Male sterilization is also known as “vasectomy”. A vasectomy severs the sperm ducts. Sperm are not released into the woman. Since conception requires that sperm and egg unite, vasectomy prevents pregnancy.
Vasectomies are 99% effective in preventing pregnancy. They do NOT protect against sexually transmitted infections (STIs).
Vasectomy is permanent. Because of this, it needs to be considered carefully. Couples often decide upon a vasectomy mutually, when they both feel they do not want any more children.
Vasectomy is rarely appropriate for young people, who may later wish to have children. Male sterilization is a simpler procedure than female sterilization. It allows men an opportunity to play an important role in contraceptive decision making.
The following points answer general concerns which people express over vasectomy.
No weight gain, weakness of risk of disease
Vasectomy does not cause weight gain or physical weakness. It does not affect erections. It does not increase risk of testicular cancer, prostate cancer or heart disease. Semen will be ejaculated as before.
Vasectomies and STIs including HIV
Vasectomies do not protect against STIs, including HIV. All men at risk of STIs, including HIV, whether or not they have had vasectomies, need to use condoms to protect themselves and their partners from infection.
Time to take effect
A vasectomy only takes proper effect 3 months after the operation. During the first 3 months, to avoid pregnancy, another method of contraception must be used.
Testing to see if it has worked
A test can be run to see whether a vasectomy has worked: a sample of the man’s ejaculate is tested for its “sperm count”. If there are less than 100,000 motile (moving) sperm per milliliter, pregnancy will not occur.
In a very very small percentage of cases, a vasectomy can fail, and a man’s partner can become pregnant as a result. He should not assume his partner has been unfaithful. A sperm count should be taken.
Risk of pain
A small proportion of men (6%) report long-term pain (up to 5 years) in the scrotum/testicles. 2% of men who have not had vasectomies report similar pain. There is therefore a small chance of long-term pain. The cause is unknown. The condition can be treated by elevating the scrotum, taking pain-killers or reversing the vasectomy.
Vasectomies are intended to be permanent and should be considered as irreversible. Choose a different contraceptive method if you want to have more children. In a tiny number of cases, the tubes that carry sperm grow back together. A repeat vasectomy resolves the problem. For some men, surgery to reverse a vasectomy is possible, but it is difficult and expensive, and providers are hard to find. There is no guarantee that reversal will lead to pregnancy.
Male sterilization v female sterilization
If a couple decides upon sterilization as their preferred contraceptive method, either partner could be sterilized. If both options are acceptable, vasectomy is preferable. It is simpler, safer, easier and less expensive.
Helping people make the decision
Health care providers can help a man make a decision about having a vasectomy by giving balanced information, by discussing other contraceptive options, and by encouraging him to consider the implications in terms of ending his fertility, with particular reference to life changes such as a change or partner or a child’s death. They should review the “six points of informed consent” to ensure that the man understands the procedure.
Available to all
Vasectomies should be available to all, irrespective of age or the number of children they have. Health care providers must not impose rigid rules. The man should be fully informed, and then decide for himself.
How and where operations are provided
If no pre-existing medical conditions require special arrangements, a vasectomy can be performed in almost any health facility, including health care centers, family planning clinics, mobile facilities, and the treatment rooms of private doctors. Vasectomies require only basic medications, supplies, instruments and equipment.