By Zachary Zane
For years I considered getting a vasectomy, but only after Roe v. Wade was overturned did I finally pull the trigger. I never wanted to be in a situation where I had to parent a child I did not want to raise.
My urologist did everything he could to dissuade me, which I’ve learned is a customary practice when the patient is a childless man in his early thirties. (If you’re older or already have a few kids, then doctors don’t try to dissuade you the same way.) He insisted that I may change my mind down the road. When I asked about reverse vasectomies, he explained that they are incredibly costly and not covered by insurance. (Planned Parenthood states that reverse vasectomies typically cost between $5,000 and $15,000, not including other possible fees.)
Additionally, my urologist explained that reverse vasectomies aren’t 100% effective. (Cleveland Clinic notes success rates are 60% to 95% for the return of sperm in your ejaculate following a reverse vasectomy. Pregnancy is possible more than 50% of the time after a reversal. However, success rates start to decline 15 years after a vasectomy.)
I explained that if—by some very, very small chance—I end up with a long-term partner and we want to have kids, we could adopt, use someone else’s sperm, or yes, try the reverse vasectomy, but I really, really doubt I’ll be in this situation. And the way I’m living my life currently, it is significantly more likely I will end up with a child I do not want than wishing I could get a partner pregnant, but being unable. So, it’s a risk I’m more than willing to take.
He agreed, and I had to sign a document stating that he had told me about the procedure and potential side effects, and I still wanted to continue with the vasectomy. Then, I had to wait 30 days to schedule my vasectomy; legally, in the state of New York, he couldn’t do it any sooner.
Cut to a few months later, and I was snipped. The procedure itself was pretty simple, but honestly, my doctor didn’t prepare me all for what was to come. I didn’t know if I had to do anything before the procedure, how long it would take, if I would be awake during it, or anything about the recovery process. (I think my doctor had performed so many vasectomies in his long career that it was second nature to him.)
So here are some things I wish I knew before getting a vasectomy. I also reached out to two urologists—Jamin Brahmbhatt, MD of Orlando Health and Michael Ingber, MD at Garden State Urology—to help answer some medical questions.
How do you prepare for your vasectomy?
Really, no prep is required. However, wearing a jock strap or supportive underwear on the day of your procedure is beneficial and reduces the “achy” feeling you get following your vasectomy. (And you’ll want to wear jocks or supportive underwear for a week afterward.)
What’s actually happening during a vasectomy?
First, we need to understand AMAB anatomy. The vas deferens, which you likely learned about in your high school health class, is a small tube that runs in the scrotum. Its job is to carry sperm from the testicle to the ejaculatory duct, which opens into the urethra.
“Our goal with a vasectomy is to interrupt the flow of sperm, nothing more,” Ingber says. There are various techniques for performing a vasectomy, and they have changed over the years. “Most physicians use a no-scalpel technique or make a very tiny incision in the scrotum to do the procedure,” Inbger says. “This leads to less bleeding, less pain, and overall quicker recovery after a vasectomy.”
How long does the procedure take?
The actual procedure takes around twenty minutes, Brahmbhatt says. (Mine was a little longer, taking about thirty minutes.) I was in the office for a total of an hour.
I had my AirPods in during the procedure and listened to Fleetwood Mac, so I didn’t have to hear the squishing sounds the doctor was making.
Is it painful?
“A vasectomy is generally not painful; it can be done with local anesthesia or taking an oral relaxing medication (in the office), or general anesthesia (in the OR),” Brahmbhatt says. “Most are done in an office setting. Some men may experience mild discomfort, pressure, or a pulling sensation during and for a few days after the procedure.”
I had local anesthesia, and honestly, that was the most “painful” part, just getting that shot in my genitals. But the procedure itself was mildly irritating at worst. My doctor kept saying it shouldn’t be painful, and if I felt a pinch, I should tell him. (I didn’t feel any pinch or pain—just some discomfort.)
The nurse gave me nitrous oxide during the procedure to sedate me. It made me a little loopy and less anxious.
What are the risks of getting a vasectomy?
“Vasectomies are one of the most common procedures we do as a urologist,” Ingber says. He adds that risks are minimal, and complications typically happen in only 1-2% of patients.
There is always a risk of bleeding. However, this is typically minimal and stops with a bit of pressure. “Sometimes we put one dissolvable stitch at the site of the vasectomy; this helps minimize bleeding in certain cases,” Ingber says. (That’s exactly what happened to me!)
Infections are extremely rare, and antibiotics are no longer used at the time of the procedure. “Sometimes we have patients apply a little topical antibiotic ointment on the sites postoperatively,” Inbger says. (For what it’s worth, I didn’t do that!)
While the pain from a vasectomy (a dull ache) typically lasts a few days after the procedure, “in some rare cases, it can last longer,” Ingber says.
How much does it cost?
“The cost of a vasectomy can vary widely based on location and provider, typically ranging from $0 to $1,000 in the United States, and it is often covered by insurance,” Brahmbhatt says. “It's advisable to check with healthcare providers and insurance for accurate pricing.”
My vasectomy was completely free and covered by my insurance; however, I did have to pay $125 for sperm testing six weeks following the procedure to check that the vasectomy was successful. (More on this below!)
Is there an age limit for getting a vasectomy?
Nope. Because men produce sperm throughout life, there is no age limit, Ingber says.
What happens to your sperm after a vasectomy?
Your testicles will still produce sperm to some extent after a vasectomy. However, the sperm cannot travel through the tube to create a viable pregnancy. “This is why the procedure sometimes can be reversed to allow viable sperm to travel,” Ingber says. “However, these procedures are costly and not guaranteed. The longer someone waits after a vasectomy to have a [reversal] procedure done, the less likely it is to be successful.”
How long is the recovery process?
Recovery is super easy. It typically takes between a week and two. I was pretty much completely back to normal after six days. For the first few days, you should not work out, lift anything heavy, or put excessive stress on your body.
FYI, I returned to work the day following my vasectomy without a problem. I took Advil in the morning for the first three days but stopped once the aching disappeared.
But make sure you have jock straps or compression underwear and wear it for at least the first few days following your vasectomy. That helps to mitigate any pain. I usually sleep naked but slept with compression underwear for a week following my vasectomy.
When can you have sex after a vasectomy?
“American Urological Association guidelines state that ejaculation should be avoided for approximately one week after vasectomy,” Ingber says. (Honestly, not masturbating, ejaculating, or having sex for a week was the most challenging part of getting a vasectomy.) “Patients may be sexually active after this period; however, you should avoid unprotected sexual intercourse until cleared by the doctor,” Ingber says.
For how long are you fertile after a vasectomy?
You are still fertile immediately after a vasectomy. I repeat: You are still fertile immediately after a vasectomy! “It's crucial to get a semen analysis around 12 weeks (or 30 ejaculates) after the procedure to confirm the absence of sperm and ensure the vasectomy was successful,” Brahmbhatt says.
I did a semen analysis six weeks after my vasectomy. (I had ejaculated probably fifty times by then.) And the semen analysis wasn’t covered by insurance. I had to pay $125 out of pocket. But two days later, my test results came back, and I was shooting blanks, so I was ready to start having unprotected sex with my partner, not worrying about potentially getting her pregnant.
Does it affect your orgasm or the amount that you ejaculate?
Nope, it doesn’t affect your pleasure or the amount that you ejaculate. It doesn’t affect the consistency or viscosity of your ejaculate either. “That’s because a vasectomy only involves the very tiny tube that transports sperm, and that does not affect ejaculation,” Ingber says. “The majority of ejaculate fluid typically comes from the seminal vesicles and prostate, which are not near the site of vasectomy procedures.” For this same reason, it doesn’t affect your orgasm or pleasure.
How my life has changed post-vasectomy:
Getting a vasectomy has been a game-changer. No longer worrying that I accidentally got any of my partners pregnant has been an enormous relief. And when my partner’s period is running late, we no longer panic. We know it’s just running a little later this month than usual.
I’m able to enjoy having sex more—and have unprotected sex with my partners who are not on birth control. (I have many female partners who are not on birth control because it destroys their bodies.)
And being able to not use condoms is just…better. Of course, vasectomies don’t protect against STIs. So, if you’re worried about contracting an STI, you should absolutely still use condoms. But if you were using condoms just for contraception, you don't have to use them anymore. And damn…condomless sex feels so damn good.
Zachary Zane is FUN FACTORY’s resident Sex Expert. His work focuses on sexuality, culture, and the LGBTQ community. He is the author of Boyslut: A Memoir and Manifesto.
He currently has two columns: “Sexplain It” at Men’s Health and “Navigating Non-Monogamy” at Cosmo. He is also the founder and editor-in-chief of Boyslut Zine, which publishes real sex stories from kinksters worldwide. His work on sexuality and relationships has been published in The New York Times, Rolling Stone, The Washington Post, and many others.
This post was written by a guest blogger, and all opinions and ideas expressed are that of the author. All ideas included are for educational and entertainment value, and do not constitute medical advice.