A vasectomy, or male sterilization, involves cutting or sealing the tubes that carry sperm into seminal fluid, or semen. It prevents semen from containing sperm but does not affect testosterone levels or sexual function.
People considering a vasectomy may worry that their testosterone levels, libido, and sexual functioning will decrease following the procedure.
Additionally, evidence suggests that people who undergo the procedure may experience improvements in their sex life.
This article asks whether a vasectomy affects testosterone levels, libido, and sexual functioning. We also outline some potential long-term side effects and health risks of vasectomy and clarify some common myths about the procedure.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth.
Does a vasectomy affect testosterone levels?
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A vasectomy is a medical procedure that involves cutting or sealing the tubes that carry sperm from the testicles to the penis. This prevents sperm from reaching the seminal fluid, or semen, which a male ejaculates during sex.
Males who have undergone vasectomy will continue to ejaculate semen, but the semen will not contain sperm.
A vasectomy alters the mechanics that make pregnancy possible, but it does not cause biological changes in males. As such, a vasectomy does not affect testosterone levels — a 2018 study found that these procedures had no long-term impact on testosterone levels in men.
Can a vasectomy cause hormonal imbalance?
Hormonal imbalance occurs when the body produces too much or too little of a certain hormone.
No current evidence suggests vasectomies cause hormonal imbalance in males. For example, a 2018 study showed that these procedures do not affect testosterone levels in men.
Some causes of hormonal imbalances in biological males include:
- having more weight or obesity
- difficulties in following a nutritious diet
- lack of exercise
- sleep hygiene issues
- chronic stress
- diabetes
- testicular issues, such as prior infection, injury, atrophy, cancer, or an undescended testicle
- drinking some energy drinks taking some supplements
- hyperthyroidism and hypothyroidism
- thyroid nodules or cysts
- injury to the endocrine glands
- hyperglycemia and hypoglycemia
- hormonal replacement drugs
- long term steroid use
- too much or too little of the stress hormone cortisol
What are the long-term side effects of a vasectomy?
All surgical procedures have the potential to cause side effects, though vasectomies carry a relatively low risk.
Some potential long-term side effects of vasectomy include:
- sterilization failure
- chronic pain syndrome
- a sperm granuloma, a harmless, small lump of sperm that has leaked out of the cut or sealed tubule
According to a 2021 review, there is no increased risk with vasectomy and the following health conditions:
- autoimmune disease
- cardiovascular disease
- sexual dysfunction
- prostate cancer
However, the review concluded that further study with long-term observation is necessary.
In older guidelines, American Urological Association also stated that vasectomy is not a risk factor for:
- stroke
- hypertension
- dementia
- testicular cancer
A person with concerns about the potential short- or long-term side effects of vasectomy can speak with a doctor.
Can a vasectomy cause erectile dysfunction?
Current evidence does not suggest that vasectomy causes erectile dysfunction or any form of sexual dysfunction.
A 2020 proposed systematic review notes that studies have demonstrated the following improvements in sexual function among males who have undergone a vasectomy:
- increased frequency of sexual intercourse
- increased sexual satisfaction
- improved libido
- improved erections
- improved orgasms
- improved confidence in sex life
Will it affect libido?
A vasectomy prevents sperm from entering semen, which a male releases during ejaculation. It does not affect the production of the hormone testosterone, which is responsible for sex drive.
Sperm makes up a very small amount of male ejaculate, so sexual satisfaction should also not decrease.
In fact, according to a 2017 study, biological males who underwent a vasectomy experienced greater sexual satisfaction following the procedure.Are there long-term health risks?
In general, medical professionals view vasectomies as relatively low risk procedures. Most people who undergo a vasectomy can:
- have sex within 7 days
- return to work within 2 to 3 days
- return to exercise within 7–14 days
However, like all procedures, there are risks of short- and long-term side effects.
According to a 2021 review, common short-term side effects include:
- pain or discomfort following the procedure
- bruising around the surgical site
- infection
The same review notes the following potential long-term complications:
- the procedure resulting in failed sterilization
- reduction in sperm quality
- sperm granulomas
- chronic pain syndrome
Life after vasectomy
A person considering undergoing a vasectomy may worry about how the procedure will affect their life.
Studies have shown that a person’s sex life can actually improve following a vasectomy. Many people who undergo the procedure report increased sexual activity and sexual satisfaction.
However, some people may experience ongoing fears or concerns relating to vasectomy. A 2018 study noted that individuals who have undergone the procedure may benefit from psychological counseling to address these fears and concerns.
Myths and facts
There are many rumors surrounding vasectomy, including those relating to the procedure itself, the risks involved, and the changes a vasectomy may bring to a person’s life.
Below are some myths and facts associated with vasectomies.
Myth: I will have a decreased sex drive, worse orgasms, or erectile dysfunction following a vasectomy
Fact: Recent studies have shown the opposite is true. Most people report having improved libido, and there may also be improved erections and orgasms following the procedure.
Myth: I will have a long recovery time
Fact: Most people who undergo vasectomy could return to work within 3 days, and most can resume sex and exercise within 1–2 weeks.
Myth: I can stop other forms of birth control as soon as I get the procedure
Fact: While vasectomies are the most effective form of birth control, they do not take effect immediately. A couple will need to continue to use other forms of birth control for several months following the procedure and until a doctor confirms the absence of sperm in the semen.
Myth: Once done, the procedure is not reversible
Fact: Though uncommon, a person can have a vasectomy reversal if they change their mind about having children in the future. However, reversals can sometimes fail, so they should only have a vasectomy if they feel confident that they do not want more children.
Summary
Vasectomy is a medical procedure that involves cutting or sealing the tubes that carry sperm into semen. The procedure permanently prevents pregnancy.
People considering a vasectomy may worry about the consequences for their sexual function. However, the evidence suggests that vasectomies have no effect on testosterone levels and have a mostly positive effect on sexual function and satisfaction.
Vasectomies also have a low incidence of both short- and long-term health complications, and doctors generally view the procedure as safe and effective in preventing pregnancy.
However, while it is usually possible to reverse a vasectomy, they sometimes fail. As such, a person should only consider a vasectomy if they feel confident that they do not want any further children.
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