The Effect of Vasectomy on the Sexual Life of Couples
Badereddin Mohamad Al-Ali, MD; Rany Shamloul, MD; Josef Ramsauer, MD; Anthony J. Bellam, MD; Ulfrit Scrinzi, MD; Thomas Treu, MD; and Andreas Jungwirth, MD
ONLINE: May 12, 2014 – The Journal of Sexual Medicine
Vasectomy is a simple procedure with a high success rate and few complications. However, there has been little research on how the procedure affects men’s and women’s sexual function. The studies that do exist have not used strong and validated questionnaires to assess male function. Only one study has considered vasectomy’s effects on women.
The goal of this study was to examine the effects of vasectomy on the sexual function of couples.
Seventy-six men (mean age 39 years) and their female partners (mean age 37 years) participated in the study. The couples had an average of 2.6 children and had been in a stable sexual relationship for at least a year. Birth control pills were their most widely-used contraceptive method.
The couples completed questionnaires at two points during the study: the first about a week before the vasectomy and the second about six months afterward. Men filled out the International Index of Erectile Function (IIEF-15) and the women completed the Female Sexual Function Index (FSFI).
Main Outcome Measures
The German-validated version of the IIEF-15 was given to the men. This questionnaire assesses five domains: erectile function, sexual satisfaction, orgasm, sexual desire, and overall satisfaction. Lower scores on the IIEF-15 indicate poorer sexual function.
For the women, the 19-item FSFI was used. This tool evaluates six domains: desire, arousal, orgasm, sexual pain, vaginal lubrication, and global sexual and relationship satisfaction. Higher scores indicate better sexual function. Women who scored below 28 were considered to have sexual dysfunction.
Vasectomies were performed on an outpatient basis. The traditional no-scalpel technique was used.
All 76 couples completed the questionnaires.
Total FSFI scores increased from 72.9 ± 12.6 to 76.9 ± 10. Statistically significant improvements occurred in the domains of sexual arousal, satisfaction, orgasm, lubrication, and desire.
IIEF-15 scores increased from 66.2 ± 7.8 to 67.8 ± 7.6 with significant improvements in erectile function, orgasm function, and general sexual satisfaction. However, scores on coital satisfaction decreased.
On average, the couples had sex 8.8 times per month. The most common postoperative complications were mild pain, acute epididymitis, hematospermia, and sperm granulomas. Four men required revision surgery because sperm was found in their ejaculate. Some men reported pressure in the testes or scrotum.
An estimated 100 million men worldwide have had a vasectomy. However, many men worry about what will happen to their sexual function afterward.
In this study, the researchers did not find significant changes between the men’s preoperative and postoperative IIEF scores. This agreed with previous research that found no changes in men’s sexual function after vasectomy.
One study by Bertero et al. did show significant changes in IIEF scores, along with improvements in the sexual desire and sexual satisfaction domains. However, in that study, men completed the IIEF seven days after vasectomy. Also, the Bertero et al. study did not find significant changes in the erectile function, orgasm, and overall satisfaction domains.
The women’s improved scores on the FSFI were unexpected and particularly notable, considering the men’s IIEF scores did not change very much. It’s possible that the women felt more relaxed after their partner’s vasectomy because the burden of birth control had been lifted. Sex might have become more enjoyable as a result.
The researchers noted that they were unable to compare the women’s results with previous studies, as theirs is the first study to examine female sexual function in light of vasectomy. One 2013 study by Fataneh et al. did look at how different contraception methods affected female sexual function. However, that study used a small number of relevant subjects and a different methodology, so a comparison was not possible.
The current study began before the American Urological Association issued guidelines on vasectomy, in which a vasectomy was declared ineffective if motile sperms were still found six months later. Among the study subjects, three out of four men who had persistent but nonmotile sperm had a revasectomy. Rates of surgical complications for vasectomy are 1 – 2%. Also, about 1- 2% of men experience chronic scrotal pain that negatively affects quality of life. However, additional surgery is not often needed for these men.
The authors acknowledged limitations, including the small sample size and the lack of long-term follow-up. They also noted that they did not evaluate the effects of vasectomy on the couples’ overall quality of life.
Vasectomy has “neutral effects” on men’s sexual function and “favorable effects” on the female partners of these men, the authors concluded. They recommended that future studies be larger and focus on the impact of vasectomy on women’s sexual function.