Fear of sexual dysfunction due to vasectomy dispelled

Men who are considering vasectomy can rest easy knowing that the procedure has no harmful effect on their sexual health, as suggested in a study presented at EAU 2023.

In a cohort of middle-aged men in Germany, those who underwent vasectomy appeared to be more sexually active, be more satisfied with their sex life, and be less likely to experience sexual dysfunction, reported lead study investigator Dr Matthias Jahnen from Klinikum rechts der Isar, School of Medicine, Technical University of Munich in Munich, Germany.

Together, the data show that “vasectomy represents a safe contraceptive procedure with no evidence of a negative impact on men's sexual function, frequency, or satisfaction,” Jahnen added.

Jahnen and colleagues collected and analysed data from 2,330 men (mean age of 50.4 years) who participated in the Bavarian Men's Health–Study. The investigators looked at the men’s lifestyle, sexual activity, sexual satisfaction, and sexual life.

Sexual problems, such as erectile dysfunction, premature ejaculation, and low sexual desire, were evaluated using validated questionnaires, the International Index of Erectile Function (IIEF-6), the Erection Hardness Score, and the Sexual Complaints Screener for Men.

Vasectomy was performed in 294 men (12.6 percent) about 9.2 years ago. Compared with men who did not receive the procedure, those who did were more likely to be in a steady partnership (95.9 percent vs 87.1 percent; p<0.001), have children (86.7 percent vs 71.4 percent; p<0.001), be satisfied with their sexual life (85.6 percent vs 80.1 percent; p=0.027), and be more sexually active in the last 3 months (91.5 percent vs 84.5 percent; p=0.005). [EAU 2023, abstract A0570]

Multivariable logistic regression analyses showed that a previous vasectomy was associated with about 40-percent lower odds of having erectile dysfunction (13.5 percent vs 20.5 percent; odds ratio [OR], 0.61, 95 percent confidence interval [CI], 0.42–0.89; p=0.005).

Meanwhile, the prevalence of low libido (4.8 percent vs 7.0 percent) and premature ejaculation (6.7 percent vs 5.1 percent) was similar between men who did and did not undergo vasectomy. Vasectomy was not associated with either outcome (low libido: OR, 0.67, 95 percent CI, 0.36–1.18; p=0.16; premature ejaculation: OR, 1.49, 95 percent CI, 0.86–2.59; p=0.289).

“Vasectomy is a safe and effective contraceptive procedure,” but not many men get a vasectomy, Jahnen said. In Europe, for example, “the most common contraceptive procedures are the pill and the condom.” [https://digitallibrary.un.org/record/3849735?ln=en]

“Even tubal ligations are more common than vasectomy,” he added.

Jahnen pointed out that much of the fear around vasectomy is that it may interfere with the sexual function, with some men worrying about losing their ability to have and enjoy sex.

The results of this study can allay men’s fears about vasectomy. Vasectomy does not hurt the sex life of men and, therefore, can be recommended without concern, Jahnen concluded.