In short, there isn’t a direct physical link with ED, but there can sometimes be an indirect psychological link.
A vasectomy is a small procedure which induces permanent sterilisation in men. This makes conception virtually impossible, and is over 99% effective in all cases.
It is highly unlikely that erectile dysfunction will occur as a result of the procedure. This is because the operation does not make any contact whatsoever with the mechanisms which are responsible for erections.
However, despite the evidence, the idea of erectile dysfunction following on from a vasectomy is still one which men find concerning.
In an article published by the Guardian in 2016, they talk about how the rates of vasectomies in the UK have sharply declined in the last 10 years. They say ‘the reasons for the apparent shift are complex, say experts. Part of it is bad publicity, with many men seemingly put off by scare stories about pain and unfounded worries about the implications for their sex lives.'
In contrast, the rates of women using long-acting reversible contraception (LARC) has steadily risen, indicating more women are carrying the contraceptive responsibility in sexual relationships.
What is a vasectomy?
A vasectomy is a small surgical procedure that cuts or seals the tubes which carry sperm to the head of the penis. This induces a state of permanent sterilisation, meaning pregnancy cannot occur following unprotected sex.
The operation typically only lasts for around 15 minutes, and is conducted under local anaesthetic.
There are two types of vasectomies: one which is conducted using a scalpel, and one which is carried out with the absence of a surgical knife. (Also known as key-hole surgery). Choosing a suitable option will come down to a chat with your doctor, and possibly your sexual partner.
Conventional vasectomies start with an injection of local anaesthetic, which induces numbness in the scrotum.
Once numb, two small cuts will be made in either testicle. This enables the doctor to reach both of the tubes (vas deferens) that carry sperm to the ejaculative duct.
Each tube will then be cut, and a small part of the tube will be removed completely. The now open ends of the tubes are then tied or sealed using heat. Typically they will be tied using dissolvable stitches.
A vasectomy which is executed without the presence of a surgical knife is slightly different: instead of making an incision in the scrotum, only small punctures are made.
A numbing agent is still used prior to the procedure, and the tubes are closed in a similar way - either by being tied or sealed using heat. Less bleeding is experienced during these procedures and no stitching takes place. It is also less painful and complications are less likely.
Recovery from a vasectomy
Most men can expect to go home the same day following their operation. Mild discomfort is a common side effect of the procedure. Bruising and swelling in the scrotal area can occur too. Mild pain relief medication like paracetamol or ibuprofen may be necessary.
Another side effect is blood in the semen, but this shouldn’t be permanent and should subside. It is highly regular in the first instances and is not something to be alarmed by. If it persists, however, speak with your doctor about it.
As soon as you feel comfortable, sexual activity is safe to resume. However, additional contraceptive methods must be used 8-12 weeks following the procedure. This is because sperm can remain in the tubes for several weeks and take time to clear.
You will be asked to return to the doctor in 12 weeks time, whereupon your semen will be tested. If the results show it is now sperm-free, the procedure was successful.
Deciding whether a vasectomy is right
Undergoing a vasectomy is something which should be considered thoroughly, as it is highly difficult to reverse.
Reverse vasectomies can be conducted, but are rarely funded by the NHS so must typically be sought privately. According to the NHS ‘If a reversal is carried out within 10 years of your vasectomy, the success rate is about 55%. This falls to 25% if your reversal is carried out more than 10 years after.'
With this in mind, it’s better to be completely sure about whether you want to have the procedure done before going through with it. You should have a detailed conversation with your doctor beforehand, who will have the ultimate say as to whether a vasectomy is right for you.
Clearly, men should only opt for a vasectomy if they’re sure they don’t want any more children, or any at all. Men in sexual relationships or marriages should also discuss it in detail with their partner.
GPs can refuse to recommend the procedure. This is more likely to happen if you’re aged 30 or below as circumstances could change several years in the future.
In most cases, vasectomies do not cost anything as they are funded by the NHS. However, waiting lists can be long. Some men may have to wait several months in certain areas.
Can a vasectomy and ED be linked?
Despite certain narratives and misconceptions, vasectomies are highly unlikely to cause erection problems. Only in extremely rare circumstances will men encounter a sexual issue following on from a vasectomy, and these are largely thought to be linked with psychological issues as opposed to physical.
Furthermore, vasectomies will not impact your sex drive in any way. The body will continue to produce testosterone, and the ability to feel aroused should not be compromised.
Physically, there is no link between vasectomies and erectile dysfunction. None of the anatomy which are responsible for erections are even disturbed during the procedure. Vasectomies have been performed now for over a hundred years, this has allowed for clinical understanding and procedure to be completely perfected.
A study showed that there was virtually no difference between the rates of erectile dysfunction between those who had a vasectomy, and those who didn’t, was virtually the same. The study even went so far as to suggest that the lack of worry surrounding pregnancy actually contributed to an increase in the quality of sexual function.
How will I be impacted emotionally?
If you’re certain a vasectomy is right for you, you may experience a great sense of relief following the procedure given that contraception isn’t something you will need to worry about in the future. (Though it’s important to stress, vasectomies do not prevent STIs.)
However, some men can encounter certain mental health problems following on from a vasectomy. There is some debate as to why this is. Some argue it surrounds the idea of masculinity and manhood, and that some men may develop insecurities around these following the procedure.
Sometimes, the psychological impacts can be so severe that it makes arousal difficult. This, in turn, makes achieving an erection hard to fulfil. On a forum on the subject of vasectomies, one man spoke of his troubles with erectile dysfunction following his vasectomy.
He said: “I honestly think it’s likely to be mainly psychological. I had the ‘snip’ myself and it took me several months to get over the sense of [a] loss of my masculinity. It did get better with time and now I am totally fine.”
Some men can become anxious and depressed after a vasectomy, but this is thought to be a minority only.
If you feel as if you have noticed changes in your mood following a vasectomy, and you think it could be contributing to erectile dysfunction, it’s advisable to sit down with your GP who will be able to offer guidance.
Other types of male contraception
Condoms remain the most popular contraceptive method among men. Barrier devices are unique in that they prevent pregnancy, as is their main objective, but can also prevent against the spread of certain sexually transmitted infections.
However, some sexual partners, perhaps those who have been together for a long time, don’t always feel that condoms are ideal or something they want to think about with every time they have sex.
But regarding male contraception, the options for men are scant compared with those of women. In the latter half of the last decade, male contraceptive methods have remained relatively similar and unchanged, whereas female contraceptive options have grown and become more varied in nature.
Excluding barrier methods and a vasectomy, there are no other effective options for men seeking protection against the prospect of pregnancy.
However, the idea of a male contraceptive pill is something which has gained widespread media attention recently. On the subject, the NHS state that “Researchers are optimistic that a safe, effective and reversible method of male contraception will eventually become a reality, although this is still several years away.”
For men, a contraceptive pill would abolish the need for a surgical procedure. This could help to eliminate the insecurities a minority of men develop after going through a vasectomy procedure.
But on the other hand, could some men taking the male contraceptive develop similar psychological apprehensions, based on the notion that the pill would temporarily affect fertility and thereby induce anxieties about manhood, leading to ED? Obviously at this stage, it’s unclear because the pill isn’t available, and this potential effect would need to be studied.