In the wake of the overturning of Roe v. Wade, urologists across the United States have noticed something interesting: An increasing number of men are rushing to get vasectomies or, at the very least, to learn more about the sterilization procedure.
In fact, Los Angeles-based urologist, Philip Werthman, MD, told The Washington Post last month that vasectomy requests have increased by 300 to 400 percent since the Roe ruling, but he’s certainly not the only doctor witnessing this uptick.
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Prior to the June ruling, “I usually received 10 to 15 inquiries and four to five vasectomy requests per week,” says Gregory Quayle, MD, an ABMS-certified urologist from Mississippi and an advisory board member at Phoenix. “Since the overturning of Roe v. Wade, I’ve started receiving 20-25 vasectomy-related questions weekly, which is 100 percent more than before — and I [believe] many of those inquiries will convert into vasectomies in the near future.”
Honestly, it’s about time. Women have always assumed more than their fare share of pregnancy-prevention responsibilities. But now, as the right to abortion is stripped away in countless states, men are seemingly stepping up...with some understandable trepidation about the sterilization process.
For anyone interested, here’s everything you need to know about getting a vasectomy, according to medical experts.
What Is a Vasectomy?
“A vasectomy is the division and/or occlusion of the vas deferens, the tube responsible for providing transport of mature sperm from the epididymis (a structure attached to the testis) to the urethra in preparation for ejaculation,” says Alfred Winkler, MD, MBA, a urologist at Weill Cornell Medicine Urology.
Simply put, a vasectomy is a method of male sterilization that’s considered a safe and effective birth control choice for those who may not want children in the future. And while the procedure is “nearly 100 percent effective in preventing pregnancy,” it doesn’t offer any protection from sexually transmitted infections, according to the Mayo Clinic. The reason vasectomies work is because the clipping of the vas deferens prevents sperm from reaching the semen. That way, when there’s ejaculation, it’s sperm-free since the swimmers stay in the testicles.
Unlike tubal ligation (female sterilization) — which is done in an operating room and involves cutting into the abdomen so the fallopian tubes can be clipped or undergo electrocoagulation (a clot created by an electric current) — a vasectomy is a quick, outpatient procedure with minimal recovery time, according to the Cleveland Clinic. In fact, “the majority of vasectomies are performed with local anesthesia and require between 15 and 30 minutes of procedure time,” says Dr. Winkler. And the Cleveland Clinic upholds that people can resume everyday activities just 48 to 72 hours post-op and return to work in less than a week. (Meanwhile, recovering from tubal ligation — aka getting your “tubes tied” — can take anywhere from one to three weeks.)
Before a vasectomy is performed, the patient undergoes a standard evaluation, which includes a physical exam and counseling to better understand what to expect during and after the procedure, explains Dr. Winkler. And on that note…
How Does a Vasectomy Work?
Similar to the iconic scene from The Office in which Michael Scott relays his own experiences with vasectomies (and their reversals), it really is a matter of snipping and clipping — far more lowkey than female sterilization.
While older approaches were a bit more invasive, today, most practitioners use “the ‘no-scalpel’ vasectomy technique,” says Michael Ingber, MD, a board-certified physician in Female Pelvic Medicine and Reconstructive Surgery at The Center for Specialized Women’s Health. “With this technique, we use a special instrument to poke through the skin, pull the vas [deferens] out, excise a segment, clip it, cauterize it and drop it back into the scrotum.”
And, as mentioned above, practitioners are able to do all of this rather quickly (15 to 30 minutes). “Before the procedure, your doctor will give you a numbing shot in the scrotum above your testicles so you don't feel as much discomfort during and after the procedure,” says Dr. Ingber. You might, however, notice “some pulling sensations” and a quick bout of nausea similar to that which occurs when you get kicked down there because “the vas travels through the lower abdomen,” he explains.
Once the procedure is complete, your doctor will close the small incision with a few stitches or a bit of glue or leave it to close on its own altogether. You’ll also be given a jock strap (if you didn’t bring one) along with specific instructions for recovery, including complications, such as inflammation, bleeding or infection, to keep in mind. These side effects, along with sperm granuloma — a painful pea-size lump of sperm that’s usually absorbed by your body — and congestion in your scrotum — a sense of pressure caused by sperm hanging out that resolves itself over time — are relatively uncommon and not serious, per the Cleveland Clinic.
“The pain is minimal, and you can take Tylenol or Motrin [for the first few days to help with swelling and pain],” says Dr. Ingber. “We instruct patients to ice on and off the first 24 hours to minimize bleeding and bruising, which is typically rare anyway, and to not lift, strain, or do any sports for one week. After this period they can do whatever they want.”
In addition to keeping strenuous physical activity at a minimum, you should also steer clear of sex for at least seven days, according to the Cleveland Clinic. And when you do decide to get back into the sheets, keep in mind that “patients are not sterile immediately after the procedure,” says Dr. Winkler, who urges folks to “use a reliable form of birth control until sterility is confirmed with a post-procedure semen analysis.” This usually takes place two or three months after the vasectomy.
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Can a Vasectomy Be Reversed?
Short answer: yes. But there are some caveats.
“Although a vasectomy is considered a permanent form of sterilization, the procedure can be reversed with significantly variable success,” says Dr. Winkler. Reversal is performed by reconnecting the vas deferens — a procedure that can take four to six hours — so sperm can once again make its way into the semen.
But the ability to impregnate someone post-reversal isn’t guaranteed. Depending on how many years have passed since your original vasectomy, the success rates of sperm returning to semen (and, thus, ejaculation) are 60 to 90 percent, according to the Cleveland Clinic. And these odds start to decline 15 years or more post-vasectomy.
Because of this, Dr. Ingber says he typically recommends a patient bring in their spouse or significant other to discuss having a vasectomy in the first place and reminds them that the “procedure should be considered permanent.”
Another option (other than reversal) to explore: Sperm banking prior to a vasectomy in case you end up wanting children in the future. As long as they’re kept at a constant temperature of -196 degrees C, your swimmers can be frozen indefinitely, according to John Hopkins Medicine.
Vasectomy Eligibility and Cost
When it comes to eligibility, there’s an age minimum more than anything.
“Typically, anyone can consent for a procedure after the age of 18, but these consent laws vary state by state,” says Dr. Ingber. And if a vasectomy is being performed at a federally funded agency (for example, if the person is on Medicare or Medicaid) then the patient must be 21 at the time of consent, adds Dr. Winkler.
In the US, the median age at which men tend to get vasectomies is 36 to 37, according to research.
If you’ve done your research and you know that a vasectomy is right for you — meaning you’re confident that you don’t want to have any children or any more children — then your next move is to find a urologist with whom you feel comfortable.
“Find out from your insurance what urologists are available to do your procedure,” says Dr. Ingber. “You can also check with your primary care provider, as some of them (family practice doctors, for example) may offer them.” Your local Planned Parenthood clinic might also provide vasectomies.
A vasectomy can cost anywhere from $0 to $1,000, depending on where you get it, whether you have health insurance and, if so, the type of coverage your plan provides, according to Planned Parenthood. That being said, you’ll be hard-pressed to find an insurance plan that will cover a vasectomy reversal — something else to keep in mind when considering sterilization.
In the weeks and months to come, as more states decide how they’re going to interpret the Supreme Court’s decision to take away women’s bodily autonomy and in light of the alarming concurring opinion penned by Justice Clarence Thomas in regards to revisting laws that govern access to birth control, conversations around sterilization will no doubt be normalized.