Considering a vasectomy? Learn about its effectiveness, risks, and impact on sexual performance. Make an informed choice!
Next up video playing in 10 seconds
Since the Supreme Court ended the federal constitutional right to abortion with the Dobbs v. Jackson Women’s Health Organization decision, interest has increased dramatically in vasectomies, a surgical type of male birth control that prevents sperm from merging with semen. For example, a 2025 study reported a 95 percent increase in vasectomies in its sample between May 2022 (before the leaked Dobbs opinion) and August 2022 among people ages 19 to 26 years.
Puneet Masson, MD, a urologist with Reproductive Medicine Associates, has seen a similar trend. “Normally, I would do about 7 to 10 vasectomy consults on a typical urology telemedicine day. Now I’m doing more than 20. Several patients, ranging from married couples with children to single childless men, have openly disclosed that the Dobbs decision encouraged them to be more proactive about their reproductive health,” he says.
The spotlight on male contraceptives has become so bright in post-Roe America that you can now find T-shirts with slogans like “Vasectomies Prevent Abortions,” and men undergoing the procedure can buy special vasectomy underwear with a pouch for a cold pack. But there is a lot of misinformation circulating about the procedure: Some men fear it will worsen sexual performance and prevent ejaculation, or mistakenly believe that a reversal later on down the line will be easy.
If you are considering a vasectomy, the top experts below have some answers about the reality of the procedure.
What Is a Vasectomy?
Vasectomy is a low-risk procedure in which a surgeon cuts and seals off the vas deferens, the tubes that transport sperm from each testicle, as a form of permanent birth control for males. Usually, this takes place under a local anesthetic that numbs only the area where surgery occurs, and a vasectomy is an outpatient procedure, which means that most people go home on the same day.
A urologist, or doctor specializing in the male reproductive system, will most likely carry out a vasectomy. However, some family doctors also have the training to perform a vasectomy.
Procedure
Your healthcare provider will likely request that you stop taking certain medications before the procedure, like aspirin, ibuprofen, naproxen sodium, and blood-thinning medications. You may also need to discuss diabetes medications with the relevant healthcare professional, if you take them.
Be sure to turn up prepared with tight underwear or a jockstrap on the day of your procedure to support the scrotum and limit swelling after the surgery. You’ll also need to bathe or shower, washing your genitals thoroughly. Your surgical team may also ask you to shave the area. If they do, use a disposable razor and avoid hair removal products or electric razors.
During the procedure, the surgeon has two options for creating an opening in the scrotum:
Incision Vasectomy They use a scalpel to cut a small hole in the scrotum.
No-Scalpel Vasectomy They use a small instrument to create and spread open a small hole in the scrotum.
After either type of cut, the surgeon will clasp the vas deferens using a specialized device. Then, they’ll divide, tie, and clip the vas deferens before using heat to burn the ends of the tube, a process known as electrocautery. Finally, they may close the incision or opening with stitches. During a vasectomy, a surgeon leaves the testicles and the rest of the reproductive system intact, removing only a small section of vas deferens.
This procedure usually takes 15 minutes or less. If you’ve had stitches, a healthcare professional will cover them with bandages and keep an eye on your overall health. Around two or three months after the procedure, your urologist or family physician will carry out a semen analysis to make sure your semen is free of sperm.
Questions to Ask When Considering A Vasectomy
As reversing a vasectomy is possible but not easy, speaking with your partner (if you have one) and your physician or urologist is vital to make sure it’s right for you. Here’s what to consider.
1. When Is a Vasectomy the Right Choice?
Performed about 500,000 times per year in the United States, according to the American Urological Association, vasectomies should be considered permanent birth control. You should only choose one when you (and your partner) are sure that your family has reached the size you’re both comfortable with.
“This is really a personal decision, and one you shouldn’t just jump into. Some people say it’s not a good time to do it if you have a newborn because you’re sleep-deprived and you may later regret it,” says Sarah Vij, MD, a urologist with Cleveland Clinic in Avon, Ohio. “Others say that if you’re a younger childless male, you really shouldn’t do it, even if you feel pretty confident you don’t want kids. But I believe that any adult male who has the ability to make his own healthcare decisions can make a decision about contraception.”
2. Doesn’t It Make More Sense for My Partner to Deal With Birth Control, Since She Is the One Who Might Get Pregnant?
People often see contraception as the woman’s problem, but for a woman, effective birth control often entails birth control pills or an intrauterine device. “We always say that a vasectomy is an act of love. It’s wonderful to see so many men taking responsibility for the reproductive health of themselves and their families, and not asking their partner to bear the total burden,” says Dr. Masson.
The equivalent of a vasectomy for women is tubal ligation, or “getting your tubes tied.” In comparison, vasectomies are safer, simpler, more effective, and less expensive, and they are an outpatient procedure.
3. Is a Vasectomy 100 Percent Effective?
Keep in mind when family planning that no birth control is totally fail-proof. “The failure rate, depending on the study you look at, is about 1 to 2 in 1,000. That’s over 99 percent effective, which is pretty comparable or exceeds pretty much all forms of birth control that we have,” says Dr. Vij.
4. Am I Sterile Immediately Following the Procedure?
No, a man has to ejaculate after the procedure in order for the sperm to clear, and the rate at which different patients clear varies tremendously. “Some guys might clear all the sperm in three ejaculations, and some might still be fertile after 30 or 40 ejaculations,” Vij explains. “I generally have patients get a semen test at three months, because the great majority of men will have cleared by then. A man should not consider himself sterile — and needs to continue using birth control — until he’s had confirmation from his doctor that he’s had clearance.”
5. I Get Squeamish Just Hearing About It. Does a Vasectomy Hurt?
This is a minimally invasive procedure that takes place on a same-day, outpatient basis and lasts about 15 minutes. There are two types of procedure — one that uses an incision and one that doesn’t. You will receive local anesthesia and light tranquilizers.
You will be sore in the area for a few days afterward, but the discomfort can be managed with rest, nonsteroidal anti-inflammatory drugs, and an ice pack.
Fun fact: Surgeons have started referring to the NCAA March Madness basketball tournament as Vas Madness, because so many men elect to have their vasectomies right before the tournament, so that they can relax on the couch with their ice pack and watch a lot of TV as they recover.
6. What Are the Risks of a Vasectomy?
The complication rate is less than 1 percent and includes bleeding, infection, inflammation, or ongoing pain, says Masson. “However, a small percentage of patients may have ongoing pain beyond just the recovery process. Should this happen, it’s important to regroup with your physician who performed the procedure.” He adds there is a 1 in 2,000 chance of recanalization, whereby the tubes reconnect, making the man fertile once again.
The risks of a vasectomy may include:
Post-Vasectomy Pain Syndrome This may lead to long-term testicular pain, pain during ejaculation, and psychological distress, and its underlying cause is unclear. It affects between 1 and 2 percent of people after a vasectomy, but it is treatable.
Sperm Granuloma This is a hard lump that can develop from the leakage of sperm from the snipped vas deferens. Sometimes, it can cause pain. However, the body almost always breaks it down and absorbs sperm granulomas, and they’re not dangerous. Pain relief can help, and compression shorts or jock straps can support the scrotum can reduce reduce symptoms.
Scrotal Congestion This is a sense of pressure or an uncomfortable feeling in the testicles, the epididymis (the tube behind each testicle that stores and carries sperm), or the lower vas deferens. Scrotal congestion may develop between 2 and 12 weeks following a vasectomy, but it usually gets better over time.
7. Will a Vasectomy Affect My Sexual Performance? Will Sex Feel Different?
“It doesn’t impact sexual functioning at all,” Masson says. “Erections are going to be completely unaffected, and you will still have orgasms and ejaculations. The reason behind that is that only a small percentage of the ejaculate comes from the testicles. Most of it comes from the prostate and seminal vesicles,” he explains. “Thus, everything will still look and feel the same; just microscopically, there will be no sperm in the semen.”
8. If I Change My Mind Later, Can a Vasectomy Be Reversed?
Yes, it can, but it’s a more complex procedure that requires a surgeon experienced in microsurgery. Insurance may not cover vasectomy reversal, making it prohibitively expensive for many people.
Also, while success rates are high, they are not 100 percent. The good news for older men is that a study found the same reversal success rate in men over 50 years of age as in younger men.
9. Is There Any Other Way to Father a Child After a Vasectomy?
Men who are interested in paternity after a vasectomy can choose to undergo surgical sperm extraction. The pros: It’s usually a lot faster than a reversal, and some techniques can take minutes and occur as an outpatient procedure. The cons: “These sperms can only be used in context with in vitro fertilization (IVF). It’s never going to be able to swim to or penetrate the egg. Then the partner must undergo the IVF process,” explains Masson. You can also bank sperm before the procedure.
The Takeaway
A vasectomy is a permanent form of male birth control that cuts and seals the vas deferens to prevent sperm from entering the semen.
The procedure is low-risk, outpatient, and typically takes less than 15 minutes, with a local anesthetic minimizing discomfort.
While the complication rate is low, potential risks include post-vasectomy pain syndrome, infection, and the very rare possibility of the tubes reconnecting.
If you’re considering a vasectomy, it’s important to be confident that you’re sure about permanent contraception and discuss it with a healthcare provider, especially if you’re considering reversal later, as reversal attempts may not be fully effective and can be costly.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Strasser J et al. Tubal Sterilization and Vasectomy Increased Among US Young Adults After the Dobbs Supreme Court Decision In 2022. Health Affairs. January 2025.
Chen T et al. Association of the 2012 American Urological Association Vasectomy Guidelines With National Trends in Vasectomy Followup in the United States. Urology Practice. March 1, 2021.
Christopher Wolter, MD, is an assistant professor in urology at Mayo Clinic in Phoenix, Arizona. He has been in practice since 2008, specializing in the areas of urinary incontinence, pelvic organ prolapse, urologic reconstruction, urologic prosthetics, post prostate cancer survivorship, erectile dysfunction, neurourology and neuromodulation, and overall functional considerations of urogenital health.
Dr. Wolter has been heavily involved in urologic education. He spent the last 12 years heavily involved in resident education and leadership for his department, including the last eight years as urology residency program director. He currently serves as the director of urologic education for the preclinical and clinical rotations for the Mayo Clinic Alix School of Medicine Phoenix, Arizona, campus.
Wolter completed his undergraduate and medical education at the University of Illinois. He then completed his urology residency at Tulane University in New Orleans, followed by a fellowship in female pelvic medicine and reconstructive urology at Vanderbilt University in Nashville, Tennessee.
Beth Levine is an award-winning health writer whose work has appeared in The Washington Post, The New York Times, O: The Oprah Magazine, Woman's Day, Good Housekeeping, Reader's Digest, AARP Bulletin, AARP The Magazine, Considerable.com, and NextTribe.com. She has also written custom content for the Yale New Haven Hospital and the March of Dimes.
Levine's work has won awards from the American Academy of Orthopaedic Surgeons, the Connecticut Press Club, and the Public Relations Society of America. She is the author of Playgroups: From 18 Months to Kindergarten a Complete Guide for Parents and Divorce: Young People Caught in the Middle. She is also a humor writer and in addition to her editorial work, she coaches high school students on their college application essays.
