The overturning in June of Roe v. Wade by the Supreme Court isn’t only sparking heated debate across the nation, it’s now spurring straight couples into rethinking their options in avoiding an unwanted pregnancy. In my practice, I’ve noticed lately that women aren’t the only ones looking for ways to prevent this from happening to them; a number of men in the Los Angeles area—and reportedly in other parts of the U.S.—are taking the somewhat controversial and often misunderstood step of undergoing a vasectomy.
In the weeks after that draft memo leaked out of the Supreme Court in early May, indicating that the days that the right to abortion care was granted nationwide, the Cleveland Clinic in Ohio reported a staggering increase in men requesting vasectomies. The figure shot from three to four men seeking the procedure per week to a whopping 90 procedures performed in the week following the Supreme Court’s Roe announcement, a movie that effectively banned abortion care in several states where trigger laws had previously been enacted.
Some men have said that they weren’t considering a vasectomy before the Roe decision was announced. In contrast, others, like Trevor, an Arizona musician who spoke to Time magazine about his decision to undergo the procedure after the ruling, had long considered a vasectomy beforehand. Ultimately, the SCOTUS decision pushed those like Trevor who were on the fence to take the plunge. Trevor told the magazine that for him and his wife, the decision was easy, as they have known for a long time that children were not part of their planned future together: “It was like, ‘Why am I holding off at this point? It’s such a big thing that I can take care of for my wife and me so easily, so why not?” he told Time.
And it may not only be middle-aged men who are getting snipped in higher numbers. Dr. Parviz Kavoussi, a reproductive urologist in Austin, told FoxTV local news stations that rather than the married men with children who for the most part make up his usual patients are now.bin notable numbers, single young men. “I’m seeing men in their 20s who have no children calling about a consultation, which isn’t abnormal, but there was an increase,” Kavoussi said.
In my own clinical practice here in Los Angeles, I have seen what amounts to a 400% increase in vasectomy requests since the Roe decision. Patients have largely told me that they were there, sitting in front of me at that moment, mainly due to the Supreme Court’s move—and some said that a factor was the murky economic climate, giving them an increasing sense of an unclear future.
The Economy and Vasectomy Trends
The economic mood getting men to rethink a future as a father isn’t exactly unusual. During the Great Recession of 2008-2009, physicians also saw a jump in vasectomy consultations and procedures. So it’s no shocker that this apparent uptick in vasectomies now is, in part, linked to fear of financial difficulties. But is this an extreme reaction to a period of very noticeable inflation and fresh questions about stability?
Perhaps how we communicate these days can offer some insight into what we’re seeing here. Many couples and men are now finding themselves more comfortable with the idea of a vasectomy after a trend began on social media promoting vasectomies and espousing that they are easily reversible. But that’s not factual. Although the procedure for a vasectomy is relatively simple and recovery time is short compared to many surgeries, the steps taken to reverse the procedure are not so straightforward. Plus, a reversal procedure isn’t guaranteed to work for all men. In fact, the success rate for vasectomy reversals ranges from 30-90%, depending on how long it has been since the initial vasectomy was performed and the experience of the surgeon.
What Happens During A Vasectomy?
During a vasectomy, which is an outpatient procedure that takes under an hour to perform, surgeons sever the tubes that carry sperm; this prevents the man’s sperm from mixing with semen. This procedure is far safer than tubal ligation, the sterilization surgery women commonly undergo after having children. Often referred to as tying one’s tubes, tubal ligation procedures kill about 25 to 30 women in the U.S. each year. But in a study from 1992, vasectomies were associated with lowered mortality rates in men who were cancer-free before undergoing the procedure.
In many ways, vasectomies are safer for couples and single men who want to remain childless. Perhaps a better question is, “why don’t more men and women know this?” and “why aren’t vasectomies promoted more than female sterilization procedures?” The latter has been proven to be more dangerous and even deadlier than a vasectomy for years.
Though this recent trend in vasectomies may largely be reactionary to the criminalization of abortion care in many states and the whims of our economy, it may show more couples that vasectomies are often the safer choice to remain out of the crosshairs of the law if faced with an unexpected or unviable pregnancy.
Debunking Common Vasectomy Myths
Over the years, a number of misconceptions and myths regarding what happens after a vasectomy—mainly how men function sexually post-procedure—have circulated. Below is a brief correction of the record.
Myth: Sex won’t feel as good after a vasectomy
Sex will be just as good after a vasectomy—or even better. The freedom from worrying about unplanned pregnancies may egg you on to be more spontaneous and will probably allow you to enjoy yourself more. A vasectomy changes what makes up your semen, not your erection, the sensations you feel, or the joy of sex.
Myth: Testosterone levels will decrease
It’s true that the testicles make both sperm and testosterone. The difference is that the testicle makes testosterone and transports it through the bloodstream, not via the vas deferens (the penis’s sperm duct). The simple fact is this: Testosterone levels don’t deplete as a result of vasectomy.
Myth: You won’t be able to have an erection or ejaculate afterward
If you could ejaculate before your vasectomy, you’ll ejaculate after your vasectomy. Ejaculatory fluid, or semen, is made in the prostate and the seminal vesicles, which are not cut during a vasectomy. The amount of fluid that comes out of the testicle with sperm is less than 1% of the overall ejaculate volume. The muscle contractions that force fluid out during ejaculation come from the pelvis and, again, are not affected by vasectomy.
Myth: A vasectomy shuts down sperm production
A vasectomy merely blocks sperm production. Men, after a vasectomy, continue to make sperm; it just has nowhere to go. Sperm typically live about 3-5 days and then peter out. Therefore, if a guy doesn’t ejaculate every 5 days or so, his sperm dies anyway—only to be replaced by millions more. After a vasectomy, the same thing happens; sperm are always in a constant state of production and decay, regardless of whether they have anywhere to go. This explains why vasectomy reversal can work.
Myth: Vasectomy causes prostate cancer
This is a myth that emerged in the 1990s and came back in 2014. It’s based on studies that seemed to show an association between vasectomy and prostate cancer. In both years, the studies were plagued with criticism for issues with their design and methodology. These flawed studies sparked larger, better-designed studies, and these showed no connection between vasectomy and prostate cancer. The American Urological Association reviewed all the data and weighed in to say that undergoing a vasectomy does not cause prostate cancer.
So, if you are a man and are now strongly considering a vasectomy in response to either Roe’s overturning or looming economic uncertainty, know this: You’re not alone. Before undergoing the procedure, it’s imperative to do diligent research on both vasectomies and the physicians in your area with the highest success rates, while understanding your options for a reversal should you change your mind later on. Also, I advise you to discuss all aspects of your decision with your physician before scheduling the procedure. This way, you’ll be making an informed and educated choice about your future.
Dr. Justin Houman is a Los Angeles-based urologist and fellowship-trained men’s health specialist whose practice is focused on testosterone management, sexual and ejaculatory dysfunction, male infertility, and Peyronie’s disease, hormone management, improving sexual function and achieving reproductive goals.
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