightlifting.

Patel noted that recovery time can vary on an individual basis: “If they feel like they’re back to normal at that one-week mark, then basically they can resume all their normal activities,” Patel said. “If they’re slowly improving, but they have some degree of residual discomfort, usually I say it’s up to them.”

What happens if you ejaculate too soon after a vasectomy?

There are no direct risks or dangers to a man's health associated with ejaculating soon after a vasectomy.

“It may be uncomfortable,” Patel said. “But it’s not going to negatively affect the success of the procedure or damage anything in terms of the testicles or the blood supply to the testicles.”

Taylor agreed that there are no health consequences or potential for long-term damage if a man ejaculates in the days immediately following the vasectomy. However, you should stick to your doctor's recommendations and abstain from sexual intercourse for at least a week to ensure uninterrupted healing.

Can my partner get pregnant if we have sex without a backup method after the procedure?

If you have sex with a female partner in the days following a vasectomy, they can get pregnant.

You are fertile for about two to three months after vasectomy because the sperm usually are viable and are quite resilient and can hang out in the ejaculatory system for that long,” said Akash Kapadia, M.D., a urologist with Georgia Urology in the Atlanta area.

For this reason, another form of birth control, such as a condom, is recommended until the doctor has confirmed that there are no motile sperm (sperm with the ability to move), also known as 'swimmers,' in the ejaculate. Most urologists will recommend a semen analysis around the three-month mark after a vasectomy to confirm the procedure was successful.

“What a lot of men don’t realize is that the sperm that are being produced on the day of the vasectomy are often stuck in the ejaculatory system,” Kapadia said. “Sperm can be viable in the ejaculatory system for up to three months after a vasectomy; that’s usually the lifecycle of sperm.”

How does a vasectomy affect ejaculation?

Men who can ejaculate prior to the vasectomy will still be able to do so after the procedure. The only change is that the semen that comes out during ejaculation will no longer contain sperm.

Semen is primarily made up of fluids contributed by the seminal vesicles and prostate. The sperm only makes up about 2% of the fluid that comes out at the time of ejaculation.

“If a guy is super in tune with the volume that he produces at the time of ejaculation, he might notice a very small difference in the volume,” Taylor said.

There is also no change in the sensation of orgasm, which typically accompanies ejaculation.

Does ejaculation feel different after a vasectomy?

An ejaculation may not feel as pleasurable if it occurs within a few days after the vasectomy, according to Patel. However, after the healing process is complete, ejaculation and orgasm should not feel any different than they were prior to the vasectomy.

“We have some small percentage of men that come in after vasectomy and report some increased discomfort after ejaculation,” Patel said. “Usually, it’s pretty minor, but it is different compared to preoperatively. A lot of that will get better with time.”

Does a vasectomy affect libido?

There’s no good evidence that suggests that a man’s libido, or sex drive, will decrease following a vasectomy, Patel said.

“There’s some evidence on the contrary, that actually in terms of libido, and the number of sexual encounters, that actually increases after a vasectomy, just because it’s foregoing or thinking about contraception for men and couples in this setting,” Patel said.

A man’s libido is a multifactorial issue, Kapadia said, and one of the critical hormones for libido, or sex drive, is testosterone. Although testosterone is primarily made by the testicles, a vasectomy does not impact testosterone levels because the procedure is merely blocking the sperm from leaving the testicle. After a vasectomy, the testicles will continue their normal functions: producing sperm and testosterone.

“We know strongly from data that there is no impact on testosterone production, or transmission and release of testosterone, after a vasectomy, and, therefore, it technically should not affect that element of the sex drive,” Kapadia said.

Kapadia added that some men have a psychological component to their sex drive and feel like it’s impacted by having a vasectomy, but there’s no scientific data that shows an anatomical or physiological link.

Does a vasectomy provide protection from STIs?

A vasectomy only protects from unintended pregnancy. Unlike condoms, a vasectomy does prevent any sexually transmitted infections (STIs).

“We still advocate that men who are not in a stable relationship or concerned regarding sexually transmitted infections use some additional protection,” Patel said.

Vasectomies are very common. In the United States alone, over 500,000 vasectomies are performed each year. Complications from the outpatient surgery are very rare. A vasectomy will not affect your ability to have an erection, ejaculate, or orgasm. It also will not impact your testosterone level or sex drive. Consult a urologist to find out if a vasectomy is right for you.

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